Permit A -• C I TY OF. T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00134
DEVELOPMENT SERVICES DATE ISSUED: 03/29/2000 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S1 13AA -00900
SITE ADDRESS: 16500 SW 72ND AVE B -07
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT : OOD JURISDICTION: TIG
Project Description: Installation of a 200 AMP service /feeder.
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: • SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 . .W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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 only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 -3417
Reg #: LIC 00051539
SUP 2053S
ELE 3 -243C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 03/29/200C $64.25 0001002 Elect'I Final
5PCT GEO 03/29/200C $5.14 0001002
Total $69.39
O RIGI NAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 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.
PERMITTEE'S SIGNATURE. ISSUED BY:
OWNER INSTALLATION ONL /
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: 1 d
LICENSE NO: RO6 3 -S
CaII 639 -4175 by 7:OOpm for an inspection the next business day
ail' OF TIGARD Electrical Permit Applica IVFD Plan Check #
13125 SW HALL BLVD. Rec'd By
MAR 2 4 2000 Date Rec'd
TIGARD OR 97223
COMMUNITY DEVELOPMENT Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # EGL° ddcieo 'CO/ 3y
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ^ Number of Inspections per permit allowed
Name (or jr,9a-f fusiness) CI II r 14 C `_ n DY►f?OI Service included: Items Cost Sum
Address 15gOO S v 1 &t 4a. Residential - per unit
Ci /State2i 1000 sq. ft. or less $110.00 4
ry p i ( i rr Q 1� " 11 ZZO Each additional 500 sq. ft. or
Commercial ❑ � Residential ❑ portion 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 (fit
Electrical Contractor 11 L . J k Installation, alteration, or relocation 1 5
Address i�y9 SE Y IcW Tev m c 200 amps or less 2
201 amps to 400 amps $80.00 2
City, ejn C ka..ivr5 State R Zip goo, f 4 01 amps to 600 amps $120.00 2
-
Phone No. tog - 3 41 1 601 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. 3 olt-k 3 G Exp.Date
OR State CCB Reg. No. 5153c1 Exp.Date CI 0 0 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 489 (o Exp.Date 5/00 Installation, alteration, or relocation
200 amps or less $50.00 2
$75.00
Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
dt05 /
i5 Exp.Date /Q0/
Over "b" amps Boe. 1000 volts,
License No p see "b" above.
Phone No. (2C1 - 3 (
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 $5.00 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: 6
1
Not required for temporary construction services. 5a. Enter total of above ees $ - ; �� .
Surcharge (.0X total fees) $ ' w
NOTICE ubtotal $ "_`
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 #
Total balance Due $
(o1.3f
I: \DSTS\ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
101112441 Date Requested / AM PM BLD
Location / b seo 'L � t/'L. Suite & ' '7 MEC
Contact Person elio.Q Ph 7 y / 3 '/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC .270,0d 3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab 7i VC � ' w �r !' -� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall / `' �
Fire Sprinkler � C� / ti / - 6 - s✓l Cl `'S up..4%e...
Fire Alarm w w -_ f'e_ Susp'd Ceiling <10.e.8 � ," � / f / �' /�
Roof ;liar � � K/ [�l1 l�
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
TRIC
ervi
ough In
UG /Slab
Low Voltage
Fire Alarm
Final
P ASS PAR
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call fqr reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date a Inspector
Other � l�t�iIt / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
gO/ /11 Date Requested ?� / / — De 2 AM PM BLD
Location M.-dd 7.2-- /11/ Suite 13 07 MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC ROOD -.00(5Y
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
Fire wall ke4a.„4,ze, 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
_TRIC312
ice /2.-677
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for einspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 7 /eJ Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Mss
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested � AM PM BLD
Location / (i5 0 0 5 w 7 Z Suite 7 MEC
Contact Person Cage Ph /5 3 V PLM •
Contractor Ph SWR
BUILDING Tenant/Owner JJ4 d 4 cad co)- / ELC ?AVV -&v /3 e(
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
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
LECTRIC
ervice
Rough In
UG /Slab
Low Voltage
• Alarm
SS ART FAIL
S
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA a /
Approach /Sidewalk
Other Date ! `b ®'P' Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.