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Permit A' CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00196 Wpc DEVELOPMENT SERVICES DATE ISSUED: 4/24/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -01601 SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 SUBDIVISION: ZONING: I -P BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of 7 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: 6 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: PACIFIC REALTY ENDERS ELECTRIC 15350 SW SEQUOIA PKWY PO BOX 1661 TIGARD, OR 97224 BEAVERTON, OR 97075 Phone: 624 -6300 Phone: 626 -4813 Reg #: LIC 00026728 SUP 2028S ELE 34 -265C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 4/24/00 $69.60 1655 Elect'l Final 5PCT DEB 4/24/00 $5.57 1655 (� Total $75.17 0°‘ 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 pl- s` This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTI0 4 • Orego - requires you to follow rules -• = hie Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 througiW•.2- 001 -1080. You may obtain pies of these rule or direct questions to OUNC at (503) 246-1987. 7_`�� • PERMITTEE'S SIGNATURE �y / / �' ISSUED BY: � � �_ _ OWNER INSTALLATION 0 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 SUP . ELEC'N: ` /�QA�_C�- /��'�`" DATE: LICENSE NO: LCOS3 Call 639 -4175 by 7:00pm for an inspection the next business day CITY QF TIGARD Electrical Permit Application Plan Chec `7312 SW HALL BLVD. Rec'd By TIGARD OR 97223 00I '-3 Date Rec'd V Pte° ' Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type L Permit # 7 - Cn 1 9 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) Og oA) 7 UJLf3 Service included: Items Cost Sum NI• Address . . 16 _ S" IP uffi 'KW .Sant CO 4a. Residential - per unit City /State /Zip 773 02 •7721/ 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 2675 1 Commerciale 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). �j Installation, alteration, or relocation Electrical Contractor L �/t1 ?E�$ fir-! - 7 - - 200 amps or less $ 64.25 2 Address P o eo 1 6, 6, ' 201 amps to 400 amps $ 85.50 2 City e ,s , , State Q� ZI l 0 �"" 601 amps to 1000 amps $ 192.50 2 401 amps to 600 amps $ 128.50 2 6t tic " `1" , p Phone No. (6 2 (C, 1 4 1.3 Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 34 -2.6s- C Exp.Date 1' --/ - 0V .4c. Temporary Services or Feeders OR State CCB Reg. No. 24' Exp.Date 1 - / 3 •144 Installation, alteration, or relocation COT Business Tax or etro No. _ Exp.Date 200 amps or less $ 53.50 2 0 5 �+ J� / ' /�/ 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n jeg- 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, � i j r' J see "b" above. License No. � S 1 Exp.Date 1G' 4d. Branch Circuits Phone No. 6 2 G get..? 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 ervice City State Zip or feeder fee. Phone No. First branch cir it . $ 37.50 3P/5Z Each addi • alb circuit $ 5.35 l,© � J r< t The installation is being made on property I own which is not 4e. Miscelldneous 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 panel, alteration or extension $ 60.00 3. Plan Review section (if required): * Minor Labels (10) $ -4134 Please check appropriate item and enter fee in section 5B. 4f., Each additional inspection over /coo() 4 or more residential units in one structure th allowabl in any of the above Service and feeder 225 amps or more Pe ins ec • $ 50.00 P Per h ur $ 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 $ F4/_,07 * Submit 2 sets of plans with application where any of the above apply. ga/go Surcharge (.5 X total 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 $ 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 $ 7✓ ' is \fists \forms \electric.doc • el l 1 7. 05/26/2000 Activities for Case #: ELC2000 -00196 _ 12:54:27 PM Assigned Hold Updated • Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 04/24/2000 DEB DONE No Hold DEB 04/24/2000 ELCC003 Permit created 04/24/2000 DEB DONE No Hold DEB 04/24/2000 ELCC730 Elect'I Service No Hold DEB 04/24/2000 ELCC799 Elect'l Final 05/16/2000 CD PASS No Hold AKJ 05/16/2000 ELCC500 (F)Issue permit 04/24/2000 DEB DONE No Hold DEB 04/24/2000 ELCC720 Wall Cover 04/26/2000 CD PASS No Hold AKJ 04/26/2000 ELCC800 Case Finaled 05/16/2000 AKJ DONE No Hold AKJ 05/16/2000 • Page 1 of 1 CITY OF TIGARD BUILDING DIVISION _ • , MST • 24 -Hour Inspection Line: 639 -4175 Business Line•. 639 -4171 • Date Requested -F(.0 00 AM PM BLD - - Location I Slc S Sig.1 (gip I A______ Suite / V CJ MEC . - Contact Person Y _. Ph gs' ! ZO go PLM Contractor - Ph SWR // BUILDING Tenan t/Owner ELC 2. — 001 9 �tj . Retaining Wall ELR Footing Access: ' Foundation • FPS • Ftg Drain . • SGN Crawl Drain Inspection Notes: • - Slab - SIT . Post & Beam " Ext Sheath /Shea Int Sheath /Shear - Framing . Insulation Drywall Nailing ? Firewall Fire Sprinkler i (.P Fire Alarm . • Susp'd Ceiling - Roof Misc: Final V �) J ' 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 - . . 4 L) PART FAIL " • Rough In , UG /Slab • Low Voltage - - F• - • Iarm .'ASS 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 1 Approach /Sidewalk Other Date /6 - !9 Inspector - � a �X Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.