Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00541
•1 .k DEVELOPMENT SERVICES DATE ISSUED: 10/14/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101BB - 00301
SITE ADDRESS: 11834 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Job No. 0I -1343
Canopy 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: 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: 3 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:
BOYLES ELECTRIC, INC.
P.O. BOX 1227
BORING, OR 97009
Phone: Phone: 503 - 668 -7440
Reg #: ELE 3-465C
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 10/14/02 $66.80
[TAX] 8% State Tax 10/14/02 $5.34 Wall Cover
Elect'I Final
Total $72.14
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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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
1- 800 - 332 -2344.
Issued By: T._P/ryl C Permit Signature:
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
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t s
Elect rical PermitApplication 1 11 I l l I l .I ,,
` - `1'1' • . - Date received: Permit , • , ma 'oD S//
�,�� 1 City of Tigard ' w•-- I M Project/Lipp!. no.: Expire date:
City of Tigard Address: 13125 SW Hall B • 97223 Date issued: By Receipt no.:
Phone: (503) 639 -4171
T • 1 1 2 01/2 -- Case file no.: Payment type:
Fax: (503) 598 -1960 OC
Land use approval: t : ; x ,0 =- -
1 \ 11 f (II ' 1'1:12 \111
O 1 & 2 family dwelling or accessory Fkommercial/industrial O Multi - family O Tenant improvement
O New construction O Addition/alteration /replacement O Other. O Partial
.tali '0 11 1\1 0101 i \ 110\
Job address: 1 4 agl i MMILMIL I NIMMIE Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: e_ c_x c) o S e I l Description and location of work on premises: Ca_ v.. O • e \ lrfIIIIMIII
Estimated date of completion/inspection: `
_. -; _- •_ =
- - - -'- (--(-Ps-I ItA4-1-01Z -' A l' l' I I-f \v1-1O.\ _,: _ - , „ _. _ - 11` 1 - - , s( - 111 - 1)1 - 1_I --- ._ > __-
Job no: p - 1 lynx
Business name: 1,1,111 eS e t', c JJVIC � -- -FI- Total no•�.
fn
Address: rommi . dw 1Vewre�endal-dogko bached Lrper
�• cl.dea atrathed garage.
City: to o'er t r State:C) I ZIP: 100 1 sv iceincbtdet
P..' .1y , C6' all E -mail: 1000 . ft. orless 4
CCB no.: 13 Dp Elec. bus. lic. no: - LI ( 5
' Each additional SOO : ,. R a . • .,, thereof __ _-
• lip. no.: • y Gi' Limited energy, residential ___ 2
,:, , res;aential MEMO 2
Is Pa,:% Each manufactured home or modular dwelling ■■.
t of : 7f' . • ' . ( - • ' - .) Date Service and/or feeder
2
S .. (1 )• ae name mgm `p a Li onise no: 5 Serdcesor feeders - tmtatlatlmo, , " 200 alteration orrebeadoa 111 .
. 2
1 ' 1 1 0 1 ' 1 : 1 2 1 1 1)11 \1:12 200 or leas
Name (print): 201 to 400 , ___ 2
Mailing address: 401 to 600 =MI 2
601 to 1000: _ _ _ 2
City: State: ZIP: Over woo : : or volts ___ 2
Phone: Fax: E -mail: Reconnect
Owner installation: The installation is being made on property I own Teasposary services or feeders -
IlN.
which is not intended for sale, lease, rent, or exchange according to imso,altertrdoo,errdoeatloa
ORS 447, 455, 479, 670, 701. 200 or less z
.� 201 , to 400 ___ 2
Owner's si
Date: 401 to 600 ___ 2
1 \ (.1 \ I :1 Ic Branch dreaits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits wdhan purchase m
Phone: Fax E -mail: of service or feeder feQ, f branch circuit 11``bS 2
Each additional branch circuit ILIM(T'(j,' 21
1'I. \\ 121 , 1 111 (I'Iea.c t lie(k :ill Thal :110% 1 Misc. (Service orfeedernot lncluded): ■■
O Service over 225 amps-commercial O Health-care facility Each u,=. or ari:...; .,. circle 2
O Service over 320 amps-rating of 1&2 O Hazardous location Each sign or outline ; . , - ___ 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration. or extension' ■■. 2
O Building over three sores 0 Feeders, 400 amps or more •
Descri.tion:
0 Occupant load over 99 persons O M a n u f a c t u r e d stntcnres or 1 W pact Each ad4ft omd inspection over the al owable to any of the above:
❑ Egress/lighting plan O Other per _ _
Submit _ sets of plans with any of the above. Investigation the
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 $ n I o`t v
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %o) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ .34
Name of cardholder as shown on credit card
Expires accepted as complete. TOTAL $ - I t 1
S
Cardholder signature Amount 440.4615 (6/00/CO114)
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, •
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Number of Inspections per permit allowed Restricted Ene »
(FOR ALL SYSTEMS) $75.00
Service Included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. R or Less $145.15 4 ❑ Audio and Stereo Systems'
Each additional 500 sq. ft. or
portion thereof $33.40 1 Burglar Alarm
Limited Energy $75.00 ❑ g
Each Maned Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener'
Services or Feeders Heating, Ventilation and Air Condition' S tem•
Installation, alteration, or relocation El �9 tng ys
200 amps or less _ $80.30 2
201 amps to 400 amps $108.85 2 ❑ Vacuum Systems'
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 $68.83 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system » ».. » » ». . » » ».»..» $75.00
200 amps or less $88.85 2 (SEE OAR 918-260 -280)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work involved:
Over 600 amps to 1000 volts,
see mob" above. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $48.85
Each additional branch circuit $8.65 ❑ HVAC
Miscellaneous Instrumentation
(Service or feeder not included) ❑
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels (10) $125.00
Each additional Inspection over p Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $82.50
In Plant $73.75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective signaling
Enter total of above fees $ ❑ Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See 'Plan Review' section on $ ' No licenses we required. Licenses we required for all other Installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account /
8% State Surcharge $
All New Commercial Buildings require 2 sets of plans. Total Balance Due $
Bdsts'forms\elc- fees.doc 02/05/02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 - • •
INSPECTIiON DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / l __ i ) AM - PM BUP
Location // e 3c/ S' SC ( ( I G /# �.- �l Suite MEC
Contact Person / Ph ( ) t P' 7y Y U PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner (3Ce g ELC 4,2 G 0 .1//
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: � SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ! /
(7 00 G( V2/) • d4 /Oi) (y PAP'
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall _ /� -
Fire Sprinkler 1P e? Ea r' / C%
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain t,
Shower Pan
Other:
Final \\
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL.
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
• - • larm
Fin D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line ,
ADA
Approach/Sidewalk Date _ jaL -1 62-.-- Inspector
Ins ector fit ir Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL