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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00330 �� ,��'' DEVELOPMENT SERVICES DATE ISSUED: 6/2/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB 00800 SITE ADDRESS: 16135 SW 74TH AVE SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I - BLOCK: LOT : JURISDICTION: TIG Project Description: Install a temporary 200 AMP service /feeder. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 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: 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: JOHN DUNCAN ELECTRO -WIRE INC 7060 SW PALMER WAY 18857 SE SUNNYSIDE RD BEAVERTON, OR 97007 BORING, OR 97009 -9222 Phone: Phone: 658 -8136 Reg #: ELE 26 -667C LIC 00067879 SUP 0002717S FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT GEO 6/2/99 $53.50 99 315860 Elect'I Final 5PCT GEO 6/2/99 $2.68 99- 315860 ORIGINAL Total $56.18 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. 7 / Permit Signature: ,' Issued By: OWNER INSTALLATION ONLY The installation is being .de 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: f � DATE: � —9 9 LICENSE NO: ?/ - 5 O Call 639 -4175 by 7:OOpm for an inspection the next business day I. �..r�l as - p 1 G'"L -- / 3/ l c CITY OF TIGARD Plan Check # Electrical Permit Appli ation 1,3125 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit #FGG t fl/l - Ce 33a Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development 1 ; t..►n c o.VN. l AL S Number of Inspections per permit allowed Name (or name of business) .rolnA ViMArnr•\ Service included: Items Cost Sum Address 1 t 13 S - S . Gl! - 1 L' L-V Iku t-- 4a. Residential - per unit --+ 1000 sq. ft. or less $ 117.75 4 City /State /Zip I laovci t 1 /� Oce ( o n x-17 0 23 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial p Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). Installation, alteration, or relocation Electrical Contractor I„ 1 ec,ivo - I.JLV e-- --0 4 200 amps or less $ 64.25 2 .• , 2 201 amps to 400 amps $ 85.50 2 Address I Q ® 1 �� G. , r t. 401 amps to 600 amps $ 128.50 2 City '''- c l, , t•-. State re low Zip 01700 601 amps to 1000 amps $ 192.50 2 Phone No. S03- GI S R- e( Over 1000 amps or volts $ 363.75 2 Job No. & ) cIr f Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Exp.Date 10 D 4 .4c. Temporary Services or Feeders OR State CCB Reg. No. Z6- 6 b Exp.Date 1 y, Installation, alteration, or relocation COT Business Tax or Metro N . 1 Exp.Date J� / 0 200 amps or less $ 53.50 5 3 5 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, /61 / O! License No. Z S Exp.Date 200 see "b" above. � Phone No. Se - G,S® - I ue 4d. Branch Circuits New, alteration_or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 b) The fee for branch circuits Address without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy if required):* panL alteration or extension $ 60.00 3. Plan Review section Minor Labels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 . 5. Fees: 5a. Enter total of above fees $ 5 * Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ pZ -to6 Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # � AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ s / 5 i : \dsts \forms \el ectric. doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ee Date Requested I ,� Atilt AM PM BUP BLD Location lUC! ( 3S — 7 L Ail Suite MEC Contact Person Jan i) Ph ( g'6? -- / 1- 7 SS PLM Contractor Ph SWR BUILDING. :. ` � _ °� Tenant/Owner ELC I II- to 330 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 /1,./o e, � ^ Fire wall 1 � v 6 II f /mot°. Y J� c .k O Fire Sprinkler CO � a C' ` s � y Vl ,o 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 <ECE Service Rough In UG /Slab v ■ Low Voltage Fire Alarm APART FAIL 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 reinspection RE: [ ] Unable to inspect - no access ADA >/ Approach /Sidewalk Date C _O g- 9 c Inspector ',_ ��. � .� /� Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.