Permit ELECTRICAL PERMIT
CIIYOF . .
TIGARD PERMIT #: ELC96 -0357
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06 / 18/ 96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 s , D PARCEL: 2S 1 12DC - 001 GG
SITE ADDRESS...: 1461e SW 72ND AVE
SUBDIVISION : SP TIGARD INDUSTRIAL PARK ZONING:I -L
BLOCK LOT •2
Project Description: Installing two services or feeders to 200amps, one service
or
feeder to 600amps and, three branch circuits.
- -- 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 2 W /SERVICE OR FEEDER: 3 PER INSPECTION : 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR 0
401 - 600 amp • 1 EA ADD'L BRNCH CIRC: 0 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
NIKE - TETRA type amount by date recpt
ONE BOWERMAN DRIVE PRMT $ 255.00 CJS 06/07/96 96- 280349
PLCK $ 63.75 CJS 06/07/96 96- 280349
BEAVERTON OR SPCT $ 12.75 CJS 06/07/96 96- 280349
Phone #: 503- 671 -2017
Contractor:
CAPITOL ELECTRIC CO INC $ 331.50 TOTAL
12810 NE AIRPORT WAY #1
-• REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Elect'l Service
Phone #: 503 -255 -9488 Wall Cover Elect' 1 Final
Reg #..: 48748
•
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Signature
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 (r. -SG ,r►rc��
t 180 days. 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: Cr 1 Gif l i c.c #Inn DATE: 6 - -
• LICENSE NO: //
Call for inspection - 639 -4175
Jr
6 , Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # FIC96 -0357
,�,�f.li�"ar , 1. Date Issued 6 -13- 96
,� I P h one (503) 639 -4171
_14 FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175 Co / /.,,,/ C,T S 6 - 1)
raaAely
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Ar kj Number of Inspections per permit allowed
,5 i
Address / S S W 7 7 Ai / Service included: Items Cost(ea) Sum
City /State /Zip by /02,/ 0 /2 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
,-,/ portion thereof $25.00
-
Commercial I� Residential 111 Limited Energy $25.00 1 -
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor 40; 4 '/ / ,e C 200 amps or less Z $60.00 / 7, D 2
Address 1 as://7 rj f , ,.p.-; w /f- y 201 amps to 400 amps $ 80 . 00 2
,
401 amps to 600 amps $120.00 / 22,,,, Q
City_ State Zip 601 amps to 1000 amps $180.00 2
Phone No. 2._ -s - -1 y 8 El Over 1000 amps or volts $340.00 2
Job NO. T(. - 3 7 2 Reconnect only $50.00 2
contractor's license NO. Z46)-' ?6 G 4c. p orary Services or Feeders
Contractor's Board Reg. o Z Installation, alteration, or relocation
Signature of Sup!. Elec'n J.-y. rihtil � 200 Tem amps or less 2
201 amps to 400 amps $50.00 2
License No. 3/3Z-5 Phone No. 401 amps to 600 amps $ 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit -I $5.00 AT
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35.00
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting 540.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension 540.00
4 or more residential units in one structure Minor Labels (10) 5100.00
t /S rvice and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional Inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour 555.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: o ,
• 5a. Enter total of above fees $ 25
NOTICE 5% Surcharge (.05 X total fees) $ / L -7
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR W 5b. Enter 25% of line A for 6.3 .7S
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 3 3/ sT
COMMENCED. word \comdeeNeo- ❑ Trust Account #
prm.eDP
Balance Due 3 /
1 d ,
cc5 - 7- 46'
111
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation >
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I I p
Date: (.D 1 eO A.M. P.M. Ent :
Address: / .i
TenantT.D .GL ' I 57o .c" Ste: MST:
! BUP:
Con /Own: MEC:
PLM
ELC: /) .35
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
ZA-Gt �c�I - , / i
1
n Inspector/11i c , ( A3.14 �� Dater --0.1.7,,r �( APPROVED _ DISAPPROVED /CALL FOR REINSP. CO
-1)/Ya-