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Permit CITY OF T ELECTRICAL PERMT PERMIT #: ,�i DEVELOPMENT SERVICES DATE ISSUED: 03/05/99 13125 SW Hall Blvd., Tigard, OR 97223 (503)639 PARCEL: 1S136AD -04301 SITE ADDRESS...:11475 SW PACIFIC HWY SUBDIVISION °VILLA RIDGE ZONING:C —G BLOCK LOT :002 JURISDICTION: TIG Pro.j ect Description : Alteration to electrical service. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION 0 EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0 LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0 MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0 - - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- - 0 — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0 201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR : 0 401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 29 IN PLANT 0 601 — 1000 amp • 0 PLAN REVIEW SECTION 1000+ amp /volt • 0 > =4 RES UNITS • ) 600 VOLT NOMINAL..: Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.: Owner: FEES TIME OUT TAVERN type amount by date recpt 11475 SW PACIFIC HWY PRMT $ 180.00 DLH 03/05/99 99- 313468 TIGARD OR 97223 5PCT $ 9.00 DLH 03/05/99 99- 313468 Phone #: Contractor: CHANDLER ELECTRIC INC $ 189.00 TOTAL 7634 SW 34TH PO BOX 80696 REQUIRED INSPECTIONS PORTLAND OR 97280 -1696 Elect'l Service Phone #: 245 -7774 Elect'l Final Reg #..: 000949 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set fort 'n 952-001 -0010 through OAR 952 -001 -1987. You may obtain a copy of these rules or direct questions to OUNC by callin' (503)2'4 Permittee Signature llted/ Issued By: : Y OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. 4 OWNER'S S I GNATURE : DATE : CONTRACTOR INSTALLATION 0 LY SIGNATURE OF SUPR. ELEC' N: 6/1/ /96 /C /O DATE : LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ - 7111111114 Community Development ELECTRICAL PERMIT APPLICATION I - A 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Ya I Permit # 6 '9 -4 /..29 __,J4 .� �l Phone (503) 639 -4171 Date Issued S 9 , - FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 ssued by Inspection (503) 639 -4175 �� 1. Job Address: -� /� 4. Complete Fee Schedule Below: Name of Development / �' "vie V di ' 1 V er A Number of Inspections per permit allowed Address ii / ,S .4 I Pne„ ; . ; L C1 v./ y Service included: Items Cost(ea) Sum City/State/Zip Ti ( r Af fire 4 7 A0.3 4a Residential - per unit 4 1 1000 sq. ft. or less $110.00 - Name (or name of business) Ve rtn L eo levv.r- Each additional 500 s9. N or � portion thereof $25.00 1 Commercial IT Limited Energy $25.00 Residential ❑ Each Manufd Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor installation only: 4b. Services or Feeders 2 Electrical Contractor �.. --.. L! r � ct Installation, 00 s or l or relocation $60.00 00 2 - Address? 0 C I )x $ n 6 96 201 amps to 400 amps $80.00 2 i Pf f -k\ ?ti State orc Zip Cr 761 401 amps to 600 amps $120.00 2 CRY P 601 amps to 1000 amps $180.00 2 - Phone No. a.cfS- 77 7Y f Over 1000 amps or voles $340.00 2 - Contractor's License No. Z 6-‹ ?..q C. Reconnect only $50.00 Contractor's Board Reg. No. 9 4c. Temporary Services or Feeders Installation, alteration, or relocation 2 Signature of Sup Elec'n 200 amps or less $50.00 2 $75.00 2 o1 License No. �o S Phone No.cf S 201 amps to 400 amps 777 1 401 amps to 600 amps $100.00 - Over 600 amps to 1000 volts 2b. For owner installations: gee •b• above. Print 4d. Branch Circuits rint Owner's Name New, alteration or extension per panel Address a) The fee for branch circuits with City State Zip purchase of service or feeder fee. 2 Each branch circuit $5.00 Phone No. b) The fee for branch circuits withou The installation is being made on property I own which is purchase of service or feeder flee. 2 not intended for sale, lease or rent. First branch circuit / $35.00 2 Each additional branch circuit Z„Ct $560 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 Each pump or irrigation circle $40.00 2 3. Plan Review section (if required): Each sign or outline lighting $40.00 - Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00 - 4 or more residential units in one structure Minor Labels (10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per inspection $35.00 - Per hour $55.00 - In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: NOTICE 5a. Enter total of above fees $ I S D 5% Surcharge (.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. ❑ Trust Account # Balance Due $ IS 1 woidPmm ,s .4,c m.app 6/30/99 Activities for Case #: ELC99 -00129 2:35:29 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 3/5/99 DLH RECD DLH 3/5/99 ELCC003 Permit created 3/5/99 DLH DONE . DLH 3/5/99 ELCC730 Elect! Service DLH 3/5/99 ELCC799 Elect'! Final 5/5/99 BRP FAIL AKJ 5/5/99 Receptacles in kitchen loose Install box extensions and plates on receptacles Install plate on receptacle under hood Indentify all circuits at panels, remove all previous marking ELCC500 (F)Issue permit 3/5/99 DLH DONE DLH 3/5/99 ELCC720 Wall Cover 3/10/99 BRP PASS B *P 3/11/99 ELCC700 Ceiling Cover 3/12/99 BRP PASS B*P 3/15/99 ELCC799 Elect'! Final 5/6/99 5/6/99 5/6/99 BRP PASS No Hold AKJ 5/6/99 ELCC800 Case Finaled 5/6/99 AKJ DONE No Hold AKJ 5/6/99 • • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / ? AM PM BLD Location /l t 7.4 A r Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner T m e p cJ / PU 6 , ELC Retaining Wall 9q— Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof r 6 T V 2 D yl S a ,s Final PASS PART FAIL PLUMBING Post & Beam Under Slab n I - q 6 S Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fi larm PASS 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 Inspector ■_ •■ _ 1 A Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.