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Permit
. CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00466 fr DEVELOPMENT SERVICES DATE ISSUED: 9/18/01 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S109AA -01000 SITE ADDRESS: 14465 SW 125TH AVE SUBDIVISION: ZONING: R -1 BLOCK: LOT : JURISDICTION: TIG Project Description: Replace existing service, add sub panel and (5) branch circuits. 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: 2 W /SERVICE OR FEEDER: 5 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: BENNY L. BANYARD OWNER 34620 NE CORRAL CREEK RD NEWBERG, OR 97132 Phone: 503 - 625 -7079 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 9/18/01 $193.85 2720010000( Elect! Service Elect'I Final 5PCT CTR 9/18/01 $15.51 2720010000( Total $209.36 This Permit is issued subject to the reg ations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in a •• rd. ce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more th. 18 days. TT' ` TION: Oregon law requires you • . ow rules .:..ted by the Oregon Utility Notification Center. Those rules are set f' -rth i' OAR 9.2 -061 0010 through OAR 952- 001 -00' o . You may obtain c•' ies of these rules or direct questions to IP Permit Signature: A Is ued By: I • OWNER INSTALLATION ONLY The installation is being made on property I own ich is n t intended for sale, lease, or rent. / 91%f OWNER'S SIGNATURE: 9— , DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: 9 /Q D/ Permit no.: £GC'gp /_00V6. ncat 1 . 1:� ; City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97 Date issued: By: Receipt no.: Phone: (503) 639 -4171 tP Fax: (503) 598 -1960 11 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction Cl Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 14 bs tJ l ZS KkiE Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: 'Subdivision: Project name: I Description and location of work on premises: t 2 E FL A.C.E £XISrtl46. 5E ic, E Estimated date of completion/inspection: A DD Z t$ PO 4 N Q, L /ftJ.b 5 Biel 1oc {ES CONTRACTOR APPLICATION FLIE SCHEDULE Job no: 0 I Y ,K, Fee Max Business name: Description Qty. (ea.) Total no. insp New residential - single or multi- family per Address: dwelling unit. Includes attached garage. City: I State: I ZIP: Service included: Phone: I Fax: I E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: I Elec. bus. lic. no: Limited energy, residential 2 City /metro lic. no.: Limited energy, non residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders — installation, alteration or relocation: PROPERTY OY% N ER 200 amps or less 7• 2 Name (print): 'gi -t ■t lJ `∎ .5PrNi ilAr--) 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 3 N. . 0-47?21ZJ L ax. (LD. 601 amps to 1000 amps 2 City: h1 E c..3 $fi i 2_. ,-, I State: O1Z I ZIP: ") 13 2. Over 1000 amps or volts 2 Phone:5M- 4.25 I Fax: I E -mail: Reconnect only l Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: ORS 447, 455, 479, 674, 01. . 200 amps or less 2 i 201 amps to 400 amps 2 Owner's signature: _ A ` 6� bate . ? d 1 401 to 600 amps 2 EN(i SEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of 5 Address: service or feeder fee, each branch circuit 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 .(Serviceorfeedernotincluded): ❑ 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: O Egress/lighting plan ❑ Other: Per inspection I I I 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 $ ❑ 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 %) .... $ Expires accepted as complete. TOTAL $ .'t0 y 6 Name of cardholder as shown on credit card • $ Cardholder signature Amount 440 -4615 (6/00/COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY FIERMIT FEES: Complete 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 `► Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 n Burglar Alarm Limited Energy $75.00 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 6 200 amps or less 2- $80.30 1 0 ` 2 201 amps to 400 amps $106.85 2 n 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 Installation, alteration, or relocation Fee for each system $75.00 200 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 n Boiler Controls a) The fee for branch circuits with purchase of service or Z s n Clock Systems feeder fee. Each branch circuit S $6.65 3 3 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 n HVAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n 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 In Plant $73.75 n Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ 3 8s Ti Other 5 1 8% State Surcharge $ I S. 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 $2.0 9 3 6 Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:idsts \forms \elc- fees.doc 08/30/01 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION ' Business Line: (503) 639 -4171 MST BUP Received Date Requested 3/2 — 3/22.— A M PM BUP Location '4'4' 65 5p✓ / t'` Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 2 00/— 006 /66 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: e» 780 26Y7 yav SIT Post & Beam Shear Anchors need i // Ext Sheath/Shear 1 / °`` 5 " Int Sheath/Shear Framing Insulation Drywall Nailing j Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In t ,. Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final T FAIL RICA Se ' Rough -In UG/Slab Low Voltage - • larm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 'ASS PART FAIL - Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA (o_-i_ Approach/Sidewalk Date � r 1 - Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ` l ' BUP Date Requested / 9 - / �" © AM PM Location / .s f&/ /. hA. Suite MEN Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner 41t3) - 0 66 Retaining Wall R Footing Access: Foundation FPS p Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation /� d � 0 CP � Drywall Nailing v / Firewall /� ��') (�i Fire Sprinkler L" a /'( � t / �-' Q v7 - 4/ `- ' d4 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 D Smoke Dampers Final P T FAIL P ECTRICA C Se /Slab ow oltage Fire Alarm t PART FAIL SI 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 7°7. Other Date D G Inspector C Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.