Permit A1 0 �, CITY OF TIGARD ELECTRICAL PERMIT
., , DEVELOPMENT SERVICES PERMIT #: ELC98 -0235
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05 / 07 / 98
PARCEL: 25112DA -00800
SITE ADDRESS...:15115 SW SEQUOIA PKWY #100
SUBDIVISION ZONING:I —P
BLOCK • LOT • JURISDICTION: TIG
Project Description: Hewlett- Packard tenant space
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL : 1
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp : 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
PACTRUST type amount by date recpt
15350 SW SEQUOIA PKWY STE 300 PRMT $ 40.00 JSD 05/07/98 98- 305579
TIGARD OR 97224 5PCT $ 2.00 JSD 05/07/98 98- 305579
Phone #:
Contractor:
ALLEN /FALK INC $ 42.00 TOTAL
9020 SW GEMINI
REQUIRED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect'1 Service
Phone #: 646 -0533 Wall Cover Elect'1 Final
Reg #..: 47238
This peruit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 sore than 180 da . ATTENTION: Oregon law requires you to fol W the rules adopted by
the Oregon Utility Notification Center. Those rules are set f. th in OAR 952- 001 -0010 through OAR 952-001- 7. You lay obtain a copy
of these rules or direct questions to OK by cal ing (503)2. 1987.
Avidir
Permittee Signature: di ' Issued : i
4••
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 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OP TIGARD Electrical Permit Application Plan Chi )
13125 SW HALL BLVD. RECEIVED Recd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 M, i Y 0 7 1998 Print or Type Date to DST /
Inspection (503) 639 -4175 � IIt �InCOm lete or illegible will not be accepted Permit# � LC 9 g Fax (503) 684 -7297 co ,:1,, <ITY e -•�_�' •:�,Q 9 Called 0
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) ii fr • " 1241 Service included: Items Cost Sum
Address 1 , J l i .t 5 .0,) �V " 4a. Residential - per unit
City/State/Zip ` /I 0 I Each additional it or less $110.00 4
Each additional 500 sq. ft. or
Commercial Residential El Limited thereof $25.00 1
Limitetd Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all urrent licenses 4b. Services or Feeders
Electrical C • tractor 1., • ■ Installation, alteration, or relocation
r �� 200 amps or less $60.00 2
Addr 0 G il r -. //_ .i 2 01 amps to 400 amps $80.00 2
City a• :,, 2 'a pia State 61C. ' Zip I -I � 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. , ',J)S0. xp.Date 16 S Reconnect onl $50.00 2
OR State CCB Reg. No. Mgr Exp.Date IkE . 4c. Temporary Services or Feeders
COT Business Tax or Metro No. - Exp.Date J Installation, alteration, or relocation
200 amps or less $50.00 2
-
201 amps to 400 amps $75.00
Signature of Supr. Elec'n �, . 401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No. 0 t' Ex
Phone No. (p to D to /0/9y see "b" above.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
•
3. Plan Review section (if required):* Signal circuit(s) or a limited energy / .�
panel, alteration or extension [ $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the4bove
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 0
Not required for temporary construction services. 5a. Enter total of above fees $ -+
5% Surcharge (.05 X total fees) $
NOTICE • Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # /2_,
$
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
CiluzA ELe 9 - egz-c)
•
CITY OF TIGARD BUILDING INSPECTION DIVISION C t' . -
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 5iyela
Date Requested: A.M. P.M. MST:
Location: _1511_,../____14g ,( L , �� _(J BUP:
Tenant: / Suite: B / / MEC:
Contractor: I;,Jt� / c . Phone: PLM:
Owner. Phone: ELC: TO i,
ELR:
IT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRIC SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved f ro ed Approved
Appr /Sdwlk Not Approved Not Approved Not Approved oved Not Approved
FINAL FINAL FINAL FINAL FINAL
dcZ,,44 --e.c.0 — P.6
r / 9 / I J
c -Ple, d. farc tanithtai?rdi.
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: 'i 0 Page of