Permit CITYOFTIGARD
Airlt�5� DEVELOPMENT SERVICES ELECTRICAL PERMIT 9-4171 PERMIT #: ELC96 -0656
DATE ISSUED: 10/16/96
PARCEL: 2S112DC -00100
SITE ADDRESS...: 15705 SW 72ND AVE
SUBDIVISION ° SP TIGARD INDUSTRIAL PARK ZONING:I —L
BLOCK LOT -2
Project Description: ADD 7 BRANCH CIRCUITS
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS ° 0 0 — 200 amp 0 PUMP /IRRIGATION 0
EACH ADD'L 5O0SF...: 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/0 SRVC OR FDR.: 1 PER HOUR 0
401 — 600 amp ° 0 EA ADD'L BRNCH CIRC: 6 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
TETRA PLASTICS type amount by date recpt
C/O NIKE PRMT $ 65.00 TAT 10/16/96 96- 285219
ONE BOWERMAN DRIVE SPCT $ 3.25 TAT 10/16/96 96- 285219
BEAVERTON OR
Phone #: 503- 671 -2017
Contractor:
CAPITOL ELECTRIC CO INC $ 68.25 TOTAL
12810 NE AIRPORT WAY #1
REG!UIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Underground Cove
Phone #: 503- 255 -9488 Wall Cover Elect'l Service
Reg #..: 48748
pp
Misprint is issued subject to the regulations contained in the , /} ‘14 X�'_gb
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm itt a gnat ure
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started •
� nn '
within 180 days of issuance, or if work is suspended for more i,4 1 d /
t 180 days. I ssu d By
OWNER INSTALLATION ONLY
The installation is being made on property I on 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 for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # .LC9(� -
,, ,r � gcl Ir ,� Date Issued /v
� .� AI Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development /pfif(x /jt/i J P/df - 5 tj Number of Inspections per permit allowed
Address /5 7D.5 7 2.-vs.' d Service included: Items Cost(ea) Sum
City /State /Zip 7, „0,7 c/ 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 Residential ❑ 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
Electrical Contractor, e!h�, Td ! //f jai ' e. I alteration, or relocation
200 amps or less $60.00 2
Address / Le/0 /...15" /,¢ 1 pA,c u- Ay 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00
City prfldA! c State D/L Zip �77 3d 601 amps to 1000 amps $180.00 2
Phone No. 2..s_57- V ' P Over 1000 amps or volts $340.00 2
Job NO. 9 4.-70 b Reconnect only $50.00 2
contractor's license NO. 7_6- 4C 4c. Temporary Services or Feeders
Contractor's Board Reg. No YAS"7 f Installation, alteration, or relocation
Signature of Supr. Elec'n -2�/f�ll Kcji - 200 amps or less 2
201 amps to 400 amps $50.00 2
License No. -2,1-7)2..-- 5 Phone No. Z�S =irt 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 $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. b b 2
First branch circuit $35.00 �6 2
not intended for sale, lease or rent. Each additional branch circuit _7 T $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 $40.00 2
Signal circuit(s) or a limited energy
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service 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 $33.00
Per hour $55.00
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: 6
5a. Enter total of above fees •j ��
NOTICE 5% Surcharge (.05 X total fees) $ P �y 3 , ' .S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ - 4,14 - 76
5b. Enter of line A for
Plan Review AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF vi
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR ew if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordkomdehelec. ❑ Trust Account #
$
prm.app
Balance Due $ ea x 2 /
/
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 Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: / /9 A.M. P.M. Ent
Address: /5 - 70,5 -- 7 ..�
Tenant: 7Z_?? J Ste: MST:
BUP:
Con /Own: • MEC:
PLM:
ELC: 1„
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
I
d3 r>:)e-__,---4
r /
Inspector: , .1 _ �„� _ � , �;` Date/47"
x APPROVED DISAPPROVED /CALL FOR REINSP. CO CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Busin ss Phone: 639 -4171
Footing Rain Drain Cover / rvice FINAL:
Foundation Water Line eiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: f � a ' l 1p A.M. P.M. try:
Address: d / ! /
Tenant: T Ste: MST:
• BUP:
Con /Own: MEC:
PLM:
ELC: �p
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: 4 Date:
A APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO