Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00472
AA DEVELOPMENT SERVICES DATE ISSUED: 8/14/00
- JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 15AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY D
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of 15 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: 14 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:
BIT HOLDINGS LTD PARTNERSHIP COCHRAN ELECTRIC
BY FORUM PROPERTIES INC BROADWAY ELECTRIC
FIVE CENTERPOINTE DR STE 290 626 SE MAIN
LAKE OSWEGO, OR 97035 PORTLAND, OR 97214
Phone: Phone: 234 -6564
Reg #: LIC 77942
• SUP 3184S
ELE 37 -546C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT DLH 8/14/00 $112.40 0004465 Wall Cover
5PCT DLH 8/14/00 $8.99 0004465 Elect'I Final
Total $121.39
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 requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules ordirect questions to OUNC at (503)
246 -1987.
ON ,9 - / 3 z- /e , 5 2- 770 - 71/4)
PERMITTEE'S SIGNATURE /1,9-/ L ISSUED BY: 4152fi
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:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By /h� /
TIGARD OR 97223 RECEIV7" Date Rec'd e 7/0/e7)
Date to P.E.
Phone (503) 639 -4171, x304
Inspection (503) 639 -4175 Print o f Type AUG 10 2000 Date Permit DST
Permit # E - 410 - 41097.2. �'ao00 �y7.
Fax (503) 598 -1960 Incomplete or illegible wi Called
1. Job Address: 4. Complete Fee Schedule Below: -
Name of Development Number of Inspections per permit allowed
Name (or name of business) /Q/ 0 44/4 'S7Z IV n Service included: Items Cost Sum 4 '
Address 4104* `` . /! NAL _ A It 4a. Residential - per unit
City/State /Zip 7'a •e ne. 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 2615 1
Commercial 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 e). Installation, alteration, or relocation
Electrical Contractor 200 amps or less $ 64.25 2
Address & VA. /VIM 201 amps to 400 amps $ 85.50 2
A 401 amps to 600 amps $ 128.50 2
City St to Zip 601 amps to 1000 amps $ 192.50 2
Phone No. .�S G.7 -4, 4- Over 1000 amps or volts $ 363.75 2
Job No. / 700 - 7 7oOto • Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 37.5(!. Exp.Date I O I / D� 4c. Temporary Services or Feeders
OR State CCB Reg. No. 7294?.. Exp.Date ti 101 Of Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.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 $ 107.00 2
Over 600 amps to 1000 volts,
License No. vim) 8 4- S Exp.DateJaJa/ Al see "b" above.
Phone No. (Sea 234 •,o 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owners Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee. -
Phone No. First branch circuit $ 37.50 � 1,
Each additional branch circuit , $ 5.35 a
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owners 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
( Minor Labels (10) $ 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 inspection $ 50.00
Per hour $ 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: La/ 40
5a. Enter total of above fees
* Submit 2 sets of plans with application where any of the above apply. .6°!o Surcharge (. �total fees) $ $ Not required for temporary construction services. Subtotal Ir $ /
NOTICE 5b. Enter 25% of line 5a for
Plan Review if required (Sec. 3) $ tit may(
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ /21. 37
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
i:\dsts\forms\electric.doc
GITY.OF TIGARD BUILDING INSPECTION DIVISION •' &
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 Z AM PM BLD
,
Location / 6 2- UO 5 w Pa c ( 4 k Suite i7 MEC
Contact Per op / Pj,,23 Av,,SG c/ PLM
Contractor , O R / S ( . e - "cc _ Ph 2 fa - G i 7 Z-- SWR
BUILDING Tenant/Owner ELC alzie -0 V? Z
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 N
Fire Sprinkler " C
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
(61
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 •
f LEQTRI _
Service
Rough In
UG /Slab
Low Voltage
Fire alarm
410 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 Date 9/i Z.- , Ins Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
8/22/00 Activities for Case #: ELC2000 -00472
4:29:40 PM
Assigned Hold Updated
Activity Description Date 1. Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 8/10/00 MAIL RECD No Hold DLH 8/14/00
ELCC003 Permit created 8/14/00 DLH DONE No Hold DLH 8/14/00 •
ELCC700 Ceiling Cover
No Hold DLH 8/14/00
ELCC720 Wall Cover No Hold DLH 8/14/00
ELCC799 Elect'I Final No Hold DLH 8/14/00
ELCC500 (F)Issue permit 8/14/00 DLH DONE No Hold DLH 8/14/00 •
ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold ZZZ 8/22/00
Page 1 of 1