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Permit CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97 -0564 - L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08 / 19 / 97 PARCEL: 2S101AA -09800 SITE ADDRESS...:12570 SW 69TH AVE #103 SUBDIVISION :MLP95 -0013 ZONING:MUE BLOCK • LOT •001 JURISDICTION: TIG Project Description : Paragon Business tenant improvement. - -- 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 MANF. 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 BRNCH CIRC: 2 IN PLANT : 0 601 — 1000 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 J T ROTH JR type amount by date recpt 12600 SW 72ND STE 200 PRMT $ 45.00 JSD 08/19/97 97- 298420 TIGARD OR 97223 5PCT $ 2.25 JSD 08/19/97 97- 298420 Phone #: Contractor: DON RIFE RIFE ELECTRICAL CONTRACTORS $ 47.25 TOTAL 1901 NE 134TH PL REQUIRED INSPECTIONS PORTLAND OR 97230 Ceiling Cover Elect'1 Service Phone #: 293 -8243 Wall Cover Elect'1 Final Reg #..: 000723 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow he rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95249110 through. OAR 95281 -1'-. . You may obtain a copy of these rules or direct questions to by calling (593)246 -7. Permittee Signature: aw Issued By: %la' 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 6:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY O1TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By 'i' - Date Rec'd I / v TIGARD OR 97223 Id Date to P.E. Phone (503) 639 -4171, x304 Date to DST Print or Type Inspection (503) 639 -4175 Permit # C 1-C9 4 5 y Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 0 1 1. Job Address: R R 4. Complete Fee Schedule Below: Name of Development / ' , LA- U t11 ` I. -0 t � N of Number of Inspections per permit allowed Name (or name of business) fA g 14 0 41 ( 7 Service included: Items Cost Sum S / Address /0 76 au tq / q G 16 1 3 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City /State/Zip 77 Each additional 500 sq. ft. or Commercial Residential El Limited 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 ,q, / E EL5C7 Installation, alteration, or relocation " u 200 amps or less $60.00 2 Address /fa/ �./ / ieL 201 amps to 400 amps $80.00 2 City /37 State 00e--- Zip 9 7:2.,_r4 401 amps to 600 amps - $120.00 2 Phone No. c 3- prs2 ? 601 amps to 1000 amps $180.00 2 Over 1000 amps or volts $340.00 2 Job No. Reconnect only $50.00 2 Elec. Cont. Lice. No. r7t ^7L77xp.Date D 7 OR State CCB Reg. No. D72 3y3 Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation r 200 amps or Tess $50.00 2 Signature of Supr. Elec'n �e'„- 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, - License No. Exp.Date / a�9� see "b" above. Phone No. 02 13 - 0.2. y� 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 Owner's Name feeder fee. i b. 6 O Each branch circuit , 2 $5.00 2 Address b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. 3 5- e o First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature 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: Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) NOTICE Subtotal $ 4.x 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 # (PI $ Total balance Due I: \DSTS \ELC96.APP Rev 9/96 . ‘... CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: I — l 6 A.M. P.M. A MST: Location: 1257 0 SIN £ q f , a(/ e. BUP: Tenant: L `1 .1. _1 `'„ .[I .: - Suite: /03 Bldg: MEC: • W V i Contractor: C _ A.! _ _ L C Phone: _ • _ : c�. PLM: Owner ILL/ Phone: ' 0 _____ l ELC: 9 ' 7-056) c/ 1 0 .I. IA.. I ' AA , � ' _' .L d .- .___,, � V ]-° ELR: 1 SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ' LECTRICAL ' SITE Site Post/Beam Post/Beam Post/Beam 'ove i. •'. Sewer /Storm Footing Roof UndFl/Slab Rough -In �Q;� jWo Water Line Slab Framing Top Out Gas Line ra o UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service R_ C. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Approved Appr /Sdwlk Not Approved Not Approved Not Approved roved Not Approved FINAL FINAL FINAL FINAL FINAL -.5-7-e' r j l' ( ( p i , C .4 C4=9 v -< -e G7cr ■ r 1 n T l . �� �..1-e C(7... ,,,, IFAMPIIMMIIMAAIWAIIIMpr ,M - :Amur, 0 Call for reinspection_ / 0 Reinspection fief $ required before next inspection O Unable to inspect Inspector: M/ 1 [� L c:%" ` )? C1 � —2 ( . Date: 7 Page( of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: O eo 77 A.M. P.M. MST: Location: /©Z ■ 70 „Cu) .� 9 ,(Pe / BUP: 1 Tenant: W B Suite: e3 Bldg: MEC: Contractor: / " _ 2 — _/ i_ _ /.1 . Phone: .:2-9 3 -- g a- 3 PLM: ry /� Owner: / Phone: ELC: 7 / - 056 4 /�J •lt ELR: SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL TRICAL SITE Site Post/Beam Post/Beam Post/Beam ov ervice Sewer /Storm Footing Roof UndFl/Slab Rough -In et ing 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 Low Volt_ Approved Approved Approved po roved ) Approved Appr /Sdwlk Not Approved Not Approved Not Approved of A ro Not Approved FINAL FINAL FINAL FINAL FINAL � .00 ' 6, 'C O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect Inspector: 171t!( 1 4 .@,( 4t4 Date: - Th-/ 7 7 Page 7 ) of