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Permit .- CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00526 11t, DEVELOPMENT SERVICES DATE ISSUED: 9/1/00 - I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BC-00900 SITE ADDRESS: 12394 SW SCHOLLS FERRY RD SUBDIVISION: PP1993 -058 ZONING: C -G . BLOCK: LOT : 003 JURISDICTION: TIG Project Description: Installation of temporary service of 200 amps or less for new construction. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: 0 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: 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: DENNIS THOMPSON VIKING ELECTRIC INC 12475 SW MAIN 4326 SE WOODSTOCK TIGARD, OR 97223 STE 518 PORTLAND, OR 97206 Phone: 503 - 781 -0124 Phone: 775 -3479 Reg #: LIC 00056527 SUP 3088S ELE 26 -569C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT CTR 9/1/00 $53.50 2720000000( Elect'I Final 5PCT CTR 9/1/00 $4.28 2720000000( Total $57,78 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 -_ •p - • • • - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain •, lies of these rulesordirect questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE ISS D BY: / ���� , / OWNER INSTALLATION ONLY The installation is being ma• on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTO' LATION ONLY SIGNATURE OF SAM. ELEC'N: %. ):� ( DATE: LICENSE NO:o�V", Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Plan Ch: do # ri f3125tW HALL BLVD. Electrical Permit Application Recd B _ TIGARD OR 97223 Date Recd - �� Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # E'GL'a '05,0 Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: - Name of Development Number of Inspections per permit allowed Name (or name of business a Few 4UT0 iP�PA'ff Service included: Items Cost Sum 4' Address 123 9 f S w ,SC/-IcLL s FFlt4r RD 4a. Residential - per unit City /State/Zip - 1 - /64 - 10 0 Cj -7 2 L 3 1000 sq. ft. or less $ 117.75 4 / / Each additional 500 sq. ft. or portion thereof $ 2615 1 Commercial X 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 contractor license 4b. Services or Feeders information for COT data base). K-111) G A I alteration, or relocation Electrical Contractor I E L rC7 /b ` 200 amps or less $ 64.25 2 Address *3.2 6 S cucoDsmctr ►v) S/ g 201 amps to 400 amps $ 85.50 2 City 0 _ W0 State Zip 9 72. Ob 401 amps to 600 amps $ 128.50 2 Phone No. 0 77 3 ' 7q 601 amps to 1000 amps $ 192.50 2 Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 2 6 - 5'41 C. Exp.Date /0 -/ - et .4c. Temporary Services or Feeders OR State CCB Reg. No. 5 7 Exp.Date 5--/Z _0 Z Installation, alteration, or relocation COT Business Tax or Metro No. l-O 75' Exp Date -/ - Q 200 amps or less / $ 53.50 , 3, 327 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, see "b" above. License No. 30gcs Exp.Date /0-1-0/ 4d. Branch Circuits Phone No. 775' 3 71 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 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 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) $ 4$446 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over eU 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: 5a. Enter total of above fees $ 5 foe * Submit 2 sets of plans with application where any of the above apply. r7 % Surcharge (. tal fees) $ Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ Iibj; 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 $ S7, 70' i:\dsts\forms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 7Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7 , AM PM BLD Location / 2 ..3 5 — w -5ci /43- ^ / 7 A Suite MEC Contact Person i Ph , 319 6 4 PLM Contractor V i lC r ni G E 7� e_.A..L, Ph SWR BUILDING Tenant/Owner ELC ZCvv- aU 52 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 Firewall ic:: Fire Sprinkler -ef Fire Alarm Susp'd Ceiling Roof Misc: Final � o PASS PART FAIL �L ez— PLUMBING i Post & Beam Under Slab 6- Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final P SS _ E RT FAIL _XLECTRICJ.> Service .4,„,, Rough In UG /Slab Low Voltage Fire Alarm F ' AS PART FAIL S E 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 reinsp ction RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.