Permit (JA CITY OF TIGARD • ELECTRICAL PERMIT
P ERMIT #: ELC2000 -00643
, �I�j. DEVELOPMENT SERVICES DATE ISSUED: 11/27/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB-04500
SITE ADDRESS: 10250 SW GREENBURG RD * **
SUBDIVISION: LINCOLN BUILDING PP1991 -055 ZONING: C -P
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Installation of a new sub -panel with 2 new circuits to feed wireless unit. Job No. 20 -1332.
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: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 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:
KNICKERBOCKER PROP, INC XXIV CAPITOL ELECTRIC CO INC
BY NORRIS, BEGGS + SIMPSON 12810 NE AIRPORT WAY
10300 SW GREENBURG RD STE UNIT 1
PORTLAND, OR 97223 PORTLAND, OR 97230
Phone: Phone: 255 -9488
Reg #: LIC 048748
SUP 3132S
ELE 26 -496C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 11/27/00 $93.60 2720000000( Elect'I Service
5PCT CTR 11/27/00 $7.49 2720000000( Elect'I Final
Total $101.09
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 co pie : ese • -s or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ��� - ISSU I 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: JOQP �
i• „ E! DATE:
LICENSE NO: 4 / , Z.9- 3 •
Call 639 -4175 by 7:00pm for an inspection the next business day
OFFICE USE ONLY
Electrical Permit Application
.'J
2ECE:VED Date received: /Ali,oD Permit no.: ELeAvor1 -i0 4
" ""' Project/appl. no.: Expire date:
�I City of Ti Date issued: By: Receipt no.:
`... 10,11 -, fin
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 , iv , 2 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval:
COMMUNITY DEVELOLw•
TYPE OF PERMIT
❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION '
Job address: 10250 SW GREENBURG RD City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name: NEW UNIT _ and location of work on premises: S.E. TELUCO CLOSET
Estimated date of completion/inspection: SET A NEW SUB - PANEL W /2NEW CIRCUITS TO FEED WIRELESS UNIT
CONTRACTOR APPLICATION . FEE SCHEDULE
Job no: 20 -1332 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 12810 NE Airport Way New residential - single or multi - family per
City: Portland State: OR ZIP: 97230 - 1029 dwelling unit. Includes attached garage.
Phone: 503 - 255 -9488 IFax: 255 -9488 IE -mail: darrell @cepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 26 - 496C 1000 sq, ft, or less $ 145.15 4
i /metro lic.no.: N/A Each additional 500 sq. ft. or portion thereof $ 33.40
LA 11/1 7/00 Limited energy residential $ 75.00 2
Signature of supervising electrician (required) Date Limited' energy, non - residential • - $ 45.00 2
Sup. elect. name.(print): Darrell McNeel License no.: 3132 -S Each - manufactured home or modular dwelling
PROPERTY OWNER Service and /or feeder $ 90.90 2
Name (print): i Services or feeders - installation,
Mailing address: alteration or relocation:
City: I State: (ZIP: 200 amps or less 1 $ 80.30 80.30 2
- Phone: Fax: . 1E-mail: •-• 201 amps to 400 amps - $ 106.85 2
• Owner installation: The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS- 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 1
ENGINEER Temporary services or feeders -
Name: . • • • . installation, alterations, or relocation:
Address: - 200 amps or-less $ 66.85 2 - - -
City: • - - State: ZIP: 201. amps to 400 amps $ 100.30 2
Phone:. Fax: E - mail: 401 amps' to 600 amps $ 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit 2 $ 6.65 13.30 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress /lighting plan ❑ Oth Misc: (Service nr feeder not included): •
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
' alteration, or extension* $ 75.00 2
*Description:
Each additional inspectionover th allowable in any of the above:
Per inspection I I $ 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 93.60
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge 8% ) $ 7.49
Name of cardholder as shown on credit card
$ withing 180 days after it has been TOTAL $ 101.09
Cardholder signature Amount accepted as complete.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
D Requested / 2- - I L/ AM PM ,, BLD_° ' �.
-
Location /0 2-1 G 5') rj - rp,•• e 6 ia---e Suite MEC + -'
Contact Person J/i ,. Ph 56 - f 39-5 4 PLM
Contractor Ph SWR
BUILDING T� Owner Oda/ / 4,- „..„ i /h - ELC 7&4 a - G f) 6 (73
Retaining Wall ELR
Footing
Foundation ACC2SS: '�, - rte 2 -p-�f FPS
Ftg Drain SGN
Crawl Drain . Inspection Notes:
Slab SIT
Post &Beam . -5i/ 6 "717,1,- r Z r � a) A ,
Ext Sheath /Shear ,
- f �. e �,�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall / l / /
Fire Sprinkler !/ _
Fire Alarm
Susp'd Ceiling
Roof l
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
jEt'ECTRIt.N_= , .
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
oar RT 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 D ate
Other f 77 Inspect Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.