Permit A C ITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00246
DEVELOPMENT SERVICES DATE ISSUED: 5/11/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 DA -00105
SITE ADDRESS: 13009 SW 68TH PKWY A � 6)41
SUBDIVISION: HOMESTEAD VILLAGE , ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of 6 branch circuits, Job No 8108.
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: SIGNALIPANEL:
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 WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 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:
HOMESTEAD VILLAGE INC PHOENIX ELECTRIC CO
ATTN: PROPERTY TAX DEPT 7379 SW TECH CENTER DR.
7777 MARKET CENTER AVE TIGARD, OR 97223
EL PASO, TX 79912 •
Phone: Phone: 684 -3600 At—
Reg #: LIC 00052288 oRIG\I'l
SUP 4140S
ELE 34 -247C ,
FEES Required Inspections
Type By Date Amount Receipt . Elect'I Service
PRMT DEB 5/11/00 $64.25 0002104 Elect'I Final
5PCT DEB 5/11/00 $5.14 0002104
Total $69.39
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 co - • - - rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE l/ ISS ED BY: ,
OW R INSTALLATION ONL
The installation is being made on property I own w ch is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUP . ELEC'N: 4 al DATE:
LICENSE NO: ' 4/ 3
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF TIGARD Plan Ch
Electrical Permit Application
13125 SW HALL BLVD. Recd .
TIGARD OR 97223 Date Recd 6
Date to P.E. ....---
Phone (503) 639 -4171, x304 Date to DST '�
Inspection (503) 639 -4175 Print of Type Permit # GLC - t90agie
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: �I)l 4. Complete Fee Schedule Below:
Name of Development I�W+1 G.5 �eq Vt 7/ _.)c._ Number of Inspections per permit allowed
Name (or name of business) J /� Service included: Items Cost Sum 4 '
)
Address Cam°( ,SrJ , 4 S ill N• -ke 19 4a. Residential - per unit
City /State /Zip Ty rcl 0 IZ / 1000 sq. ft. or less $ 117.75 4
/ Each additional 500 sq. ft. or
portion thereof $ 26/5 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 perrnit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor PAner,t yx Ekj,.i. 200 amps or Tess $ 64.25 2
Address ?Ric Sc..) Te ti. CcAir- Q 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City ii rd State OAS Zip 5 7a .23 601 amps to 1000 amps $ 192.50 2
Phone tdo. 68 y- ,.?i, DO Over 1000 amps or volts $ 363.75 2
Job No. 9/0 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. .3f - ? y9G Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. 3 g Exp.Date 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 i ---0).-- _ Over t
amps to amps $ 1 07.00 2
(/ Over 600 amps to 1000 volts,
see "b" above.
License No. *IUD S Exp.Date Branch Circuits
4d. Phone No. New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch c $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 3 2- S D
Each additional branch circuit 5 $ 5.35 ifp , 7,j
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
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
if required):* panL e levation or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 343F 799.
4 f. Each additional inspection over
/AO .40
Please check appropriate item and enter fee in section 5B. Pe
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: ,/ 1
5a. Enter total of above fees $ 6 /, IS
* Submit 2 sets of plans with application where any of the above apply. ,5 Surcharge (86-x total fees) $ ,S,19
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 �y $ OR
WORKS SUSPENDED OR ABANDONED FOR A PERIOD OF 1 80 DAYS ® Trust Account # S-3) a) Cp ' !J /4
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 6 l .3 q
is \d sts \forms \e l ectri c. doc
CITY OF TIGARD BUILDING INSPECTIO % v • ' 04-6"/L--- IA- " r 1c,G.[� e
M S
24 -Hour Inspection Line: 639 -4175 Busine s Line: 639 -4171
BUP
Date Requested o 0/ � /n 0 AM P BLD
Location C OO ! st CO b eat) A Suite • MEC
Contact Perso 7 {! 1 - PLM
Contractor �,rv' i u t./P�.. - ' h Z-09- 63 SWR
BUILDING Tenant/Owner 014 S 4 - ' ELC
Retaining Wall EL. ) 002
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: •
Slab 6 - CuL. - SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling c
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
ECTRICAI3
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
t__ 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 II for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date • i Inspector _ _ _ ., _ Ext
Other —
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Lino, 6 39 -4171 MST
Date Requested S � ?2/00 AM . PM BUP
Location 306/ 9 P&p 4 Suite — A 4 i D
,
Contact Person al Ph 7.01 (OS PLM
Contractor Oil e4v04 Ph SWR
BUILDING Tenant/Owner ELC ' X 002 -fb
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: eat, pAOK— SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation / - --
Drywall Nailing _ /. ia..
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_ PART FAIL
�LECTRICi E
Service
ouq iD
UG /Slab
Low Voltage
Fire Alarm
F'
P 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
Other c / Z 6 Inspector Ext
( �' , oT FAIL DO NOT REMOVE this inspection record from the job site.