Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
•r ,I°I�I'� PERMIT #: ELC97 -029
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/03/97
PARCEL: 2S113AD -01900
SITE ADDRESS.. °:16600 SW 72ND AVE #B -10
SUBDIVISION :ROSEWOOD ACRE TRACTS ZONING:I —L
BLOCK • LOT •9 JURISDICTION: TIG
Project Description : INSTL 1 SERVICE /FEEDER & 3 BR N H CIRCUITS // JOB # 72171
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD'L 5008F. ° °: 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 • 1 W /SERVICE OR FEEDER: 3 PER INSPECTION 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 0 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
PACTRUST type amount by date recpt
15350 SW SEQUOIA PKWY PRMT $ 75.00 TAT 06/03/97 97- 295383
STE 300 5PCT $ 3.75 TAT 06/03/97 97- 295383
TIGARD OR 97224
Phone #:
Contractor:
OREGON ELECTRIC CONSTRCTN INC $ 78.75 TOTAL
1010 SE 11TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Underground Cove
Phone #: 234 -9900 Wall Cover Elect'l Service
Reg #..: 000000
Q
This permit is issued subject to the regulations contained in the j'( ,(Lk
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm' e S i g n at u
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 1 :v days of issuance, or if work is suspended for more
than 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 n f 7
SIGNATURE OF SUPR ° ELEC' N : , /.� DATE: `�'/3
Ci �%
LICENSE NO: c. kyj , 5
Call for inspection — 639 -4175
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Community Development ELECTRICAL PERMIT APPLICATION
r`
13125 SW HaII Blvd.
Tigard, OR 97223 Planck/Rec. #
c, r. ; Permit # a�
4 ■�'� I , i, Phone (503) 639 -4171 Date Issued ' G7 "1
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: JOB NO. 72171 4. Complete Fee Schedule Below:
Name of Development Flight Dynamics Number of Inspections per permit allowed
Address 16600 SW 72nd, Bldg. 10 Service included: Items Cost(ea) Sum
City /State/Zip Tigard, OR 97281 4a Residential - per unit 4
1000 sq. ft. or lees 1110.00
Name (or name of business) Flight Dynamics Each additional 500eq.ft.or
portion thereof 125.00 1
Commercial ® Residential ❑ Limited orgy 125:00
Each Manuf'd Home or Modular 2
Dweling Service or Feeder 168.00
2a. Contractor installation only: 4b. services or Feeders
O REGON ELECTRIC GROUP
Installation. iteration. or relocation 2
Electrical Contractor 200 amps or less 1 160.00 60.00 2
Address 1010 SE 11TH 201 amps to 400 amps 180.00 2
City Port land State OR Zip 97214 401 amps to 600 amps 1120.00 2
601 amps to 1000 amps 1180.00 2
Phone No. 234 -9900 Over 1000 amps or volts 1340.00 2
Contractor's License No. 26 -95C Reconnect only 150.00
Contractors Board Reg. No. 203
4a Temporary Services or Feeders
Installation, alteration. or relocation 2
Signature of Supr. Elec'n 200 amps or lees 150A0 2
License No. 2841S hone No. 234 00 201 amps to 400 amps 175.00 2
401 amps to 600 amps 1100.00
Over 600 amps to 1000 volts
2b. For owner Installations: sea le above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension For panel
Address a) The fee for branch circuits ttlth
City State Zip of service or feeder Ise. 3 2
Phone No. b) 15. 15.00
The fee for branch circuits "Whets
The installation is being made on property I own which is purchase or ears** ov feeder Am 2
not intended for sale, lease or rent. Fret branch circuit 135.00 2
Each additional branch circuit 15.00
Owners Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (If required): Each pump or irrigation circle 140.00 2
Each sign or outline lighting 140.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter tee in section 5B. panel, alteration or extension 140.00
4 or more residential units in one structure Minor Labels (10) 1100.00
Service and feeder 225 amps or more
System over 600 wits nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as desc.ibed in N.E.C. Chapter 5 Per inspection 135.00
Per hour 155.00
In Plant 155.00
Submit 2 sets of plans with application where any of the above
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apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a Enter total of above fees $ 75.00
5% Surcharge (.05 X total tees) $ 3.75
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal S 7H_ 7 5
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
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 $
COMMENCED. ❑ Trust Account r $
Balance Due $ 78.75
RECEIVED
JUN 0 3 1997
COMMUNITY DEVELOPMENT
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: tg //4$ 1 ` I A.M. P.M. MST:
Location: 1 to (e 0 C 'not BUP:
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Tenant: Suite: ' L /3 —' 1dg: MEC:
/ �T !�
Contractor ` ' l•�! . �n . P hone: 0 0 Q -1 ,3 U PLM:
Owner: Phone: ELC: 9 O . - 3 oZ-
--0-OvU7--- �
jlY c5".J1.C.D ? ELR:
• SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam • Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Lg
Approved Approved Approved pproved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL
LIPAFB.MiEW —
.311/ �� - - A
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(.. _ _ .... . " : 2 .... , , /0 )
0 Call for reinspection 0 Reinspecti fee of $ required before next inspection 0 Unable t inspect
Inspector . r' 4,7, p ( I' L{ Date: j /6 - Page of