Permit CITY OF TI GAR D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00388
r DEVELOPMENT SERVICES . DATE ISSUED: 6/28/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 BC -00101
SITE ADDRESS: 08- 1 -&5 HUNZIKER ST C
SUBDIVISION: ;a ZONING: I -L
BLOCK: 8 � � LO : �J RtSDtCTION: TIG
Project Description: Installation of 601 to 1000 amps service and 3 nch circuits for new building.
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: 6014-amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 3 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: 1 PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: . CLASS AREA/SPEC OCC:
Owner: Contractor:
KNEZ REALTY GROUP ALAN FITCH ELECTRIC
8250 SW HUNZIKER RD 25973 S MOEHNKE
TIGARD, OR 97223 BEAVERCREEK, OR 97004
Phone: 620 -6142 Phone: 503 - 632 -4784
Reg #: LIC 00106872
ELE 3 -387C
SUP 3721S
FEES
Type By Date Amount Receipt Required Inspections
PRMT DEB 6/28/99 $208.55 99- 316457 Elect'l Service
Elect'I Final
5PCT DEB 6/28/99 $10.42 99- 316457
Total $218.97
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 folio es adop e byte Oregon Utility Notification Center. Those
rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0080. You may o ain copies of these ruFes or direct questions to OUNC at (503)
246 -1987.
Permit Signature: I ued 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:
C.4 RAC WNS 4 ATKIN ONLY
SIGNATURE OF SUPR. ELEC'N: y DATE:
LICENSE NO: r 7 g/ rJ
Call 639 -4175 by 7 :00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Ch rk
13125-SW HALL BLVD. Recd y
TIGARD OR 97223 w t G d02- Date Recd (0
Phone (503) 639 -4171, x304 1 Date to P.E.
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # &it / 9w - 05.5er
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development V'Is z: ; 3u t N't Number of Inspections per permit allowed
Name (or name of business) ,,pp Service included: Items Cost Sum 4 '
Address j i ¶ S " )Vs) Azl + okA, 'F-1U • 4a. Residential - per unit
1000
City/State /Zip l ar(�O Each additional it ft. or l 5 s $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial P4 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 t'v Ltd 't) f 1 Cu) F o...tt 200 amps or less $ 64.25 2
Address z_ c1 3 s. il(1se_Nato fez- 1--1J' • 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
Cityl State Oa- Zip Gi Ot 601 amps to 1000 amps / $ 192.50 /IL, so 2
Phone No. - .(9 Z.- 4c - j-sp.) Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 -3 1- CG Exp.Date IV -- ca,ft .4c. Temporary Services or Feeders
OR State CCB Reg. No. tt9 Lo W? Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date cal 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n (° 401 amps to 600 amps $ 1 07.00 2
Over 600 amps to 1000 volts,
License No. ' g2 1- t S Exp.Date iV -dl - p I see "b" above.
4d. Branch Circuits
Phone No. CJj'Z • 147.3/- Z l4 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 3 $ 5.35 (4,05 ,Off' 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 .
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (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 q SS
described in N.E.C. Chapter 5 5. Fees: Aog
5a. Enter total of above fees $ ;. D
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ •
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 $ a / Q ' 7
is \fists \forms \electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5? AM PM BLD
Location �� bS � t 1�/�- Suite C / / MEC
Contact Person F - Ph ) 3'b°76 / PLM
Contractor Ph SWR
rBUILDINGe "� ° o ; p a Tenant/Owner CA 0,2_," ELC SZ
Retaining Wall ELR
Footing Access:
Foundation t e,�dt� ~ ' �rjp � _ � FPS
Ft g Drain ` , o SGN
• Crawl Drain Inspection Notes:
Slab 40.00.? CO ...'ry d4.2, Zaffg• SIT
Post & Beam
Ext Sheath /Shear r/ C.� tatinpt.. ogoom 4441t.
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler (/�
Fire Alarm "'
Susp'd Ceiling y .91)(
Roof r�
Misc: ����YYYY"`"'"
Final
PASS PART FAIL
PLUMBING FNAISED
Post & Beam
Under Slab
Top Out dot
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fir- • larm
PART 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
Other Date A/U/4 1' Ins xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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