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Permit 7 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00361 A l;ti 1 DEVELOPMENT SERVICES DATE ISSUED: 06/27/2000 .,� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133AD-02200 SITE ADDRESS: 12930 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: R -7 BLOCK: LOT : JURISDICTION: TIG Project Description: 4 Branch Circuits 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: WESTGATE BAPTIST CHURCH JPC ELECTRIC 12930 SW SCHOLLS FERRY RD PO BOX 905 TIGARD, OR 97223 BEAVERCREEK, OR 97004 Phone: Phone: 503 - 632 -8138 Reg #: ELE 3 -424C LIC 136798 SUP 4181S FEES Required Inspections Type By Date Amount Receipt Rough - in PRMT JMT 06/27/200C $53.55 0003301 5PCT JMT 06/27/200C $4.28 0003301 Total $57.83 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 / / 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 'f CITY Plan Check # 13125 SW HALL BLVD. Electrical Permit Application Rec'd By 1� � RECEIVED Date Rec'd TIGARD OR 97223 Date to P E Phone (503) 639 -4171, x304 JUN 2 6 2000 Date to DST Inspection (503) 639 -4175 Print of Typ M�� 0 0 3 ( 0 1 Fax (503) 598 - 1960 Incomplete or illegible will notbelacaMENT Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development DuffOr, Relnnvclel i n C Number of Inspections per permit allowed Name (or name of business) W esi5cde. 64015t tA Service included: Items Cost Sum Address 1 2_q 30 S W GhcD((S 1er rki R d . 4a. Residential - per unit City/State /Zip Tiia rd OR. ci "122 3 1000 sq ft or less $ 117 75 4 Each additional 500 sq ft. or portion thereof $ 2615 1 Commercial tg 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). Installation, alteration, or relocation Electrical Contractor t PL E I ec. -ri c. 200 amps or less $ 64 25 2 Address P(7 Is.)( 9c5 201 amps to 400 amps $ 85.50 2 2 _ 401 amps to 600 amps $ 128.50 2 City ]" 7 �F2lVer'crC State CDP� Zip C170C4 601 amps to 1000 amps $ 192.50 2 Phone No. a.32_-5I 38 Over 1000 amps or volts $ 363.75 2 Job No. 13(,F C) Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 3 -424E Exp.Date i 011100 4c. Temporary Services or Feeders OR State CCB Reg. No. 13 lerIge Exp.Date 2_3 O I Installation, alteration, or relocation COT Business Tax or Metro No. 54037 Exp.Date 10 I B 200 amps or less $ 53.50 2 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 License No. 41 P I Exp.Date Over 600 amps to 1000 volts, see "b" above. 4d. Branch Circuits Phone No. Co - 81 3 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 I $ 37.50 3 ?.5O Each additional branch circuit 3 $ 5 35 I Co sO$ 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 imgation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42 75 Signal circuit(s) or a limited energy (if required):* panL alteration or extension $ 60.00 3. Plan Review section ( Minor Labels (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: 5a. Enter total of above fees $ 3.,S * Submit 2 sets of plans with application where any of the above apply. g llv r o Surcharge ( 05-X total fees) $ •,�` Not required for temporary construction services. ubtotal .0 g $ C 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 $ 57.53 i• \dsts \lorms \cicctnc doc CITY OF TLGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 —� • INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested � AM PM BUP Location _ v . _ _�.�� !i 2 _ Suite MEC Contact Person 6- Ph ( / ) yd 7 " /( 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC - l Footing ELC Foundation g Access: Ft P, 3 \ " l 0 3 ELR Drain � ... Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof V Other: f Final PASS PART FAIL PLUMBING 14l Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other:. Final PASS RT FAIL MECHANI L Post & Beam Rough -In Gas Line Smoke Dampe Final P _ PAP AIL ELECTRICAL Rough -In UG/Slab Low Voltage Fire Alarm ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. �% PART FAIL SI ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk D,.5 7` ® Inspect Ext Other: Final DO NOT REMOVE this Inspection record f m the Job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 r BUP Date Requested � 7 ! D AM PM BLD Location _ C !_ i�,,' — / A.. . LI Suite MEC Contact Person - ,Q. � Ph? Q� Z �I PLM v �s Ph c)7_ - SWR Contractor I BUILDING Tenant/Owner A i ii,,, L-A ELC c 9. 00C) Of)3Ce/ Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: l L Slab � � E l e C T C' a—• SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear • • Framing Insulation Drywall Nailing Firewall Fire Sprinkler /f/ /2019 Fire Alarm Susp'd Ceiling /4 .I, w /t C / / -dr! 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 PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm •S PAR Cr SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Other Date � Inspector c�C Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.