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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00765 1114( DEVELOPMENT SERVICES DATE ISSUED: 12/30/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AA -TTOOA SITE ADDRESS: 12123 SW 69TH AVE SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE BLOCK: LOT : OOA JURISDICTION: TIG Project Description: 200 amp temporary service or feeder RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 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: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: TIGARD CORPORATE CENTER LP CAPITOL ELECTRIC CO INC 15400 SW MILLIKAN 12810 NE AIRPORT WAY BEAVERTON, OR 97006 UNIT 1 PORTLAND, OR 97230 Phone: Phone: 255 -9488 Reg #: LIC 048748 SUP 3132S ELE 26 -496C FEES Required Inspections Type By Date Amount Receipt Elect'1 Service PRMT BON 12/30/199c $53.50 99- 320776 Elect'I Final 5PCT BON 12/30/199c. $4.28 99- 320776 n R 1 ` . A Total $57,78 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 or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE ISSUED BY: 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: '1k DATE: LICENSE NO: Call 639 -4175 by 7:OOpm for an inspection the next business day • CITY OF TIGARD Plan Check# _ 13125 SW HALL BLVD. ELECTRICAL PERMIT APPLICATION Rec'd By TIGARD, OR 97223 Date Recd Phone (503) 639 -4171, X304 Date to P.E. Inspection (503) 6394175 Date to DST Fax (503) 684 -7297 PRINT OR TYPE Permit # INCOMPLETE OR ILLEGIBLE WILL NOT BE ACCEPTED Called 1. Job Address: 4. COMPLETE FEE SCHEDULE BELOW: Name of Development TIGARD CORP. CENTER Number of Inspection per permit allowed Service Included: Items Cost Sum Name (or name of business) 4a. Residential - per unit 1000 sq.ft.orless $117.75 4 Address 12123 SW 69TH AVE. Each Additional 500 sq. ft. or portion thereof $26.25 1 City /State /Zip TIGARD, OR. 97223 Limited Energy $60.00 Commercial X Residential Each Manufd Home or Modular Dwelling Service or Feeder $72.75 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Service or Feeders Electrical Contractor CAPITOL ELECTRIC CO., INC. Installation, alterations or relocation Address 12810 NE AIRPORT WAY 200 amps or less $64.25 2 City PORTLAND State OR Zip 97230 -1029 201 amps to 400 amps $85.50 2 Phone No. (503) 255 -9488 401 amps to 600 amps $128.50 2 Job No. 99 -555 601 amps to 1000 amps $192.50 2 Elec. Contr. Lic. No. 26 -496C Exp. Date 10/1199 Over 1000 amps or volts $363.75 2 OR State CCB Reg. No. 48748 Exp. Date 8 -22 -99 Reconnect only $53.50 2 COT Business Tax or Metro No. 00004542 Exp. Dat /1/99 4c. Temporary Services or Feeders Signature of Supr. Elec'n �/4 Installations, alterations or relocation 200 amps or less 1 $53.50 $53.50 2 License No. 2865 -S Exp. Date 10/1/01 201 amps to 400 amps $80.25 2 Phone No. (503) 255 -9488 401 amps to 600 amps $107.00 2 Over 600 amps to 1000 volts see "b" above. 2b. For owner installations: 4d. Branch Circuits Print Owner's Name New, alteration or extension per panel Address a) The fee for branch circuits with City State Zip purchase of service or feeder fee Phone No. Each branch circuit $5.35 2 b) The fee for branch circuits without The installation is being made on property I own which is not purchase of service or feeder fee. intended for sale, lease or rent. First branch circuit $37.50 2 Each add'nl branch circuit $5.35 2 Owner's Signature 4e. Miscellaneous (Service or Feeder Not Included) Each pump or irrigation circle $42.75 2 3. Plan Review section (if required): * Each sign or outline lighting $42.75 2 Signal circuit(s) or a limited energy Please check appropriate item and enter fee in section 5B. panel, alteration or extension $60.00 2 4 or more residential units in one structure Minor Labels (10) $100.00 Service & feeder 225 amps or more System over 600 volts nominal 4f. Each additional Inspection over Classified area or structure containing special the allowable in any of the above occupancy as described in N.E.C. Chapter 5. Per inspection $50.00 Per hour $50.00 • Submit 2 sets of plans with application where any of the above apply. In Plant $59.00 Not required for temporary construction services. 5. Fees: PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 5a. Enter total of above fees $ $53.50 NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK 8% Surcharge (.08 X total fees) $ $4.28 IS SUSPENDED OR ABONDONED FOR A PERIOD OF 180 DAYS AT ANY Subtotal $ $57.78 TIME AFTER WORK IS COMMENCED. 5b. Enter 25% of line 5a. for Plan Review if required (Sec. 3) $ Subtotal $ $57.78 Trust Account # Total balance Due $ $57.78 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 1 T AM PM BLD Location / 2-I 2 3 1,q-nA Suite MEC Contact Person 3VVA/1k.)N- Ph Otil SA—L0382, PLM Contractor (4.()) ) l Ph SWR � BUILDING Tenant/Owner ELC i L / j 'co os Retaining Wall ELR r 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 Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL Y / 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 ZEE R 8<frvice Rough In UG /Slab Low Voltage Fire Alarm C, PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before ne. inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: , ' [ Unable to inspect - no access Fire Supply Line A AF DA Approach /Sidewalk D [' Other D 3 0 0 Inspector �!� i' I . _/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.