Permit A, - CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00369
r� DEVELOPMENT SERVICES DATE ISSUED: 6/21/99
' �! 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S1 12 D C -00100
SITE ADDRESS: 15705 SW 72ND AVE
SUBDIVISION: SOUTHERN PACIFIC TIGARD INDUST ZONING: I -L
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Add a first branch circuit to an existing commercial space.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
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: 1 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 onlv: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY PHOENIX ELECTRIC CO
15350 SW SEQUOIA PKWY #300 7379 SW TECH CENTER DR.
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT GEO 6/21/99 $37.50 99- 316294 Wall Cover
Elect'I Final
5PCT GEO 6/21/99 $1.88 99- 316294 •
Total $39.38 , ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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. �//
Permit Signature: Issued By j
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: C1 -
�J/ /0 5 d G% DATE:
LICENSE NO: �1
Call 639 -4175 by 7:OOpm for an inspection the next business day
JUN -21 -99 MON 07:49 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02
RECEIVED '
C ITY OF TIGARD El ectrical Permit Applicatio Plan Check #
13125 SW HALL BLVD. JUN 21 1999 Recd By
TIGARD OR 97223 COMMUNITY DEVELOPMENT • Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 g l Date to DST
Inspection (503) 639 -4175 Print or Type'
Fax (503) 684 -7297 •
Incomplete or illegible will not be accepted cane ���1 -�3(vp
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development \\ Number of Inspections per permit allowed
Name (or name of business?, L\./c . ' 1 , Service included' Items Cost Sum
r� '
Address 1.,S'1 (YS c� .(1 7 ,4 V,..s,, 4a. Residential - per unit
ip . \ . C.A. ach additional 500 sq. ft. or 1000 sq. ft. or less $110.00 4
City /State /Z - --
Commercial Residential El portion thereof $25,0 1
Limited Energy $25.00
� SI B >\ \'1N-e.v'�W '.11 0C) {. Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a, Contractor installation only:
(Attach copy • a I current licenses) • / 4b. Services or Feeders
l_C. n
Electrjcatracto ., -. Q • , , `1 Installation, alteration, or relocation
Address'T Il l 0 ., n L. ( k J 2ooamps or less $80.00 2
City ` `r r Fk. State ()l� Z 201 amps to 400 amps $80.00 2
_ P -a_ 3 . 401 amps to 600 amps $120.00
L _P_hone_Nal .l. .� 801 amps to 1000 amps $180.00 - 2
. Job No. 94-1( 0 1 Over 1000 arnps or volts $340.00 2
r Reconnect only $50.00 2
Elec. Cent Lice. No. �I - l Ul �- Exp.Date _ 2
OR State CCB Reg. No. 5p - Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 7f n4'J Ex .Date Installation, alteration, or relocation
200 amps or Tess $50.00
Signature of Supr. Elec'n t? _ 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
License No. G S' Exp.Date Over 600 amps to 1000 vows,
Phone No. C h 4 I - .kQC.X P see "b' above.
4d. Branch Circuits
N ew, 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 foe.
Address Each branch circuit $5.00 2
City State Zip b ) The fee for branch circuit U
Phone No. - without purchase of 31 • S
service or fodder fee.
First branch circuit 1 $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
Owner's Signature (Service or feeder not Included)
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
Minor Labels (1 O) or extension $1 2
00.00
Please check appropriate item and enter fee in section 5B.
M
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 votts 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
t
I. Submit 2 sets of plans with application where any of the above apply. 5. Fees: - c
Not required for temporary construction services. 5a. Enter total of above tees 3 7. $ ��a
5% Surcharge (.05 X total fees) • j • �1 $ -
NOTICE Subtotal $ ..
• PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 5b Plan Reviewjf r requi ir rel for
(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK S btotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Trust Account # S a \ �� � >rf
Total balance Due 31, $) P�/
•
I1DS7SICLC%,APP Rov 9/95
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
,q BUP
Date Requested �l�b ! AM PM BLD
Location I 5 OS "7 2.2't Suite MEC
Contact Person `JD Aikji Ph (Qgy'" yv PLM
Contractor d"Y Ph .S7z. 63 /P SWR q p _q
BUILDING > Owner ELC I / 9 s P f
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 BAAfif._
Drywall Nailing � �
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
PASS PART FAIL
LEC 1
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4111 41,' 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 Date Ins , P��.�
Other Ext
Final '
PASS PART . FAIL DO NOT REMOVE this inspection record from the job site.