Permit CITY ° I GAR ) ELECTRICAL PERMIT
4
PERMIT #: ELC2000 -00438
.6 - DEVELOPMENT SERVICES D ATE ISSUED: 7/31/00
` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09785 SW WASHINGTON SQUARE RD D -12
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of 3 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: 2 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:
PPR WASHINGTON SQUARE LLC SPARK ELECTRICAL CONSTRUCTION
P.O.BOX 21545 4508 NE 123RD
SEATTLE, WA 98111 VANCOUVER, WA 98682
Phone: Phone: 701 -7822
Reg #: LIC 143886
SUP 4394S
ELE 26 -997C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT DEB 7/31/00 $48.20 0004123 Elect'l Final
5PCT DEB 7/31/00 $3.86 0004123
Total $52.06
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 uires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 - 0010 through 0 • - 952 - 00 14 80. You may obtain copie • es • - s or direct questions to OUNC at (503)
246 - 1987.
PERMITTEE'S SIGNATURE ` / ISSUE BY' ' — o 0
W - INSTALLATION ONLY
The installation is being made • n 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: VS 9 7 3
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Plan Ch ck #
Electrical Permit Application Recd B 11r
13125 SW HALL BLVD.
TIGARD 97223 Date Recd - /.B
Date to P E
Phone (503) 639 -4171, x304 Date to DST - �/t
Inspection (503) 639 -4175 Print of Type Permit# L� 0 J
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: ��,,// 4. Complete Fee Schedule Below:
Name of Development 2 d 1 / � % #( Number of Inspections per permit allowed
iL
Name (or name of business) Service included: Items Cost Sum 4 '
Address 9 ''s w�4 ;n 4a. Residential - per unit
City/State /Zip / ..' 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 se). Installation, alteration, or relocation
Electrical C ntracttor k Lam / o ea..) , A. "' 200 amps or less $ 64.25 2
Address 4 'f ', , 4/ 12 S'&' 2..--e 201 amps to 400 amps $ 85 50 2
City �/ � e, e,b m- State a ',4 Zip 9 pd' Z 401 amps to 600 amps $ 128.50 2
ty �Pi't p 601 amps to 1000 amps $ 192.50 2
Phone No. (r. .7) 5. ./- 7d2 2 Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2 6 - ,647 Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. ,VS 8f 6 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. , ( '.Date 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. 43 Exp.Date
Phone No. AV 722 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
I feeder fee.
Print Owners Name Each branch circuit $ 5.35 2
Address I b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit / $ 37.50 37 - S
Each additional branch circuit _ Q $ 5.35 /p , -7?") The installation is being made on property I own which is not 4e. Miscellaneous v � -
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
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
1 . Minor Labels (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
Service and feeder 225 amps or more Per Per hour h our on $ 50.00
$ 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: q "g
5a. Enter total of above fees $ / 0
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 3 - $ SD
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 # CO
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 5
i:\dsts\forms\electric.doc
-.CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / AM PM BLD
Location 9 S' . S .3 1 4✓ AJ441 5,` R & 'Qc/(Suite / / Z MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC o2 'ki' - Cre/ 1 43 Y
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 GU ( /U�"'�L. En
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 FAIL
ECT
Nice
Rough In t",
UG /Slab
Low Voltage
Fire Alarm
F'
PASS 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 � / - ep 7 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 AM PM BLD
w
Location C f 7 g') � Wa54 Suite /2-- MEC
Contact Person Ph 70/ 7k Z L PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 2 ui —v0 Q air
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 • _ _ /Ari
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
�E TRIC
ice
Rough In
UG /Slab
Low Voltage
Fire Alarm
ORO 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 ns P D Inspector Ext
Final
PASS PART FAIL O OT REMOVE this inspection record from the job site.