Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00382
s �l- �� , DEVELOPMENT SERVICES DATE ISSUED: 07/27/2001
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101DD -00100
SITE ADDRESS: 07000 SW SANDBURG ST
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: (1) branch circuit to truck dock. Job #21 -977
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 HMI SVC/ FDR: 6014-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:
PAPE' PROPERTIES + CAPITOL ELECTRIC CO INC
PAPE', TERRANCE/TOOKE, DIAN + 12810 NE AIRPORT WAY
PAPE', SHIRLEY N UNIT 1
EUGENE, OR 97440 PORTLAND, OR 97230
Phone: Phone: 255 -9488
Reg #: LIC 048748
SUP 3132S
ELE 26 -496C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 07/27/2001 $46.85 2720010000( Wall Cover EXPIRED
Elect'I Final
5PCT CTR 07/27/2001 $3.75 2720010000(
Total $50.60
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 -6699 or 1 -800- 332 -2344.
Permit Signature: Issued By: Q
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• yfi Ze-eATL-R DATE:
LICENSE NO: W /06
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit A lication OFFICE USE ONLY
44 �.� Date received: MTh Permit no.: j /� ,� /i 5,-,11
Project/appl. no.: Expire date:
- d i City of Tigard W REC EIVED Date issued: ; Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BL I, ARD, OR 97223 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960 c, r7 70 1
Land use approval: JUL (' I
'QM (WMEP''
TYPE OF mom
❑ I & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement
o _ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 7000 SW SANDBERG ST. City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name: DOCK LEVELE (Description and location of work on premises: TRUCK DOCK
Estimated date of completion/inspection:
Job no: 21 -977 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. Insp
Address: 12810 NE Airport Way New residential - single or multi - family per
City: Portland State: OR ZIP: 97230 -1029 dwelling unit. Includes attached garage.
Phone: 503 - 255 - 9488 IFax: 255 - 9488 1E darrell(ojcepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 26 - 496C 1000 sq, ft, or less $ 145.15 4
City/metro lic.no.: �1 /A Each additional 500 sq. ft. or portion thereof $ 33.40
e j'� �� 7/26/01 Limited energy residential $ 75.00 2
Signature of supervising electrician (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print): Richard Martin License no.: 2865-S Each manufactured home or modular dwelling
PROPERTY OWN ER Service and/or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: I State: /ZIP: 200 amps or less $ 80.30 2
Phone: Fax: IE -mail: 201 amps to 400 amps $ 106.85 2
Owner installation: The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 1
ENGINEER Temporary services or feeders - ,
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps S 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps 5 133.75 2
/'LAN REV IE\\' (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
Cl Service over 320 amps- rating of 1 &2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: 1 5 46.85 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress/lighting plan ❑ Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle 5 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting S 53.40 2
Signal circuit(s) or a iimited energy panel,
EXPIRED 'Des r i ptio rextension' $ 75.00 2
'Description:
Each additional inspectionover th allowable in any of the above:
Per inspection I 15 62.50 1 I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 46.85
Credit card number: / / Notice: this permit application Plan review ( ) $
Exp1Ls expires if a permit is not obtained State Surcharge 8% ) $ 3.75
Name of cardholder as shown on credit card withing 180 days after it has been
$ TOTAL $ 50.60
Cardholder signature Amount accepted as complete.