Permit , -
CITY OF T ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97-0150
- a'1l1. 13125 SWHaII Blvd., Tigard, OR 97223 (503) G39-4/7Y DATE ISSUED: 03/13/97
PARCEL: 2S113DD-00400
SITE PIDDRESq...: 13701 SW PACIFIC HWY
SUDDIVISION ...: ZONING:
BLOCK..........: LOT.............:
Project Description: Reconnect only
- ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS....: 0 0 – 0 PUMP/IRRIGATION....: 0
EACH ADD'L 500SF. . . : 0 201 – 400 0, SIGN/OUT LINE LTG..: 0
LIMITED ENERGY. . . .. : 0 401 – 600 amp.. . . . . . : 0 SIGNAL/PANEL.......: 0
MANF. HM/ SVC/FDR..: 0 601+amps-1000 yoIts.x 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. : 0 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.....: 1 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Ownert, – --------- FEES_-- –
DRY CLEANING STATION , type amount by date recpt
13701 SW PACIFIC HWY PRMT $ 50.00 DRA 03/13/97 97-291698
' 5PCT $ DRA 97
TIGARD OR 97223 '
Phone #:
Contractor: -- – ---- ------ --
APPLICANT $ 52.50 TOTAL
. REQUIRED INSPECTIONS -------
Elect'l Service
Phone #: Elect'l Firtal
Reg #..:
This permit is issued subject to the regulations contained in the,,
Tigard nnicipel Coda State of Ore, Specialty Codes ad all other .i+tee Signature --'
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started / ~
within 18% days of il.suscE, or if mc'k is suspended for ure _~~— »r
then 182 days. T -`'� By
---------- ------- OWNER INSTALLATION ONLY--- ------------------
The installation bei.ng made on property, ..1 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 . for inspect ion 7, 639-4175
CITY OF TIGARD Electrical Permit Application Plan Chec
13125 SW HALL BLVD. Rec'd By •
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DS
Inspection (503) 639 -4175 Print or Type Permit # "ei
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: (� / 4. Complete Fee Schedule Below:
Name of Development T k 30..r d 1 V. k at 1 CIA' Number of Inspections per permit allowed
Name (or name of business) s /
g n D ( A C�„i S - I a t i m Service included: Items Cost Sum
1
I
Address \3 7 0k > i QCAt t �■ c J W y 4a. Residential - per unit
s � O O. loco additional it or less $110.00 4
City /State/Zip Z
Each additional 500 sq. ft. or
Commercial 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 Installation, alteration, or relocation
200 amps or less $60.00 2
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only __L $50.00
Elec. Cont. Lice. No. Exp.Date �O �D
OR State CCB Reg. No. 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 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No.
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 Owners Name feeder fee.
Address Each branch circuit $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
-. First branch circuit $35.00 2
The installation is being ma on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or ent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signatur 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. S. Fees: �,, CI
required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ ASO
NOTICE Subtotal $
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 # $ 'S Z,5 0
Total balance Due
I:\DSTS \ELC96.APP Rev 9/96
MAR -13 -97 THU 11 :05 AM POWERTRON, INC. FAX NO. 503 645 3764 P. 02/02
nrin 13 71 11 •
To whom it may concern:
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Re: Tigard Retail Center
• Authorization for electrical inspection
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• I hereby authorize the•tenants, Carlson: Stevens Management LLC, to request and arrange
for the electrical inspection by the City of :Tigard; which is.required prior to PG.E
• reconnecting the service at 1370i SW Pacific Hwy. Tigard OR
Sincerely, CL
•
• Powertron •
Authorized representative
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: &la4 /97 A. M. P.M. MST:
Location: yy�� /3701 3 7 ,,
u � J ' I � c /�� BUP:
Tenant: 79//77 On / /� rf 15510 A / Suite: Bldg: MEC:
Contractor: / 2 _/ Phone: / PLM:
Owner: M � r�i Qd Phone: - �J J J`~ 3 l /� off-- J LC: c1"7-0/S
: 77- o .;cD?
—_,SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ECTRICAL > SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service 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
Approved Approved Approved - .proved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved . �, 9 'roved Not Approved
FINAL FINAL FINAL FINAL FINAL
e c__J C 42 ( re c e-r)1 ft v- (--- 'Capp /*./) ri,
GREW! .4114 4 1 o
..p - c - S/c 77-522 co:k
0 Call for reinspection 0 Reinspection fee of required before next inspection 0 Unable to inspect
Inspector: 1/1/1, C Q ( p" Date: 6-- �.1 C 7 Page i of (
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