Permit -fir- -�
CITY OF TIGARD ELECTRICAL PERMIT
ut� DEVELOPMENT SERVICES PERMIT #: ELC98 -0544
�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE I SSUED : 09/14/98
PARCEL: 2S 1 1 2DD-0 1 600
SITE ADDRESS. . . : 1 5495 SW SEQUOIA PKWY #100
SUBDIVISION • ZONING:I —P
BLOCK • LOT ° JURISDICTION: TIG
Pro ect Descript : Alteration to electrical service.
- -- 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: 2 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 - - --
BACHOFNER ELECTRIC, INC type amount by date recpt
55 SE MAIN PRMT $ 45.00 DLH 09/14/98 98- 309105
PORTLAND OR 97214 SPCT $ 2.25 DLH 09/14/98 98- 309105
Phone #:
Contractor:
BACHOFNER ELECTRIC INC $ 47.25 TOTAL
55 SE MAIN
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'1 Service
Phone #: 233 -2006 Wall Cover Elect'1 Final
Reg #. : 000445
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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- ' through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Perm ittee Signature: // / /L61. I ssued By: ir/ /A)�;�/
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 : -' "nL L e'9 -7 70 A/ DATE : `/ / %/9
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD ElecttliffilEWnit Application Plan Check #
13125 SW HALL BLVD. Rec'd By .2:,4-ft
TIGARD OR 97223 SEP 1 , Date Rec'd 5//y/9f
Date to P.E. ,
Phone (503) 639 -4171, x304
C��nMUr:11 6�:,� I p � Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accept d Permit # AZ d 98
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Honeywell Service included: Items Cost Sum
I
Address 1 5 4 9 5 SW Sequoia Prkwy /r 1 CD 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State/Zip T i g rd Ore 9 7 2 2 4 Each additional 500 sq. ft. or
Commercial ® Residential 1=1 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
Electrical Contractor Bachofner Electric,Inc: Installation, alteration, or relocation
5 5 S E Main 200 amps or less $60.00 2
Address 201 amps to 400 amps $80.00 2
City P f d State Orc Zip 9 7 21 4 401 amps to 600 amps $120.00 2
Phone No. 213- 7 0 (l 6 601 amps to 1000 amps $180.00 2
Job No. 71 S 7 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 2 6- 4 51 C Exp.Date 1 Q / 1 / 9 8 ✓ Reconnect only $50.00 2
OR State CCB Reg. No. 44569 Exp.Date 3 / 6 / 9 5 1/ 4c. Temporary Services or Feeders
COT Business Tax or Metro No. •.Date Installation, alteration, or relocation
7 200 amps or less $50.00 2
Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
/
Over 600 amps to 1000 volts,
License No 2 8 0 8 S Exp.Date 1 0 / 1 / 9 8 ✓ see "b" above.
Phone Nc. 23 1-2(10 6 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
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee.
First branch circuit 1 $35.00 35.00 2
The installation is being made on property I own which is not Each additional branch circuit _2. $5.00 10.00 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 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. S. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 45.00
5% Surcharge (.05 X total fees) $ 7_75
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 # 47.25
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
03, BUP
7 Date Reque � AM PM BLD
7'
Lo ation / _ �.. /L/ i Gl �- -le w�/ MEC
Contact Person / P / / PLM
Contractor _ % �! �/ Ph ° - 33 0
BUILDING Tenant/ ca ner genay9 �
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 / ��, / .oi.. L , . � / -
Firewall / -
Fire Sprinkler -- _ .' _ _ — /
1110 t
_ .•i /:
Fire Alarm /
R Ceiling
Roof
Misc: fie--'/..---a
Final
PASS PART FAIL O ��
PLUMBING _�" J
Post & Beam .43....94 G
Under Slab
Top Out
Water Service
0
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P FAIL
ECTRICA
Service
Rough In
UG /Slab
Low Voltage
F• - ' larm
i lar PART FAIL
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
Appr Date
oach /Sidewalk // 3 -- 9? Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.