Permit •
Cliv OF TIGARD ELECTRICAL PERMIT
: ,�,,, q, DEVELOPMENT SERVICES PERMIT #: ELC97 -0768
: - �� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 11 /20/ 97 7
PARCEL: 2S112DD -01600
SITE ADDRESS...: 15495 SW SEQUOIA PKWY #
SUBDIVISION ZONING:I —P
BLOCK • LOT • JURISDICTION: TIG
Project Description: Tenant improvement - AirTouch Cellular
1 - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
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.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 1 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
15115 SW SEQUOIA PKY PRMT $ 40.00 JSD 11/20/97 97- 301104
STE 200 5PCT $ 2.00 JSD 11/20/97 97- 301104
TIGARD OR 97224
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 42.00 TOTAL
PO BOX 230547
REDUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Elect'1 Service
Phone #: 503- 624 -3631 Wall Cover Elect'1 Final
Reg #..: 000750
This permit 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 more than 180 days. ATTENTION: Oregon law requires you to follow he rules adopted by
the Oregon Utility Notification Center. Those rules are set for in OAR 952-001 -0010 through OAR 952- 001 -198 . You may obtain a copy
of these rules or direct questions to OUNC calling (. °'',/1987. '
Permittee Signature: •_ IL/ / Issued By: .-41111111111•
O
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
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
rd
AP
CITY OF TIGARD Electrical Permit Application Plan Check # �,
13125 SW HALL BLVD. Rec'd By //
TIGARD OR 97223 Date Rec'd 0 l''
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 4175 Incomplete or illegible will not be accepted Permit # - p <,�
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
ant A , n ‘1 o c/G t CA( l u 1 h ,..----- . Number of Inspections per permit allowed
Name (or name of business) .1 1 Arvice included: Items Cost Sum
Address /C Y q � Sk.) S - P u n i a Oc, roc 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State/Zip `r C ti-A.4 /L 9.4'ZZ y Each additional 500 sq. ft. or
Commercial 1 El Li Residential portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor lit) i 1/4 .A,. w (-1 -c F e c 1 ' /w - 200 amps or less $60.00 2
Address Po 13, . Z L s '7- 201 amps to 400 amps $80.00 2
City rr S !4 n n State 0./t_ Zip Sy 9 Z� / 401 amps to 600 amps $120.00 2
Phone No. (, z u - 36 T / 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
Job No. 1 /, � Reconnect only $50.00 2
Elec. Cont. Lice. No. . 3 ` I 2S3 Exp.Date /v_i - 9 k
OR State CCB Reg. No. ?-sd y`, Exp.Date g - b I 9 4c. Temporary Services or Feeders
COT Business Tax or Metro No. /5 Exp.Date Q / - SR` Installation, alteration, or relocation
Q 200 amps or less $50.00 2
Signature of Supr. Elec'n 12-- 0 201 amps to 400 amps $75.00 2
2
G / 401 amps to 600 amps $100.00
l (` S - S Over 600 amps to 1000 volts,
License No. Exp.Da /0 - - c e" see "b" above.
Phone No. 6, -2 4 - Z i. "1 r
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 circ $5.00 2 -
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. 3
First branch circuit t $35.00 2
The installation is being made on property I own which is not Each additional branch circuit / $5.00 S~ 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 the above
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:
Not required for temporary construction services. 5a. Enter total of above fees $ 4
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 # ?Z cri
Total balance Due $
t-
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ,{ p G- /0-.3? A.M. P.M. MST:
4
Location: / 5 - 1 . - , /rt l BUP:
Tenant: AI R V (La C-LL L 4 g___- Suite: Bldg: MEC:
Contractor: Vie a4rnatt, Fi0.0.(t' Phone: 5( - 363) PLM: 7
Owner: Phone: n ELC: / -/ - D / -�
�p (�
'�o�fl / / V .Q ( R P I / W c ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL 1 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 /Alm Crawl/Found Dr Heat Pump Low V.
Approved Approved Approved ir Approved
Appr /Sdwlk Not Approved Not Approved Not Approved lot : •..... ed Not Approved
FINAL FINAL FINAL FINAL" FINAL
0 1-44-LeZ..--__-'
'KA - �-�.t; „ „.�.�
ao .......,
O Call for reinspectio . 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: --L-,_.... - . __.....r' Date: 6 /U • goo Page of