Permit CITY OF TIGARD ELECTRICAL PERMIT
P ERMIT #: ELC2000 -00261
I,r.Ji DEVELOPMENT SERVICES DATE ISSUED: 05/19/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110CA 00200
SITE ADDRESS: 11980 SW IMPERIAL AVE 008
SUBDIVISION: KING CITY ZONING: ?
BLOCK: LOT : JURISDICTION: KIN
Project Description: Install a first 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
WESTON INVESTMENT CO GEORGE + SONS ELECTRIC CORP
2154 NE BROADWAY PO BOX 339
PORTLAND, OR 97232 CLACKAMAS, OR 97015
Phone: Phone: 654 -8634
Reg #: LIC 00035600
ELE 3117C
SUP 3185S
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT GEO 05/19/200C $37.50 0002304 Elect'I Final
5PCT GEO 05/19/200C $3.00 0002304
Total $40.50 ORIGINAL
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 copies of these rules or direct questions to OUNC at (503)
246 - 1987.
PERMITTEE'S SIGNATURE . 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: � • DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application
Plan Check#
13125 HALL BLVD. ���� Rec'd By
TIGARD OR 97223 RE Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 � y 1 9 ZOM Date to DST
Inspection (503) 639 -4175 Print of T pp g Permit #ECC -6 OvZfs/
Fax (503) 598 -1960 DE�eaME'Nt Called
( ) Incomplete {�iDl�le wl I not be accepted
1.. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) (O Service included: Items Cost Sum
Address / /9iO 5*; IM/ ' /A I_ A (✓C 44" 9 4a. Residential - per unit
City/State/Zip fr/A16-- G / 7)/ sq. ft. or less $ 117.75 4
ry p Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial ❑ Residential 4P /9/f 6= 6= / _ 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 (, -tea4/ E 41 S eAlS 51_6-C. 200 amps or less $ 64.25 2
Address p0, /.X 3 3 7 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City L LA- L7rA A-7 A S State L R , Zip 970/3- 601 amps to 1000 amps $ 192.50 2
Phone No. 6 -5 `t - 8 C 3 ' Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 - // 7 C Exp.Date /0 -/ -0 a' 4c. Temporary Services or Feeders •
OR State CCB Reg. No. 33 6 '7 Exp.Date 3 - 7 -P-0 , °, Installation, alteration, or relocation
COT Business Tax or Metro No.08 0 Exp.Date a - / -/ 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Su r . Elec'n 401 amps to 600 amps $ 100.00 2
g p e�� Over 600 amps to 1000 volts,
see "b" above.
License No. 3/ 9 5 S Exp.Date /o-/ -/
Phone No. E 3 9 (3 `74 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 $ 5.35 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 -3 7. 57
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
(if required):* panL alteration or extension $ 00 :00
3. Plan Review section
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:
• 5 a. E nter total of above fees $ 3 25-4
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 3. £D
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 $ i t - 0
is \dsts \forms \e l ectric, doc
CITY OF TIGARD BUILDING INSPECTION DIVISION • MST
24 -Hour Inspection Line: 6394175 - Business Line:) 639 -4171
( �' 3� •
Date Requeste. (O r AM /k �' PM BUP BLD
Location 4° 40 _hi Suite MEC
Contact Person Ph PLM
s�
Contractor C - 2. Ph SWR
BUILDING.¢ ° � x ay ", Tenant/Owner ELC c ooler 1 72 002 49/
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab �r SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall .r-
Fire Sprinkler � //' Gil r at rcc.J : / Viz)
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer P
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
SS PART FAIL
ELECTRICAL
service
Rough In
UG /Slab
Low Voltage
Fire Alarm
;IC3 PART FAIL
Sllt
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 Date i6' /' .� Inspector c..�, -+�, -� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.