Permit ' \- CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00031
�1� DEVELOPMENT H O BMEN SERVICES DATE ISSUED: 1/21/00
(503) 639 -4171
PARCEL: 1 S134BC -00500
SITE ADDRESS: 12388 SW SCHOLLS FERRY RD
SUBDIVISION: PP1993 -057 ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Electrical TI
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: 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: -
MCDONALD'S CORPORATION J + J ELECTRIC INC
036/0002 PO BOX.813
•
PO BOX 66207 ALBANY, OR 97321
CHICAGO, IL 60666
Phone: Phone: 541 - 928 -7695
•
Reg #: SUP 3252S
LIC 00000322
ELE 22 -3C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT BON 1/21/00 $37.50 00- 321303 Elect'l Final
5PCT BON 1/21/00 $34.00 00- 321303
Total $71.50 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 I j _ mad 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: G aT l C D DATE:
V
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
,- •
RECEIVED .. #�� 4/
Community Development ELECTRICAL PERMIT APPLICATION
JA 9 2000 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # \ Pr
CO I ' ELOPMENI Permit # L LC7 -(2 l . Iii Phone (503) 639-4171 _ . �y FAX (503) 684 -7297 Date I ssued I - t - 2 .VOO
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by O
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
t
p
Name of Development it r � 7 7 - eve '• . - . Number of Inspections per permit allowed
Address i , b ?S 6, . ,. ) 'v 2,(j Service Included: Items Cost(ea) Sum
City /State /Zip r.d , Of) % 12. 3 4e. Residential - per unit 4
l� 1000 scut or lees $110.00
Name (or name f business) 7Y C 77?4 . ZL 1 E I additional 600 It. or $25 1
Commercial Residential ❑ Limited Envy, $25.00
Each Manurd Homa er Modular 2
Dwelling Service or Feeder 662.00
2a. Contractor installation only: 4b. Services or Feeders
/ Installation, alteration. or relocation 2
Electrical CAntra tor J z.[.GC.) 200 amps or less $80.00 2
Address 0. co x 201 ampe le 400 „np3 $50.00 2
City State C12 Zi 4173.Z/ 401 amps to 200 amps $120.00 2
`1 p 601 amps lo 1000 amps $120.00 2
Phone No. g= 7(oYT Owr 1000amp,orvote $340.00 2 -
Contractors Liclense No. a A -3G ,, - 7- Reconnect only $50. .
Contractor's Board Reg. No '3 al "IJU_. 4c. Temporary Services or Feeders
' Inv. `\ Installation, alteration, or relocation 2
Signature of Sur. Elec n t � , 200 amps or lees $50,00 _ 2
License No. 5 S Phone No all 'x8-74:9.5 201 amps to 400 amps $75.00 2
401 amts to $00 ampe El00.00
IV l 20 Over 800 snips to 1000 volts
2b. For owner insta I lions: ere -b• above.
4d. Branch
Print Owner's Name aeration extension Now, erallon or extensisi
on per panel
Address a) The lam tar branch circuits with
City State Zip purchase of Lemke w /mitt ft. 2
Each branch circuit 65.00
Phone No.
b) The lee for braroh circuits MawwwI
The Installation is being made on property I own which is porches. of service or feeder fee. i 1
not intended for sale, lease or rent. Fest bran h time $95.00 7 ( -
Each additional branch circuit $8.00
Ownef5 Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required):, Each pump or irrigallon circle $40.00 2
Each sign or Outline lighting $40.00
Signal cirwt(e) or a Ilmhod energy 2
Piece, check appropriate item and enter lee in section 5B, panel, alteration or extension $40.00
4 or more residential units in one structure Minor Latlele i10) 5100,00
Service and feeder 225 amps or more
System over 600 volts nominal 41. 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 it peCtan $36.
Per hour $55.00
In Plant 555.00
Submit 2 eels 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 $ 35.05
54'0
a -05.1 Surcharge (.05 X total fee $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 0 Subtotal $ _ 'z W
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, Oil IF
5b. Enter evi 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 0 $
Balance Due $ 3 7trt
raebmnW i pm.rrq1 -� j ] .
2 0
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested I-3 /^ h 0 AM PM BLD
Location / 3 ? g � /? �� �S bY/ . Suite MEC
Contact Person ti y //I / S Ph'4i — 92g-- ' .-- PLM
Contractor J- J i J f . Fh SwR
BUILDING Tenant/Owner ELC WOO — 3(
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 3 - (��J/%1 S /) Y SIT
Slab ,
Post & Beam JJ
Ext Sheath /Shear Y e. 0 — fO/fro.
Int Sheath /Shear
Framing
Insulation
Drywall Nailing / '/ bd VI q l
Firewall
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling t R' �S
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
PAS T FAIL
ELECTRICAL
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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 2
Approach /Sidewalk
Other Date / — 3/ — 'v n Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.