Permit .,
CITY OF TIGARD ELECTRICAL PERMIT
_
4 A DEVELOPMENT SERVICES PERMIT #: ELC99 -0115
� �' DATE ISSUED: 02/24/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-0171
PARCEL: 19135BA -00102
SITE ADDRESS...:1O164 SW WASHINGTON SQUARE RD #84 -1
SUBDIVISION •OAKBURG ZONING:C —G
BLOCK LOT -001 JURISDICTION: TIG
Project Description: Electrical TI
- -- 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 7 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
LONG DRUGS type amount by date recpt
10164 SW WASHINGTON SO RD PRMT $ 70.00 B 02/24/99 99- 313207
TIGARD OR 97223 5PCT $ 3.50 B 02/24/99 99- 313207
Phone #:
Contractor:
SME INC OF SEATTLE $ 73.50 TOTAL
927 RAINIER AVE SOUTH
REQUIRED INSPECTIONS
SEATTLE WA 98144 Ceiling Cover Elect'l Service
Phone #: 206 - 329 -2040 Wall Cover Elect'1 Final
Reg #..: 122009
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 - 001-8010 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: Issued By: • 0.----
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 : 01i1A 1 l
1Or DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY►oF TIGARD
Electrical Permit Application Plan Check #
'13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd - 2-
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST �►
Inspection (503) 639 -4175 Print or Type Permit # Gi.. �1 i q r 5
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: j / 4. Complete Fee Schedule Below:
W
Name of Development O-+h, n 5 4 ■ 3 ^ . 1 JG,P Number of inspections per permit allowed
Name (or name of business) LO/ s Service included: Items Cost Sum
Address / d IAV s, w, W9i11 , iixae_ -14' 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City/State /Zip 1 : n R. , q 72 a 3 Each additional 500 sq. ft. or
Commercial El Li Residential portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) ( 4b. Services or Feeders
Electrical Contractor - SAE E Inc_ D- Sec // /Q. Installation, alteration, or relocation
200 amps or less $60.00 2
Address 9k7 1�, 4•e r Ai... so. 201 amps to 400 amps $80.00 2
City Sec / State £4../4. Zip 9s i t" y 401 amps to 600 amps $120.00 2
Phone No. (a6i 3,2,9- "Intl 0 601 amps to 1000 amps $180.00 2
Job No. 746S t) / Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 7- 7SSC Exp.Date
OR State CCB Reg. No. l a.a.o09 Exp.Date • 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
- 200 amps or less $50.00 2
201 amps to 400 amps $75.00
Signature of Supr. Elec'n S �,L� �� ,� `' 401 amps to 600 amps $100.00 2
/ / Over 600 amps to 1000 volts,
License No. 3.9y/S / Exp.Date f D I d / see "b" above.
Phone No. '2t A - 3 ... y--.a.Oy0
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. 3 1
First branch circuit ( $35.00 J 2
The installation is being made on property I own which is not Each additional branch circuit 7 $5.00 3 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $ 100 . 00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 7
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ ?. 3 So
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 7 3 So
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�h o BUP
Date Requested g / b / q AM ( PM BLD
Location i 01 1L(skV Suite MEC
Contact Person -rnm Ph 2e49';96 — 3)0.2 PLM
Contractor Ph SWR (]
BUILDING en Owner .04 S • (j - ELC Qq'01 jS
Retaining Wall} 4 4
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: , SGN
Slab - - L SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall 1 V / � 461? /
Fire Sprinkler Per iwt (� O. E�+ C Q- Q O 9 L —
Fire Alarm �-
Susp'd Ceiling �— i C — 9 g. Q / J ��
Roof
Misc:
Final
PASS PART FAIL , /
PLUMBING � S 60 i ,er111/1.5
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer —�
Rain Drains � �S e .. _ _ . ,I - 4 _
Final
PASS PART FAIL I rase
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
gaiZERIDALI
Service
Rough In
UG /Slab
Low Voltage
Fire A
40
PASS 'ART 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 ` y' Ins
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.