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Permit
CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2002 -00498 r DEVE PMENT r RVIICES 639 -4171 DATE ISSUED: 9/24/02 PARCEL: 1S135BC-00201 SITE ADDRESS: 10765 SW GREENBURG RD SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of service panel and (6) branch circuits for outside lighting. 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: 6 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: BELANICH, ROGER M VIKING ELECTRIC INC BY SOUTHLAND CORP 4326 SE WOODSTOCK PO BOX 711 STE 518 DALLAS, TX 75221 PORTLAND, OR 97206 Phone: Phone: 775 -3479 Reg #: LIC 00056527 SUP 3088S ELE 26 -569C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT CTR 9/24/02 $120.20 2720020000( Rough -in Elect'l Final 5PCT CTR 9/24/02 $9.62 2720020000( Total $129.82 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 r - -• op e• •• • - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obt copies of these rules o direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Permit Signature: # y ' � Is • ued B 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 DATE: LICENSE NO: 30 S Call 639 -4175 by 7:00pm for an inspection the next business day l Electrical Permit Application Date received: 9 , 0,9-- Permit no.: map .4./ [ _iltlitil City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 - 1960 Case file no.: Payment type: • Land use approval: .. . TYPE OF .PERMIT • - - _ - ,., LI 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi - family__ ❑ Tenant improvement ❑ New construction Addition/alteration /replacement ❑ Other: ❑ Partial ' .JOB.SITE INFORMATION Job address: 0 6 S k 6 REED R G Q 17 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: • Project name: Co/we:0 S u. Q. EN re Description and location of work on premises: r , t _ egivec- F 0075) 0 L l $ Estimated date of completion/inspection: , '` CONTRACTOR APPLICATION • FEE SCHEDULE - ' Job no: / Fee Max Business name: Vi IA) 6 r L. -/� Desc ription Qty. / (ea.) Total no. insp New residential - single or multi- family per Address: S — CDs! 7 / a dwelling unit. Includes attached garage. City: /06e2 j L 4,1,Y State:pk ZIP: . 66 Service included: SD 3 775 7 - / - 5 577 Phone: Fax b � E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof __ CCB no.: j 5 /ploy/ Elec. bus. lic. no: - -- j 6Qc Limited energy, residential ___ 2 City/metro lic. no.: V /o -I -o Y QQQ q. d 7 Limited energy, non - residential ___ 2 i leiliaW / Each manufactured home or modular dwelling Signature of supervising electrician (required) Date 'mo Z Service and/or feeder 2 Sup elect name (pnnt):AON C !4!f/ L L p NI License no: 08'8 S Services or feeders —installation, alteration or relocation: .µ� ,. ,., , PROPERTY -OWNER ,•-•• . , , , w , . ,- • - -- 200 amps or less II/110 LO 2 Name (print): 201 amps to 400 amps ___ 2 401 amps to 600 amps ___ 2 Mailing address: 601 amps to 1000 amps ___ 2 City: State: ZIP: Over 1000 amps or volts ___ 2 Phone: Fax: E -mail: Reconnect only ___ 1 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 llation, alteration, or relocation: II 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 2q Address: service or feeder fee, each branch circuit J I r yV 2 City: State: 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's apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle ME ■ 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, al ❑ 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 $ ) 2 D • 20 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been L,, State surcharge (8 %) .... $ ! ° 6 9 Expires accepted as complete. TOTAL $ 12 q• S Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6 /00 /COM) • ■ Electrical Permit Fees: Limited Energy' Fees: ` " TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 1, 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 n Burglar Alarm • Limited Energy $75.00 Each Manufd Home or Modular I Garage Door Opener' Dwelling Service or Feeder $90.90 2 Services or Feeders In Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 Vacuum Systems 201 amps to 400 amps $106.85 2 ri 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 200 amps or less $66.85 2 Fee for each system $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. Branch Circuits IT Audio and Stereo Systems New, alteration or extension per panel a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. n Clock Systems Each branch circuit $6.65 2 . b) The fee for branch circuits I I Data Telecommunication Installation without purchase of service or feeder fee. n Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation 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 Minor Labels (10) $125.00 I I Landscape Irrigation Control Each additional inspection over n Medical the allowable in any of the above Per inspection $62.50 n Per hour $62.50 Nurse Calls In Plant $73.75 Outdoor Landscape Lighting Fees:• F Protective Signaling Enter total of above fees $ I Other 8% State Surcharge $ • Number of Systems • 25% Plan Review Fee See "Plan Review" section on $ front of application. * No licenses are required. Licenses are required for all other installations Total Balance Due $ Fees: • Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ • is \fists \forms \elc- fees.doc 10/09/00 CITE 77 TIGARD 24 -Hour Inspection Line: (503) 639 -4175 INSPE ivi'1 DIVISION Business Line: (503) 639 -4171 MST BUP I' Received 1 0 �' o ( Date Requested 7 / �© AM PM BUP Location / 7b ! r � ° % � � Suite r MEC Contact Person 1C O71 Ph ( ' ) PLM Contractor li t' Ph ( ) SWR BUILDING Tenant/Owner ELC o2— ?'i 447 Footing Foundation Access: ELC Ftg Drain 7-/( ELR Crawl Drain [[ Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation II// j� Drywall Nailing 1 1` / h� / ��CJ'j l` Firewall Fire Sprinkler '�'� `'�'< 1 / [- ` Fire Alarm Susp'd Ceiling Roof Other: ' Re) 1 Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In 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 Z M I PAITW FAIL C Aervic �j Rough -In UG /Slab Low Voltage Fire Alarm cab C� PART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinspection RE: ill Unable to inspect — no access Fire Supply Line ADA 10 0,P I nspector _ • Ext Approach /Sidewalk D a t e TF-Csi Other: IV Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL