Permit 1
CITY OF TIGARD ELECTRICAL PERMIT
m DEVELOPMENT SERVICES PERMIT #: ELC97 -0759
A �I — / 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: i i / 17 / 97
PARCEL: 1S126C0 -01109
SITE ADDRESS...:O95O0 SW WASHINGTON SQUARE RD
SUBDIVISION - ZONING:C —G
BLOCK • LOT • JURISDICTION:
Proj ect Description : Installation of fifteen (15) branch circuits to commercial
site.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD' L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR - 0
401 — 600 amp - 0 EA ADD'L BRNCH CIRC: 14 IN PLANT : 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
JC PENNY type amount by date recpt
9500 SW WASHINGTON SQUARE PRMT $ 105.00 TJH 11/17/97 97- 301003
PORTLAND OR 97223 5PCT $ 5.25 TJH 11/17/97 97- 301003
Phone #:
Contract or:
OREGON ELECT CONSTRCTN /GRP INC $ 110.25 TOTAL
1010 SE 11TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'1 Service
Phone #: 234 -9900 Wall Cover Elect'1 Final
Reg #..: 026 -95
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188
days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987. / •
Permittee Signature: d ,,, . � u/ ''( ssued By: ∎_'1i. J
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 : an DATE: ////7/,97
L I CENSE NO : /3O2 - S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
,,.- A
1
Tigard, OR 97223 Permit # E Lt / r
3 I - 0 / 5
/M�,.I�I Date Issued Ij / -/0 7
.� ■ Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: � 4. Complete Fee Schedule Below:
Name of Development t ) C, T p . 4 Number of Inspections per permit allowed
Address 6- ► ,iu) � � .1 Service included: Items Cost(ea) Sum
City /State /Zip W , P / 0 2 / ita- 4a. Residential - per unit
U ' 1000 sq ft or less $110 00 4
Name (or name of business) J C
/ Each additional or less
sq ft or
/ portion thereof $25.00
Commercial I
�I , Residential r I Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
4b. Services or Feeders
0 r� # ; I alteration, or relocation 2
Electrical Contractor t /._ _%_4' 200 amps or less $6000
Addre 1123 ! . (017 201 amps to 400 amps � � P P $80.00 2
±,�
l I , State A ( Zip q / // [s 401 amps to 600 amps $120 00 2
City P 7 �_/ 601 amps to 1000 amps $180.00 2
Phone No. /_) t Over 1000 amps or volts $340.00 2
Job NO. qq9I. / Reconnect only $5000 2
contractor's license NO. d6, -95-C.. 4c. Temporary Services or Feeders
Contractor's Board Reg. No • Installation, alteration, or relocation 2
Signature of Supr. Elec'n •0� i %s �� :� 1 200 amps or less 2
2
License No. 7.5a4 - 4 Phone No. j „I { • - 201 amps to 400 amps $50 00
, iQ 401 amps to 600 amps $75 00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent.
First branch circuit I $35 oo
Each additional branch circuit /` f $5 00 44
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or imgation circle $40 00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
-
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00 -
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ /05 - : a
NOTICE 5% Surcharge (.05 X total fees) $ S..23
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. worftomde,,eieo- ❑ Trust Account #
P" app
Balance Due $ jia aj 6--
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RECEIVED
. N OU 17.1997
COMMUNITY DEVELOPMENT
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 AM PM BLD
//���
Location `.� U) l • Suite MEC
Contact Person Ph PLM
Contractor • Ph SWR
BUILDING Tenant/Owner ELC 9 : • e ( v
Retaining Wall ELC 1 - •
Footing Access:
Foundation FPS
Ftg Drain - SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam 64 . 9 7-
Ext Sheath /Shear •
Int Sheath /Shear �
Framing et--C. . IS- (5I 2,3
— -
Insulation
Drywall Nailing
Firewall nn /
Fire Sprinkler fT !I S' s /erns cope r / o (e)s7,
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 � r /� 2 Q
MECHANICAL &LC, G�. c 19) uoT4d 3 2s,,T be. p
Post & Beam l
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL •
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART 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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk p
Other Date 7 25 ` 7 Inspector 4 �.,,,be ` Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.