Loading...
Permit • CITY OF T I G A R D DEVELOPMENT SERVICES � ELECTRICAL PERMIT PERMIT #: ELC2000 -00524 ,�� DATE ISSUED: 08/31/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S109DD -06100 SITE ADDRESS: 12730 SW PRINCE ALBERT CT SUBDIVISION: ZONING: BLOCK: LOT : JURISDICTION: KIN Project Description: One branch circuit RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: MCBETH, CARSON ROSE CITY ELECTRIC CO INC 12730 SW PRINCE ALBERT CT 4012 NE CULLY BLVD KING CITY, OR 97224 PORTLAND, OR 97213 Phone: Phone: 287 -6164 Reg #: SUP 2127S LIC 00003567 ELE 26 -113C FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT CTR 08/31/200C $37.50 2720000000( 5PCT CTR 08/31/200C $3.00 2720000000( Total $40.50 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 Q 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 SW HALL BLVD. "RECEIVED Rec'd B li TIGARD OR 97223 Date Rec' Date to P.E. Phone (503) 639 -4171, x304 AUG 2 8 2000 Date to DST Inspection (503) 639 -4175 Print of T UNITy DEVELOPMENT Permit #LaQ!I0 Q75 ,af Fax (503) 598 -1960 Incomplete or illegible will not be accep Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development ■ A , A. Number of Inspections per permit allowed Name (or name of business) I, miff ' ' _ CN Service included: Items Cost Sum Address 1 a 1.; wt) S (,J rl n cu • • I` L per Residential - r unit T Co�.c� OK,. 1000 sq. ft. or less $ 117.75 4 City/State /Zip cJ . �� Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial ❑ 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 contra or license 4b. Services or Feeders information for COT data �+ Installation, alteration, or relocation Electrical Contractor L ( t CJ 200 amps or less $ 64.25 2 Address Q 2. l ■ v ' 201 amps to 400 amps $ 85.50 2 City 1 i , . _. , State Q YL., Zip S jK 401 amps to 600 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. S '7 - ( / 6 oi Over 1000 amps or volts $ 363.75 2 Job No. I 5 6 (1 L • Reconnect only $ 53.50 2 Elec. Cont. Lice. No. _,-.) G- 113 (�Exp.Date 0 ' . t. 4c. Temporary Services or Feeders OR State CCB Reg. No. 3 7 Ex ate /AM 00 Installation, alteration, or relocation COT Business Tax or Metro No. 0000/ xp.Date di/0 i 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 $ 107.00 2 �^ Over 600 amps to 1000 volts, License No. 9- I)- 7 =._ Exp.Date / d Di I� see "b" above. Phone No. 7 - l� J V / 4d. Branch Circuits 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 2 b) The fee for branch circuits Address without purchase of service d City State Zip or feeder fee. / Phone No. First branch circuit f $ 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 described in N.E.C. Chapter 5 . 5. Fees: S 5a. Enter total of above fees $ 3 7 * Submit 2 sets of plans with application where any of the above apply. ubt'� 05 X total fees) $ Not required for temporary construction services. $ 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 $ yo is \dsts \forms \electric.doc AUG -24 - 00 THU 02:57 PM City of King City FAX:503 639 3771 PAGE 2 KING CITY 15300 S.W. 116th Avenue, King City, Oregon 97224 -2693 Phone: (503) 639.4082 • FAX (603) 639.3771 • Notice To Contractors. Working In King City Due town intergovernmental agreement with the City of Tigard, many building related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be returned to King City staff for correction and no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAN .REVIEW, this form must be signed by a King City staff person. King City staff will simply sign this form indicating land use approval. Take this signed form TO the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are available at 6394171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: 4/c-- « - located at:, a'/3o 5&) il,...,,AgTact • • King City Represen tive I DST5XCNST DOC • • AUG -24 - 00 THU 02:57 PM City of King City FAX:503 639 3771 PAGE 1 KING CITY 15.300 S.W. 116th .venue. King City, Oregon 97'14 Phone: 6`39 -40132 • FAX COVER SHEET DATE TO \ �� vL f r �,'1c�.. , AT TN : 1 *) FROM MESSAGE - This transmittal contains. pages, including this Cover Sheet. If you experience any problems, please contact: City of King City (503) 639 -4082 Fax Number (503) 639 -3771 • 9/12/00 Activities for Case #: ELC2000 -00524 10:52:21 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes f ELCA001 Application received 8/28/00 MAIL RECD No Hold JMT 8/31/00 ELCA799 Elect'I Final No Hold JMT 8/31/00 ELCA500 (F) Issue permit 8/31/00 JMT DONE No Hold JMT 8/31/00 ELCA510 (F) Reprint permit 9/11/00 ZZZ DONE No Hold ZZZ 9/11/00 • • • • Page 1 of 1 CI OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 71 MST BUP Date Requested 9 Z— AM PM BLD Location 1 Z 130 f ' Pk/ CA / /6 rf c I " uite MEC Contact Person Ph 7v - 90 9' PLM Contractor k„ C. (17 Ph c2- 62/C, C � SWR BUILDING Tenant/Owner ELC 0Zu ° e - c. ) ° 5 Z 51 Retaining Wall ELR 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 Fire wall i � Fire Sprinkler /' . _ V4 — 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 ASS PART FAIL ELECT Service Rough In UG /Slab Low Voltage ? 1L2..A larm ig - CIWP 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 Date Z Inspector . - EiEt' Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.