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Permit CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97 -0797 AI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 4171 DATE ISSUED: i / 05 / 97 PARCEL: 1S126C0 -01109 SITE ADDRESS...:09500 SW WASHINGTON SQUARE RD SUBDIVISION ZONING:C —G BLOCK • LOT JURISDICTION: Project Description : Installation of one (11 branch circuit to commercial site. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp 0 PUMP /IRRIGATION ° 0 EACH ADD'L 500SF...: 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: 0 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 J. C. PENNEY type amount by date recpt 9500 SW WASHINGTON SQUARE RD PRMT $ 35.00 TJH 12/04/97 97- 301450 TIGARD OR 97223 SPCT $ 1.75 TJH 12/04/97 97- 301450 Phone #: Contract or: OREGON ELECT CONSTRCTN /GRP INC $ 36.75 TOTAL 1010 SE 11TH REQUIRED INSPECTIONS PORTLAND OR 97214 Ceiling Cover Elect'1 Service Phone #: 234 -9900 Wall Cover Elect'1 Final Reg #..: 0026 -9 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 180 days of issuance, or if work is suspended for more than 180 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: fi Issued By: ,L,(,�/J.///4",_ 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 : /2/5107 LICENSE NO: /340? ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + ++ is Community Development ELECTRICAL PERMIT APPLICATION .- 13125 SW Hall Blvd. 1n� Tigard, OR 97223 Permit # F 1I I�l..9 q - ®risi ,, Date Issued la.'�4 I g 7 �.� �� Phone (503) 639 -4171 FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: /f cee4( 4. Complete Fee Schedule Below: Name of Development J (� - Number of Inspections per permit allowed Address q5 fv 0.)(ude. � / �j Service included: Items Cost(ea) Sum �7 / Y P Cit /State /Zi o4 / / 3 4a. Residential - per unit / 1000 sq ft or less $110 00 4 Name (or name of business) ,-C• �-( V ,5 Each additional 500 sq ft. or portion thereof $25 00 Commercial L� . Residential El Limited Energy $25 00 1 r� Each Manufd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Le., r , ,_ ' Installation, alteration, or relocation Electrical Contractor' i �lr . /�1� 200 amps or less $60 00 2 Address /G i • J • I I -__[ �eiMil 201 amps to 400 amps $80.00 2 City rt . t -te d / Zip 6 /7 , 3 401 amps to 600 amps $12000 2 `1 7 p 601 amps to 1000 amps $180 00 2 Phone No. 7 . --d 3 Over 1000 amps or volts $340.00 2 Job NO. 998 g Reconnect only $50 00 2 contractor's license NO. ct(o _7 SC 4c. Temporary Services or Feeders Contractor's Board Reg. No ._ _I 3 , Installation, alteration, or relocation Signature of Supr. Elec'n _�F /y . , ,?• 200 amps or less 2 License No. /��oz - Phone No.No.!, 'i� 73 201 amps to 400 amps $50 00 401 amps to 600 amps $75.00 2 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 $ 5 not intended for sale, lease or rent. First branch circuit / $35 --- 00 1 9J , (/a Each additional branch circuit $5 00 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: - , ' 1 �( 5a. Enter total of above fees its r NOTICE 5% Surcharge (05 X total fees) $ /, 73 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. word\comdeveleo- ❑ Trust Account # $ prm app Balance Due $ 3( 73 I. . ) . , • RECEIVED • DED 091997 ' COC �P,7UNITY DEVELOPMENT -• I F e o 1 nt -ASS CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 3 P 3 J9J> A.M. P.M X MST: Location: C BUP: Tenant: cT50 0 W �' �� Suite: Bldg: - MEC: . Contractor: P oFi ne: 6 qk— 0 7 3 PLM: Owner: Phone: _ \ ELC: ! - 7 — 07? 7 ��� j-4.-e) (1 b}_amLJ C1 2 ci_449 ELR: ..--/Y1..0 f-- -01-- STT: BUILDING BLDG (con't) ING MECHANICAL ----4112SUMW SITE Site Post/Beam Post/Beam Post/Beam . • r Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved A • • Approved Appr /Sdwlk Not Approved Not Approved Not Approved ■ of : •rov Not Approved FINAL FINAL FINAL FINAL 1.4-0-a - rad rikeiJ fek114:ufS Cil ibreoLi 4B O • • 1 �t1 JP ki . y ) \Y ���� _ N. 1 ,i( \ � el i . UL O Call for reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect Inspector: Date: - Page of CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD //�� Location ` 1.��V l 9 • Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 9 i • e ( v Retaining Wall ELF 9 • 1 Footing Access: • Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam 6(C 97� 07 S Ext Sheath /Shear Int Sheath /Shear �` � Framing �-��-C_. I S Z Insulation Drywall Nailing Firewall DD Fire Sprinkler fT I � .c s It e ms Cj eQ 1^ J C , Fire Alarm Susp'd Ceiling Roof O Thji Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Q MECHANICAL &IL q mid, /� 3- 2�-- T & rD Post & Beam c�v 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 9 Other Date - `- ° Inspector 4 ��it0A_ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.