Permit CITY O T I G R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00224
eAil DEV WL PMENa Tigard, ) 639 -4171 DATE ISSUED: 05/01/2001
PARCEL: 2S 112AC -00800
SITE ADDRESS: 14645 SW 74TH AVE
SUBDIVISION: AT &T BROADBAND CABLE ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of service /feeders with (4) branch circuits. Job #7954
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/ SVCI FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 4 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:
BHK PROPERTIES LLC MCCOY ELECTRIC CO
14280 SW 72ND AVE 2014 SE 9TH AVE
TIGARD, OR 97224 PO BOX 42428
PORTLAND, OR 97214
Phone: Phone: 234 -7521
Reg #: LIC 00008277
SUP 2175S
ELE 26 -82C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
5PCT CTR 05/01/2001 $8.55 2720010000( Elect'I Service
Elect'I Final
PRMT CTR 05/01/2001 $106.90 2720010000(
Total $115.45
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 -6699 or 1 -800- 332 -2344.
Permit Signature: 07-1 f g IN Issued By: . _ AIL //
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: Crn £� /� DATE:
LICENSE NO:
—
Call 639 -4175 by 7:OOpm for an inspection the next business day
r Electrical Permit Application
Datereceived:4 i 1 Permit no.- - _ f• AU
/MO. . l i t� `" '
., •�� City of Tigard Project/appl. no.. Expire date:
CityofTigard Address: 13125 SW Hall Blvd, Tiga fi
l Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
W1Ni 0. 2001
: TYPE OF PERMIT
O 1 & 2 family dwelling or accessory ,Commercial /industrial • 0 Multi - family ❑ Tenant improvement
New construction ❑ Addition/alteration/replacement - ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: tfiriptic Sk 7 a Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: kw Fjk)A ,t6A4 Description and location of work on premises: 71 LfZ i %? b ,i..
Estimated date of completion/inspection: r
.. CONTRACTOR APPLICATION -' , SCHEDULE FSCHEDULE E
Job no: ,q, Fee I Max
Business name: MC CO Et Tn4C Description Qty. (ea.) Total no. insp
New residential - single or multi - family per
Address: ep 1 SE eilb vL, dwellingunit .Includesattachedgarage. •
}
City: ,yz,,'.1 t ,L State ZIP.c fl `4 Service included:
Phone:556'3 - 231 -7y 4 I Fax: 2.74...947/ I E -mail: 1000 sq. ft. or less 4
CCB no.: B2- I Elec. bus. lic. no: Zen - a Zc_ Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City etr0 lic. no.: 3 2..' Limited energy, non - residential 2
__ t f Z A/0 / Each manufactured home or modular dwelling
Sign ure of supervising electri ian (required) Dat Service and/or feeder 2
Services or feeders — installation,
Sup. elect. name (print): J re_ .. 1 License no: 2 ( 1$ " S alteration or relocation:
PROPERTY OWNER 200 amps or less '
Pn:5D BD:5D 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: 1 ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name' A. Fee for branch circuits with purchase of
Address: service ur feeder fee, each branch circuit I " iQ,L6 24,10 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
• PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑. Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ /0(0, 90
❑ Visa ❑ MasterCard expires if a permit is not obtained' Plan review (at %) $ �
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ F. cs
Expires accepted as complete. TOTAL $ // . T5
Name of cardholder as shown on credit card
Cardholder signature Amount 440-4615 (6 /lx) /COM)
Electrical Permit Fees: Limited Energy Fees:
Corn lete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4
Check Type of Work Involved:
Residential - per unit • •
1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40. 1
Limited Energy $75.00 I I Burglar Alarm
Each Manufd Home or Modular .
Dwelling Service or Feeder $90.90 2 Garage Door Opener
•
Services or Feeders n Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 I I Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
lat• - -- - -- - - -- -- Fee _for each system-- - -- -- - - -- - - - $75.00
Installation, alteration, Y�
200 amps or less $66.85 2 (SEE OAR 918 - 260 - 260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. n Audio and Stereo Systems
Branch Circuits ❑
New, alteration or extension per panel Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each.branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire Alarm Installation
First branch circuit ' $46.85 n
Each additional branch circuit $6.65 HVAC
Miscellaneous ❑
Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a.limited energy
panel, alteration or extension $75.00 n Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over n Medical
the allowable in any of the above
Per inspection $62.50 n Nurse Calls
Per hour $62.50 I � I
*
In Plant _____ $7 —_ 1_ Outdoor Landscape Lighting
Fees: n Protective Signaling
Enter total of above fees $ ' n Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due ' $ •
. Enter total of above fees $
El Trust Account #
8% State Surcharge • $
Total Balance Due $
•
i:\dsts \forms \elc- fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-1-lour Inspection Line: 639 -4175 Business Line: 639 -4171 MSfi
• BUP
Date Requested J- /X AM PM BLD
Location 7Y * &el / (—g /q6(6 Suite MEC
Contact Person Ph 563' 2 73- 72/ PLM
•
Contractor Ph SWR 22.
BUILDING. Tenant/Owner ELC / ��
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
L Lab
ice
Rough In •
UG /Slab
Low Voltage
Fire Alarm
Fi
ASS ART FAIL
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
Approach /Sidewalk
Other Date Inspector �� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.