Permit •
CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000-00614
DEVELOPMENT Tigard, O
SERVICES (503) 639-4171
DATE ISSUED: 11/8/00
SW Hall Blvd.,
PARCEL: 1S126C0-01403
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Service and three (5) branch circuits. Job No. 33273.
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: 1 W /SERVICE OR FEEDER: 5 'PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
MAY DEPT STORES COMPANY, THE OREGON ELECTRIC CONST /GROUP
ATTN: PROPERTY TAX DEPT 1010 SE 11TH AVE
611 OLIVE STREET PORTLAND, OR 97214
ST LOUIS, MO 63101
Phone: Phone: 234 -9900
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 10/31/00 $100.25 2720000000( Wall Cover
5PCT CTR 10/31/00 $8.02 2720000000( Elect'l Service
5PCT CTR 11/8/00 $1.06 2720000000( Elect'I Final
(additional fees not listed here)
Total $122.63
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 ISSUED B �.
.IJ
OWNER INSTALLATION ONLY V _
The installation is being made on property I own which is not intended for sale, lease, • t.
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
OCT -25 -2000 11 04 P.01/01
_ L " L L L' J LLU1J. »G»
- ' Electrical Permit Application
� ` - Datcroceivcd: /0/25/-6 Permit no. * z vv /
4 1V :A i l City of Tigard Project/appl. no.: Expire data:
Ciry ofTFgard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.;
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type;
kfl Land use approval:
N
■ TYPE OF PER1
0.
0 1 & 2 family dwelling or accessory 3 F.D Commercial/industrial 0 Multi- family 0 Tenant improvement
Oo 0 New construction )1 Addition/alteration /replacement 0 Other. 0 Partial
JOB SITE INIORM ATION
.4 Job address: '''' , , IzJ/S . i ,, rJ is , Bldg. no.: Suite no.: Tax map /tax lot/account no.: -
Z Lot: Block: Subdivision: .
(� Project nam: ' _ - e . Description and location of work on premises:
Estimated date of completion/inspection: •
Q .
t Job no: 3 32 73 Fee Max
Business name: Description Qty. (ea.) Total no. map
Address; 1 01? 1 1 t
r an E lectric Croup
New resraat�a l- si�e told-family per h Ave _ , dwewngunitlndud[satbehedgarag
City: Portland S �eOR ZIP97214 Service included
a Phone: - ' - a • Pax: ' - s t mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft or portion thereof
CCB no.: 03 Elec. b s. lie. no: 26-95C Limited energy, residential 2
4 l1 City/m .II . no.: A , =1II Limited energy, non-residential 2
OPNIIIP g. 4� 1 0 / 2 5J 00 0 Each manufactured home or modular dwelling
Signature o supervising electrician (required) Dale Servieeand/orfaeder - ._ 2
S up, clad name (print): License no: Services or feeders- installation,,
,q alteration or relocation:
PROPERTY OWNER 200 amps or less 1 , irov 2
Name (print): Mier & Frank 201 amps to400amps 2
401 amps to 600 amps
Mailing address9300 Washington SQ. Rd. 6 01atnpsto1000amps 2
City: Tigard 'State: OR I ZIP: 97233 Over 1000 amps or volts 2
Phone: [Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property 1 own Temporary maces or (ceders - —
installadon, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less _ 2
ORS 447, 455, 479, 670. 701 201 amps to 400 amps 2
Owners signature: Date: _ 401 to 600 amps 2
•
Branch circuits- new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 3 lg 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2 —
Phone: Fax E Each additional branch circu -
PLAN REVIEW (''lease check all that apply) Mc. (Service or feeder not included):
O Service over 225 amps-commercial O Health - care facility Each pump or irrigation circle 2
0 Service over 320 amps-rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal eircuit(s) or a limited enemy parcel.
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories 0 Feeders. 400 amps or more •N scr i p p on:
0 Occupant load over 99 persons 0 Manufactured suuctvrrs or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighungplan 0 Other: Per inspection I I I 1
Submit ^ sets of places with any of the above. Investigation fee
The above are nor applicable to temporary construction service. Other
'Not all jurisdictions accept credit cards, please call jurisdicuon for more information, Notice: This permit application
Permi fee $ 10C . 2 5
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $
Credit card numea: / / within 180 days after it has been State surcharge (8%) .... $ E . 02
' accepted as complete. TOTAL $ n F, - 2 7
Name of Cardholder as shown on credit card
$
can:molder signature Amount , — r/ R 440-4515 (6A0/COM)
�� 1 r /eiti f TOTAL P.01
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
i - , BU,P
to Requested // ( AM PM BLD -
Location 'J . Lv' G/9) k SG/ b' Suite MEC
Contact Perso '/ ) l "S �VM / crJG,,� ,2 Ph 5J 4f 9- 2j /Y PLM
Contractor r-C Si_ c-c- E Ph SWR
BUILDING Tenant/Owner (•" 4 ti/ ii" ELC 2livd -kJ G Ize
Retaining Wall V ELR
Footing Access: L 1 FPS
Foundation in-L- �, i
Ftg Drain Ij I (' / SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear / , 6,1- /�( ✓ lee-16f • i,Jq.- rekvs -e
Int Sheath /Shear
Framing
Insulation
Drywall Nailing _�� �_ O D4, ,
Firewall
Fire Sprinkler . �� S / /mac � - - -
Fire Alarm
Susp'd Ceiling . ( �) L /A r " *.4- ` <__,
Roof
Misc:
Final
PASS PART FAIL
PLUMBING /47:7 A49"
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
PASS PART FAIL •
CTRIC
Rough In
UG /Slab' o�✓'-
Low Voltage
Fire Alarm
PAS' PART FAIL
S
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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date //- /3 - 0-D Inspector / _�_ _ Ext
Final
r\ PASS PART FAIL DO NOT REMOVE this inspection record from the job site.