Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00403
1Ij DEVELOPMENT o (503) 639 -4171
SERVICES DATE ISSUED: 7/20/00
SW Hall Blvd.,
PARCEL: 1S126BC-01500
SITE ADDRESS: 09000 SW WASHINGTON SQUARE RD
SUBDIVISION: HRtjBRSSY CENTER ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of 2 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PORTLAND HOTEL ASSOCIATES STONER ELECTRIC
BYRETS 2701 SE 14TH
100 SPEAR ST STE 1440 PORTLAND, OR 97202
SAN FRANCISCO, CA 94105
Phone: Phone: 233 -3631
Reg #: LIC 00044823
SUP 4025S
ELE 26 -122C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Final
PRMT DLH 7/20/00 $42.85 0003858
5PCT DLH 7/20/00 $3.43 0003858
Total $46.28
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE /y,9--/LE� ISSUED BY: ,(:(02/7
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
iaou CITY OF TIGARD
CITY OF TIGARD 002
d'13125 SW HALL BLVD. Electrical Permit Application Rec Check #________________
TIGARD OR 97223 Recd By
� � JUL 1 Date Recd
Phone (503) 639-4171, x304 200 } Date to P.E.
Inspection (503) 639 -4175 CO M M� NI T I' Date to DST
Fax (503) 598 -1960 Print of Type QEVf(UH,,,� Permit # L LL'
Incomplete or illegible will not be accepted Called -----------7)
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development
Name (or name of business) EB�ssy 3-.., , .r�S Number of Inspections per permit allowed
Address ° 1e o o Sw Service included: Items Cost Sum
l.�) A3rf r i 4 ro il . J. 4a. Residential - per unit
City /State/Zi R
1 ,G AT OR- '3722_3 1000 sq. fl. or less
Each additional 500 sq, ft, or $ 117.75 4
Commercial ® Residential ❑ portion (hereof $ 26 25
Limited Energy 1
Each Manufd Home or Modular $ 60.00
2a. Contractor installation only:
Dwelling Service or Feeder $ 72.75
(Prior to permit issuance, applicants must provide contractor license 2
information for COT data base). 4b. Services or Feeders
Electrical Contractor S rhN G Installation, alteration, or relocation
Address 19 p 200 amps or less $ 64.25
5 � I'-O�� 201 amps to 400 amps 2
City J/Y1,�..,pv K, F State Ink Zip 9 72 2 2 401 amps to 600 amps $ 85.50 2 r•
Phone No. __211 4( 02 - [ o$i7a 601 amps to 1000 amps $ 128.50 - _ 2
Job No. 3e 20p s Over 1000 amps or volts $ 192.50 2
Reconnect only $ 363.75 2
Elec. Cont. Lice. No. 2.4.-1 Zz $ 53.50 2
¢� 823 Exp.Date / ( 1 >,1 4c. rem
Exp.Date o3 (2o p / post Services to or Feeders
COT Business Tax or Metro No. 14/ Exp pate b r o / Installation, 2amp o less
alteration, or relocation ;
OR State CCB Reg. No.
,/�� ® A 200 amps $ 53.50 1
P / t A __ _,/ 201 amps to 400 amps $ 80.25 2
Signature of Su r. Elec'n �, \ 401i amps to 600 amps 2
Over 600 amps to 1000 volts,
/'see' b "above. $ 107.00 2 .
License No 349G. s Exp.Date / e 1 /e,
Phone No. z --(,„5 0
4d. Branch Circuits
New. alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits
with purchase of service or !
Print Owner's Name feeder fee.
Address Eacir branch circuit S 5.35 '
b) The fee for branch circuits 2
City
State Zip I without purchase of service 7!
Phone NO . or feeder fee.
First branch circuit / $ 37.50 f7 SD ,
made on property Each additional branch circuit / $ 5.35 Ste'
The installation is being P perty I own which is not
intended for sale, lease or rent. (Service Miscellaneous
o or e _
•
(Sr feeder a edeer r e not inducted)
Owners Signature Each pump or irrigation circle $ 42.75
Each sign or outline lighting
' / Signal cirwlt(s) or a limited energy '- $ 42.75
3. Plan Review section (if required): panel, alteration or extension
Minor Labels (10) $ 07.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional Inspection over $ 107.00
4 or more residential units in one structure
Service and feeder 225 amps or more the allowable in any of the above
Per inspection
System over 600 volts nominal Per hour $ 50.00
In Plant $ 50.00
Classified area or structure containing special occupancy as $ 59.00
described in N.E.C. Chapter 5
5. Fees:
Submit 2 sets of plans with application where any of the above apply. 6a. Enter total of above fees Ya, 'S
Not required for temporary construction services, pp y t Surcharge (.06X total fees) d $
Subtotal ,3 y3 $ 3. SD
$ g
■
NOTICE 56. Enter 25% of line 5a for
S
'ERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Plan Review d required (Sec. 3) y4, $ t9
Sutota
3 NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR bl $ --W--
VORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS
T ANY TIME AFTER WORK IS COMMENCED. 0 Trust Account #
Total balance Due Cei< $ 47 3,-
dsts \forms\e lectric.doc
0401 /6e 59 /, D 7
'CITY OF TIGARD BUILDING INSPECTION DIVISION MST
' 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Z- AM PM BLD
Location ?COO W 4511 S- Ad • Suite _ MEC
Contact Person ,�1� Ph 57) C 2 -s Z - J
' ) PLM
Contractor < 5/04t oyvfl l mil( i\ 5 kei r r Ph SWR
BUILDING Tenant/Owner ELC .Z'iai -f vo 03
Retaining Wall . ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer •
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
ASS PART FAIL
ELEC
Service
Rough In
UG /Slab
Low Voltage
F' - larm / n
i ce ; _ (30114i, 47GVn. --
O P PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for r inspection RE: Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Z7 ott2 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.