Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00698
DEVELOPMENT SERVICES DATE ISSUED: 12/03/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133AC -KNOW1
SITE ADDRESS: 10751 SW 130TH AVE
SUBDIVISION: KNOWLEDGE BEGINNINGS DAYCARE C ZONING: R -25
BLOCK: LOT : 001 . JURISDICTION: TIG
Project Description: Electrical permit for new daycare facility
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 HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 63 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 1 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
HULSEY DEVELOPMENT CO SEVEN PEAKS ELECTRIC
PO BOX 8600 1748 NE MEERKAT AVE
BEND, OR 97708 BEND, OR 97701
Phone: Phone: 541 - 389 -5461 ORIGINAL
Reg #: LIC 135301
ELE 9 -227C
SUP 4539S
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT KJP 12/03/199E $465.55 99- 320155 Wall Cover
PLCK KJP 12/03/1995 $116.39 99- 320155 Underground Cover
5PCT KJP 12/03/199E $37.24 99- 320155 Elect'I Service
Elect'I Final
Total $619.18
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty 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.
g ovLe k ix .14 PERMITTEE'S SIGNATURE ykA /4 jY _____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
SIGNATURE OF SUPR. ELEC'N: K I, ` 1, u R' "-" DATE: Z- `J ^ i I
LICENSE NO: (
Call 639 -4175 by 7:00pm fo an inspection the next business day
11/10/99 WED 16:56 FAX 503 598 1960 CITY OF TIGARD a002
CITY OF TIGARD Electrical Permit Application plan Check # 1/ � y �
13125 SW HALL BLVD. Rec'd By y
TIGARD OR 97223 Date Rec'd // -/ S ` r
Date to P.E. 11 - A, 41 [
' Phone (503) 639- 417f, x304 Date to DST / I ' - 91'
Inspection (503) 639 -4175 Print of Type C ` /Z" ,j
e.
YP - frjo -,7i . ermit #
Fax (503) 598 -1960 a ped ��
I ncomplete or illegible will not be ac
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development I A() L 6i B E6it t(1�-lb S Number of Inspections per permit allowed
Name (or name of business) SAl Service included: Items Cost Sum
Address /0 7 i 5 Le 130'Hi 4a. Residential - per unit
I - y
City /State /Zip t 6 e-h O 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof $ 26.75 i
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 Sc )) !J t S a V_ 200 amps or less $ 64.25 2
Address i / < S • Aa Al in, 201 amps to 400 amps $ 85.50 2
City ii _ State A) /2- Zip Ir. , Q 401 amps to 600 amps 1 $ 128.50 1 R .'U 2
601 amps to 1000 amps $ 192.50 2
Phone No. S eri/ 3 ?) 9 ' - - - ii, 6 / Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. ( 7 -Z2 - 7 C. Exp.Date UCT" 00 ` 4c. Temporary Services or Feeders
OR State COB Reg. No. / 35 7 i Exp.Date ¶ )-' I ). o ✓ j ' Installation, alteration, or relocation
COT Business Tax or Metro No. Ex .Dal 200 amps or less $ 53.50 2
A 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n M 401 amps to 600 amps $ 100.00 2
Over 600 amps to 1000 volts,
License No. 3 / a Exp.Date OCT Q f C / see "b" above.
Phone No. No.
3 �'j`l - Sz/6 1 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 2'3 $ 5.35 7 37.-05_ 2
Address b) The fee for branch circuits
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
panel, alteration or extension $ 60.00
3. Plan Review section (if required):* Minor Labels (10) $ 100.00
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
Per inspection $ 50.00
Service and feeder 225 amps or more 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:
6a. Enter total of above fees 4::15-- * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $
Not required for temporary construction services. Subtotal $
6b. Enter 25% of line 6a for
NOTICE Plan Review if required (Sec. 3) $ //6-3
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 0 Trust Account # C/
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ , " 9 L'.
i : \dsts \fors \elcctri c.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested L 1 AM k PM BLD
Location 10 S i 1 5"f uLe_. Suite MEC
Contact Person pl'1 i Ph SIO_ Cp b "I ) PLM
Contractor Ph SWR G
BUILDING Tenant/Owner ELC le t9- rc(pei 0
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
I)
Roof r
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
(PLECTRICA
Service
Rough In
UG /Slab
Low Voltage
4 Fi � re ,Al Alarm
S 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other Date Z Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
04/28/2000 Activities for Case #: ELC1999 -00698
8:45:14 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 11/15/1999 GEO RECD No Hold BON 11/18/1999
ELCC003 Permit created 11/18/1999 BON DONE No Hold BON 11/18/1999
ELCC102 Plans routed to Plans Examiner 11/18/1999 BON DONE No Hold BON 11/18/1999
ELCC110 Plans checked /approved by PE 11/22/1999 BRP PASS No Hold DGW 11/22/1999
ELCC115 Approved plans routed to DSTs 11/22/1999 BRP PASS No Hold DGW 11/22/1999
ELCC700 Ceiling Cover 11/22/1999 11/22/1999 02/18/2000 BRP PASS No Hold AKJ 02/21/2000
ELCC720 Wall Cover 11/22/1999 11/22/1999 02/18/2000 BRP PASS No Hold AKJ 02/21/2000
ELCC725 Underground Cover 11/22/1999 11/22/1999 No Hold DGW 11/22/1999
ELCC730 Elect'I Service 11/22/1999 11/22/1999 03/08/2000 CD PASS No Hold RB 03/09/2000
ELCC799 Elect'l Final 11/22/1999 11/22/1999 04/20/2000 CD PASS No Hold AKJ 04/20/2000
ELCC117 DST Post - Review complete 11/29/1999 BON DONE No Hold BON 11/29/1999
ELCC400 (F)Ready to issue 11/29/1999 BON DONE No Hold BON 11/29/1999
ELCC500 (F)Issue permit 12/03/1999 KJP DONE No Hold KJP 12/03/1999
ELCC700 Ceiling Cover 03/08/2000 CD PASS No Hold RB 03/09/2000
ELCC700 Ceiling Cover 04/14/2000 CD PASS No Hold AKJ 04/16/2000
ELCC800 Case Finaled 04/20/2000 AKJ DONE No Hold AKJ 04/20/2000
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