Permit CITY OF TIGARD - -.� T T .�. � Y
PERMIT I:!-C9c3- f73;_0
,� ` 1� ,�� DEVELOPMENT SER�I DATE ISSUED: 08/19/98 39-4171
rt(-? RCE'- . 25101. AD-`Zap 600
SITE -.•. : ,r -,5 SY ;7 ,9TH t AVE
E C
EN 1 • r _, 1 - -hi ,, • ..� . P7RTI ' :ND f ;ITT r-.1_IT -7 O' '7 .1(_'. - IaAI E
ENE ... ... _ 'l -._ - . � -.. ..d -.l 1 -_ 7H TS ... f
<J'. �. ! .. 1_t a l'ix.�1-
^LOCI:.: G .... - .. 4 . LOT.... ... — R SD I 0 ON (13
Pro j 2 c De scri. pt i on: Add electrical to a coy ;ercial building,
•RES I DENT I ('L UNIT - - - -- --TEMP SRVC/FEEDERS-• - - --- _ iv; r r- -
1000 SF OR LESS. ^ .. 0 1 -- 2021 amp....... 0 PUMP /IRRIGATION..... 0
EACH ADD' L 50009F, ... 0 0 i •- 4210 3 SION /OU LINE '_T6C . 0
LIMITED ENERGY.....: 0 401. - 800 amp....... 0 0 SIGNAL_ /PANE'._.......: 0
MANE. :-IM/ SVC / "DR„ . o 0 O01 amps- 1.l?i0Qi volts.. 0 !Y..T.NCR LABEL (10)... . :0
- - - -- SERVICE /FEEDER - - - - -- - - -- BRANCH CIRCUITS----- - -- -ADD' L INSPECTIONS--
I C ^. tI r F r-. P T NSPECTI r•
0 .. 200 an'p... „ a _ 0 i:i!�JC"'' ��_ OR �_.G =D��, 41 s ->_i�? _ ..�1- .� +_.1 �,�t G .. r: 0
2 01 - 400 amp....... 1 1st !'v /O SRVC OR FDR. . 0 PER HOUR.......... , . .
40011 - 6O0 amp......: 0 EP. rn-1DD' L E1RNCI1 C I RC n 0
itREVIEW I : r:l... `.h: l ., a ^ .
01 -- 1 000 amp.....: ., . . : 0 -_.- _..- .- .__.--------- •--- PL.r-�N SECTION----------------
1000 amp /volt.... r . 0 )=4 RES L!NITS......... ) 620 VOLT ?`'(J 1INI L.. ,
Reconnect only.....: 0 SVC/FDR >= 225 AMPS... CLASS AREA /SPEE. O'CC. .
JOHN MCCROSREY ty7e amourt
1_ (b ry^(} date recpt /�
14125 SW FARMINGTON PRMT '235= 00 GEO 05/12/96 96 -305 J:_1L_
BEAVERTON OR 97005 5PCT $ 14.25 GEO 05/12/98 98-- 305682
Phone uF
Contractors
RIFE ._1 t �ra CONTRACTORS
= 1_� ;(�' ?�1�" L. -,!_ 229.25 TOTAL
1901 NE 134TH P'_.
------- REQUIRED INSPECTIONS --- ----' --
PORTLAND OR 97230 Csi.?'.l_ Cover Elect' 1 Service.
,'hone C:o 972- -8243 Wal?. Cover Elect' I Final.
Re 7 72343
This permit is issued sub ject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codas and all other
applicable laws. All work will be done in accordance 1ii.`,h approved plans, This permit c. l expire if work is at started within 180
days of issuance, or if work is suspended for more than in days, ^TTEr4'TICi.: 3r•eg ;r. lar; requires you to fo'.ow the rules adopted by
the Crego Utility Notification Center. MG5E mules a-e set fc th ir, CAR 32- 21 - °i1C through ;- E- 2Z1 -'S87. You E obtain e copy
of these ::secr:i::t:T Fz O'' C s +_tee! !. 4011 41;
-- - - - -- - OWNER INST2LLATION ONLY
The installation is being mace on pr•'cpert'•; I or which is not intended 'Thr
sale, ?.easa, or rent.
OWNER'S SIGNATURE - DATE
-CO 1 TRr=.. - i OR r' STAL! -. i-1T TON f.1NI2I
GI5NPTUR' 97 SUPR. DATE:
LICENSE N O e __�.� --- •-- - - - --- - - -�_.. v______ _.— _ ___ _. —__ �_ ___ —
, hd- .- . '-z . -F•-. . -.- -{- . 1-- i -t• . •k-'r--- ••i -: -. . -. . -.- -1••-- - 'r•'r•. f- :- -l- •i -•I•- -F •t--: -i- , f- ;--:- h .
Call ,,39_•4175 by 7°,00 p. fll. for ::n the
r - { - . - - ... ..}..' - f••. - . . . --; - F { ° - - i-•'r-.- •'r•� --r-. •f -�--: -I-•- F- -f--F- r1• •i--4-- i- -h-f'-- ?•-i- -i- -i--h-� -: - i•- i--'-- i- -'r••t- -t- -'-- t-:--i••- �-r_..I •'ri-- : - -'r.� ..r✓..._
R
CITY OF TIGARD Electrical Permit Application Plan Check # fr J - 5 -7
13125 SW HALL BLVD. Rec'd By 6:1 r3
TIGARD OR 97223 Date Recd ---.- - 98 -
Date to P.E. rt - C - r
Phone (503) 639 -4171, x304 Date to DST CD -1 ---t1 Inspection (503) 639 -4175 Print or Type Permit # EGA 3.Z
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 0(v / qg • -444.-
1. Job Address:. 4. Complete Fee Schedule Be/ow:
t_c �,� `' � "( i 1
Name of Development Number of Inspections per permit allowed
Name (or name of business) /lC C/V 0..S t' eV Service included: Items Cost Sum
Address /2 6 .,?.- S w 6 / /9 i/E 4a. Residential - per unit
City /State /Zip or less $110.00 4
`� -ach a ad ddit tional 500 sq. ft. or
/ portion thereof $25.00 1
Commercial Res(� i dent i /a - 9 � a3 Each al ❑ 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 cur nt licenses) 4b. Services or Feeders
Electrical Contractor CG EC 7 Installation, alteration, or relocation
�+ 200 amps or less $60.00 2
Address / / O / ia4 / 3y ,e(--r- 201 amps to 400 amps X $80.00 PD' "" 2
City /��?'Gi7 State Zip 9 'a2 _To 401 amps to 600 amps $120.00 2
Phone No. 77.2 - P y3 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts - $340.00 2
Reconnect only - $50.00 2
Elec. Cont. Lice. No. .-,.1 (0 6X:Exp.Date /e) / i /
OR State CCB Reg. Noe! 702 y7 Exp.Date fP /i /5.j' 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
V.e._ 200 amps or less $50.00 2
201 amps to 400 amps Signature of Supr. Elec'n 9 R 401 amps to 600 amps $100 00 2
p / //� rj Over 600 amps to 1000 volts,
License No ?7./V S Exp.Date .Date C see °b° above.
Phone Nc 7 - 2)4/.7 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. ----
//')�
Address Each branch circuit y/ $5.00 ,gV 2
b) The fee for branch circuits
City, State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $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. 5. Fees: ...-------
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ vt
NOTICE Subtotal $
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 # $ � a �
Total balance Due •
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
4 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
MST
15 47 Date Requested I --- / 0 AM K PM BLD
_/�, n
Location 12-625 (5C) 6g17 / ao-e_ Suite ) MEC
k Orit--- Contact Person / / Ph ,aR3 - O p / a `J'3 PLM
/ - 1
Contractor `: • _ _ _ _ Ph SWR
BUILDING Tenant/Owner 11 _ ii f /_, _ 14,E__
401091
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 r . �, • ., / - 40 - dr/L....
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
P FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Al •
F. illt
''''"E
IV 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA .
Approach /Sidewalk j� Other D // i / � /9f Inspector____ v �� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.