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Permit
CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00469 +1'14' DEVELOPMENT SERVICES DATE ISSUED: 8/14/00 I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0-01107 SITE ADDRESS: 09451 SW WASHINGTON SQUARE RD A -16 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Tenant Improvement 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: 1 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: 39 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: KEC ELECTRIC INC 2110 NW ALOCLEK DRIVE SUITE 614 HILLSBORO, OR 97124 Phone: Phone: 439 -0904 Reg #: LIC 000992 SUP 4489S ELE 34 -426c FEES Required Inspections Type By Date Amount Receipt Rough - in • PRMT RCP 8/14/00 $306.15 0004460 Elect'l Final 5PCT RCP 8/14/00 $24.49 0004460 Total $330.64 This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR. Speaalty 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 SIGNATUR ' ISSUED BY: '- 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 CITY OF TIGARD Plan Check # ; .13121 SW HALL BLVD. Electrical Permit Application Recd By TIGARD OR 97223 Date Rec' 1 -OO Date to P.E. Phone (503) 639 4171, x304 Date to DST , / Inspection (503) 639 -4175 Print of Type Permit # e - - 4 /41 Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development X14 Cc/A-0- Ste . Number of Inspections per permit allowed Urr&Lof name of business) 4Jrl7so 5' C•'10 Service included: Items Cost Sum d e SW (.,x4-...7 So ,41 j . vile< AI -(6 4a. Residential - per unit City/State /Zip �9.or' Q /- 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 26.75 1 Commercial Er Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data b / Installation, alteration, or relocation Electrical Contractor c�c7 c i . 200 amps or less $ 64.25 2 Address a //eNw A- cvcx.,( ,0t ifi.e /q 201 amps to 400 amps $ 85.50 2 CI /111 �- p Sta D r Zip 9' 7 (a '{ 401 amps to 600 amps $ 128.50 2 City p 601 amps to 1000 amps $ 192.50 2 Phone No. 43, 05 ©y Over 1000 amps or volts $ 363.75 2 Job No. no - /(6 f Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 3 L/ -'i, 6 C Exp.Date /DAticaZ 4c. Temporary Services or Feeders OR State CCB Reg. No. 994 4 7 Exp.Date 51.13/0 A Installation, alteration, or relocation COT Business Tax or Metro No. vi 3 Exp.Date Lf /1/a ( 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n ? _ 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, • see "b" above. License No. 4/gir 9 S Exp.Date (° / 4/ 4d. Branch Circuits Phone No. 4(74� coy New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit / $ 37.50 3 ( 7 5 Each additional branch circuit c) $ 5.35 A o e , 6 . The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy panel, alteration or extension $ 60.00 60, 3. Plan Review section (if required):* Mi � Minor Labels bels (10) $ 100.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Per inspection $ 50.00 Service and feeder 225 amps or more Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ ' ( 5 * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ a 4 1 • 4 /1 Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # 2 7 r / AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 3 O. b �l is \dsts\forms \electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP • Date Requested l 1 ,, AM PM BLD 6 < Location �j �J � �"� Gfl SJ /` Suite 4i MEC Contact Person Ph j 19 79 / PLM Contractor Ph SWR BUILDING Tenant/Owner ELC UV 4 /69 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 Alarm Susp'd Ceiling Roof C 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 ke D A SS PART FAIL ECTR ice Rough In UG /Slab Low Voltage Fire Alarm in at, APART FAIL SITE 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 inspection RE: Unable to inspect - no access ADA Approach /Sidewalk p Other D Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. "CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 , BUP Date Requested e'�-'7 AM PM BLD Location 0 F C/) / (dG 34 57 Lvi/ #rs /1R%., Suite I MEC Contact Person m Ph 51y 7? / 3 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 'v J -G l/ [/ 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 C iii ass PASS PART FAIL PLUMBING V • Post & Beam Under Slab • Top Out Water Service Sanitary Sewer Rain Drains • Final PASS PART FAIL MECHANICAL / Post & Beam Rough In Gas Line i .! - — / 6 Smoke Dampers D W — ? Con 1► rocior o Q )/7) i1 i sii 0 Cl / 2 e, ti? /p /` h Final PASS PART FAIL r e "ti S v I pi 7-li A s- o 4 v e � S CTRICAL �� Rough In L` /s1t UG /Slab Cw w Low Voltage F• a a SITE S PAS ART FAIL c fill /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 v Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION- MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP Date Requested Y- "1 AM PM BLD Location q1 /J1 sw "s4 51 Al Suite 1' /s MEC Contact Person Ph j/f 7f/3 PLM Contractor eL � Ph SWR BUILDING Tenant/Own , ELC ;Ovid 1 /6 f 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 Drywall 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 PASS PART FAIL ELECTRI ervice $C =6 ee 1171A ' Low Voltage Fire Alarm F'. 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 reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date 7 /V Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 7Gt Z 3,/P Date Requested - ?"Z2D AM X PM BLD Location o9 cis std 4/ a Suite MEC Contact Person 1101 Ph <79 78'/ 3 • PLM Contractor Ph SWR BUILDING Tenant/Owner Pi yC ELC Re's? ® -® 1/ Retaining Wall ELR Footing Foundation Access: r- t (vii I" / f n _ _ /_� FPS Ftg Drain '�I �f�i SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation • 11 / Drywall Nailing ,�� __ �` ° / 1 //,4_/t 4 �"`°.•�.�� 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 - PASS PART FAIL Servic- .1 G/S ab Low Voltage Fire Alarm Fin.• 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 reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Other V Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.