12559 SW MAIN STREET-1 IS NIdW MS 69926
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12559 SW MAIN ST
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98-0017
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 01/12/98
PARCEL: 2SIO2AC-00800
S J TE ADDRESS. . . : 12'559 SW MAIN ST
SUBDIVISION. . . . : ZONING:CBD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG
Project Description: Labor Ready
---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
MANE. 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 Br(NCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 — 1200 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
LABOR READY type amount by date recpt
12559 SW MAIN ST PRMT $ 35. 00 JSD 01/12/98 98-302433
TIGARD OR 97223 SPCT $ 1 . 75 JSD 01/12/98 98-302433
Phone #:
Contractor: ----- --------------------------------------------------------------
PAGEL_ ELECTRIC $ 36. 75 TOTAL
1927 21ST AVE
----- -- REOU I RED INSPECTIONS
-- ---
FOREST GROVE OR 97116 Ceiling Cover Elect' l Service
Phone #: 357-4013 Wall Cover Elect' l Final
Reg #. . : 000215
This perait is issued subject to the regulations :ontained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All cork will be done in accordance Mith a Quad plans. This perait will expire if work is not started within 181
days of issuance, or if work is suspended for sore than 181 days. ATTENTION: Oregon la4rpquiresyou the rules adopted ',)
the Oregon Utility Notification Center. Those rule"re s forth R %2-1t-1111 t . '1hw may obtain a copy
of these rules or direct,gpkions to y calli g 1 1 46-1
Permittee Si n ature I s sued By:
H
N -----------------------------OWNER INSTALLATION ONLY--------------------------- ----
The
----------------•-------- -----The installation is being made on property I own which is not intended for
-J sale, lease, or, rent.
m OWNER' S SIGNATURE: DATE:
J ---------------------------CONTRACTOR INSTALLATION ONLY-----------------------------
SIGNATURE OF SUPR. ELEC' N: DATE:
LICENSENO: ___.__------.-._..__...._................. _.-__.__�_
+++++++++++++++++++++++++++++++++++++++f+++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
++++++++++++++++++-++++•++++++++++++++++++++++++++++++++++++*++++++++++++++++++++
Coi.imunity Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. C LC-<,�,�rj�
Tigard, OR 97233 Permit #
' Phone (503) 639-4111 nate Issued
FAX (503) 684-7297
CITY OF TIOARD TDD No. '503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of DevelopmentNumber of Inspections per permit allowed
Address = --�� '�t Service included Items Cost(es) Sum
City/State/Zip___J,r.ty� 4a. Resldentlal -per unit
1000 sq 11 or less $110.00 4
Name (or naw— of business)!-.pt(;�+jFach additional 500 sq rl or
't ponion thereof $2500
Commercial Residential �� Limited Energy $25.00 1
Each Msnufd Home or Modular
Dwelling Service or Feeder $88.00 2
2a. Contractor installation only:
----� / 4b. Services or Feeders
Electrical Contractor ` Installation alteration,or relocation
- r, _ 200 amps or less 00.00 2
Address 1 201 amps to 400 amps $80.00 2
Cltv_4�,�,i State Zip ll 401 amps to 800 amps V_ $12000 2
Phone No. 3 r 0 I A a 601 amps to 1000 amps -- 0.00 2
Over 1000 amps or volt $34
s 3340.00 2
Job NO. 11 lie Reconnect only 35o on 2
contractor's license N - C--
Contractor's Board R 59 4c. Temporary Services or Feeders
Installation,$iteration,or relocation
Signature of Sunr. Elec'n 200 amps or less 2
License No. Phone No. 40 t 201 amps to 400 amps $50.00 2
'! �- 3 401 amps to 600 amps $7500 -
Over 600 amps to 1000 volts $100 n0 -
2b. For owner installations: see"b••above.
4d. Branch Circuits
Print Owner's Name. New,alteration or extension per pane
Address s)The fee for branch circuits with
-- - - — — purchase of service or feeder fee. 2
City _ State_ Zlp_ Each branch circult $5.00
Phone No b)The fee for branch circuits without -'
The installation is being made on property I own which is purchase of service orfeeder fee. 2
- !'
r101 Intended for sale, lease or rent First branch circuit $3500 2Each additional branch circuit $5.00
Owner's Signature4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or Irrigation circle $4000 2
Each sign or outline lighting __ $40.00
Signal clrcult(s)or a limited energy 2
Please check appropriate Item and enter fee in section 613. panel,alteration or extension $4000
d 4 or more residential units in nne structure Minor Labels(10) p� $10000
IRK Service and feeder 225 amps or more
NSystem over 600 volts nominal 4f. Each additional Inspection over
Classified area or structure containing special occupancy the allowable In any of the aboveinsp — --
as described in N E C Chapter 5 Per hour Per hour tion $35 00
$55.00
In Plant $5500
m Submit 2 sets of plans with application where any of the above ----
(? apply. Not required for temporary construction services. 5. Fees:
W NOTICE Be. Enter total of above fees $ 35 —
.J
5%Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTIOV 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) E
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
Subtotal
COMMENCED. ❑ Trust Account#
$
Balance Due $ .7
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: �— —Y A.M. __--- P.M. MST: _
Location: �� _ BUP: _
Tenant: G1XJ D"C ^_ Suite: Bldg: NEC:
Contractor: _ Phone: � PLM: p,
(honer: Phone: S / r 7T / ELC:�1! ' L
_ ELR: "
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site PosUBcam Post/Beam PosUBcam Cover Sewer/Storm
Footing Roof UndFYSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In U0 Sprinkler
Foundation Insulation Sewer [lmxVDuct Reconnect Vault
Bsrnt Damp Daywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UCLSIab `
Shear/Sheath Fire Spklr/Alm Crawl/Found Ih I lest Pump ow Volt ,q� G�C,
Approved Approved Approved --ft—ppm-Mi Approved
Appr/Sdwlk Not Approved Not Approved Not Approved vat Not Approved
FINAL FINAL FINAL FINAL FINAL.
CL _ --
1 -
J_
177 Call for reinspection 13 nspection fee of S required Wore next inspection C1 Unable to inspect
f _ fame: / `, Page of
Inspector: __�— ----
CITY OF TIGARD
ELECTRICAL PERMIT —
• COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)630-4171 PERMIT #: EL R96-0213
DATE ISSUED: 06/28/96
PARCEL: 2SIO2AC-00800
SITE ADDRESS. . . : 12559 SW MAIN ST
3U.:-VI V ISION. . . . : ZONING:CBD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
Project Description: Installing protective signaling.
A. RESIDENTIAL—---- R. COMMERCIAL------------------------
AUDIO & STEREO. . . : AUDIO & STEREO_ : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE C:OMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : : HVAC:. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. . : . .
TOTAL # OF SYSTEMS: 1
Owner: ------------------------------------------------------- FEES
LABOR READY type amount by date recpt
12559 SW MAIN ST PRMT $ 40. 00 CJS 06/28/96 96-281139
SPCT t 2. O0 CJS 06/28/96 96-281139
1I(3ARD OR 97223
Phone #:
Contract or s -----•---------------------__.-------------------•----------------------•-
ADT SECURITY ALARMS t 42. 00 TOTAL
70:3 NE. HANCOCK
------- REQUIRED INSPECTIONS -------
PO RTLAND OR 97212 Wall lover Elecet' 1 Final
Phone #: 503-284-3265 Elect' 1 Service
Re�, #. . : 59944
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Per•a, t e e Signature
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 xore r_
than 180 days. I s s'Aed By
INSTALLATION ONLY----------------------------------
The installation is being made on property I own which is not intended for
sale, lease, or rent.
IL OWNER' S SIGNATURE: � _ DATE:
t`
N _._..___.___________.___.____._.___CONTRACTOR INSTALLATION ONLY-----------------------------
.J SJ UNF1 PURE. OF SUPR. ELEC;' N: .� _ DATE:
m
W LICENSE NO:
Call for inspection — 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. 1c.9��-�� �
Tigard,OR 97223 PERMFc 1.F# L13 _
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED 6_ �(�s'-91r,-
TDC No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LLOjCAATIIOONN OF INSTALLATION 4. TYPE OF WORK
L��-_U) 0
Ad RESIDENTIAL—Restricted Enerrggyy Fee. . . . . . . . . 190.flp
(FOR ALL SYS7014S)
City 0 State Zip Check Type of Work Inn red:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ElAOdiciand Stereo Systems
15 NOT STARTED WITHIN 180 BAYS OF ISSUANCE OR IF WORK Is SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener"
ADT SKI)RITY SYSTEMS,INC. ❑ Heating,Ventilation and Air Conditioning System'
Contractor 703 NE HANCOCK Type ❑ Vacuum Systems*
- --VOMANU.-M97212
Address El(503)294.3265 —-- --
/ ----.—_—
nate _� —9 cj COMMERCIAL—Fee foi each system . . . . . . . . 1.4=
(SEE OAR 918-260-260)
Property Owner Chuh.Yypi:of Work Involved:
Contractor's Board Reg. No. `:_ ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone# __- ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
n��,, ,,[� ❑ Fire Alarm Installation
3 Y3"ylU/ ❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address — ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City Stale Zip ❑ Medical
This permit is issued antler OAR 918-320-370.This applicant agrees to make only
❑ Nurse Calls
restrirted energy installations(1 W volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
following.
1. Only use electrical licensed persons to do installations where requimrl.(Certain Protective Signaling
residential and other transactions are exempt from licensing.These have Other
d asterisks(').All others ne-d licensing).
2. Call for an inspection when all of the installations under this permit are ready
F^ for inspection at 503-639-4175. ❑ Number of Systems
` 3. Purchase separate permits for all installations that are not ready'or inspection
CC when the inspector is not to inspect under this permit. •No licenses are required. t irrnws are redulred f x all other installations.
J 4. Assume responsibility for assuring that all corrections regni;ed by the inspector
are done,and
(; 5. Assume responsibility for calling for a final inspection when all of the 5. FEES
W corrections are completed.
eJ
The person signing this ermit must he the applicant or a person a. Enter fees $ yy
authoriz to bin .Mu Natant.
b. 5% Surcharge(.05 x total above) $ p1• Q0
Signature TOTAL $ D
Authority if other than applicant
ENERGAP.CHP
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: A.M. P.M. MST:
Location: _ - ---_-- BUP:_
Tit: _ _ Suite: Bldg:: MEC:
Contractor:_--- JA Phone: _ PLM: —,
Owner:_— — Phone: ELC:
tAQ - Srr: _
BUILDING BLDG(coni) PLUMBING MECHANICAL. ,LECTRICA SITE _Site Post/Beam Post/Beam Post/Beam Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing 'I op Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Iiaxl lct Reoorme t Vault
Bsmt Dame Ihywall Stone Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C 2vt
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ileat Pump
Approved Approved Approved Approved Approved
App,/SdwIk Not Approved Not Approved Not Approved N ved Not Approved
FINAL FINAL FINAL FINAL
- T
L
0
U
0 Call for remspectio n Reinspection fee of Srequired before next inspection 0 Unable to irspect
Inspector: Date:_` _ _jr' _ Page of-