Permit •
C ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2000 -00151
-
*et DEVELOPMENT SERVICES DATE ISSUED: 4 /5 /00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AB-00400
SITE ADDRESS: 07400 SW LANDMARK LN
SUBDIVISION: ZONING: I -H
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI and data telecommunications limited energy
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: 1
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 4 W /SERVICE OR FEEDER: 5 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:
HAYTER FAMILY LIMITED PARTNERS PHOENIX ELECTRIC CO
23643 SW STAFFORD HILLS DR 7379 SW TECH CENTER DR.
WEST LINN, OR 97068 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt •
Ele Service
PRMT BON 4/5/00 $343.75 0001179 Elect'l Final •
5PCT BON 4/5/00 $27.50 0001179
Total $371.25 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 1-1( Jl CGL��h- l� ✓` l 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
P SIGNATURE OF SUPR. ELEC'N: 1 1k-C Art" 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 SW HALL BLVD. Rec'd By
TIGARD OR 97223 /� e 1� L eo Date Rec'd - -7,0)
��1i Date to P.E.
Phone (503) 639 -4171, x304
Date to DST
Inspection (503) 639 -4175 Print of Type Appt 70 Permit # ZIP- arirro
Fax (503) 598 - 1960 Incomplete or illegible will not be acce pp p00 Called
O � M Up��t`! D
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ,A rc t.4�r :: Number of Inspections per permit allowed
Name (or nnam1 'e�of business) � .\ , Gti -e--- Service included: Items Cost Sum 4 '
Address I` .3O I � f-- O-Y'(t\y (- .N1.--. L---V\ 4a. Residential - per unit
City/State /Zip • 1 . _ O _. c - , 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commerci4 Residential ❑ Limited Energy $ 60.00
P e ' E r � - y„ Each Manufd Home or Modular
L k ^ �` Dwelling Service or Feeder $ 72.75 2
a. Contractor install ton only:
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT • . to • ase). Installation, alteration, or relocation
Electrical Contract �p8p ��i Co 200 amps or less � 00 $ 64.25 �. 2 ■
_ 201 amps to 400 amps $ 85.50 2
Address ( 13 x 1 �,� acs/ 6
401 amps to 600 amps $ 128.50 2
City l t 1 State 0A--- 0'( Zip 6- i1 )-D--) 601 amps to 1000 amps $ 192.50 2
Phone N�. �n w / Over 1000 amps or volts $ 363.75 / 2
Job No. . - U' Reconnect only $ 53.50 2
Elec. Cont. Lice. No. ( iC_ i Exp.Date .4c. Temporary Services or Feeders
OR State CCB Reg. No. . j a Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. • 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n a--3 - 401 amps to 600 amps $ 1 07.00 2
/ s Over 600 amps to 1000 volts,
License No"
G 14 Exp.Date see "b" above.
\ 4d. Branch Circuits
Phone No. - ,: LQ( 1 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 r:9{/‘ �5 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 $ 42.7
g Signal circuit(s) or a limited energy `��f�
3. Plan Review section i � � f re uired : Minor L
*
panel alteration or extension $ 07.00 Lp[/
Q La alteration
(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
described in N.E.C. Chapter 5 5. Fees: ,
5a. Enter total of above fees $,S 9
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ - T
Not required for temporary construction services. Subtotal $ .3 . 9-3
56. Enter 25% of line 5a for
" NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR-CONSTRUCTION-AUTHORIZED Subtotal $ !J /
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 $
is \dsts \ forms \e l ectric. doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
J BUP
Date Requested (/i r 7co AM PM BLD
Location _____a DD Lt�'1 Suite MEC
Contact Person • CIDA/A. Ph (O SL — 3 O® PLM
Contractor . Ph SWR
; Tenant/Owner (1r c- Pr n , ELC 1.000-001S
Retaining Wall ELR
Footing Access: 1
Foundation S: i^ FPS
q / I ��
Ftg Drain � 6 i - 70/ S' SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall .L
Fire Sprinkler �
Fire Alarm
Susp'd Ceiling _
Roof
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
CTRI )
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
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 reinspe tion RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other D / L Inspector ��1 Ext
_ --
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site. •