Permit ELECTRICAL PERMIT
C ITY OF TIGARD PERMIT #: ELC2001 -00371
�1�fj. DEVELOPMENT SERVICES DATE ISSUED: 07/23/2001
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113B0 -00300
SITE ADDRESS: 08048 SW SHAFFER LN NEW DURHAM
SUBDIVISION: BOREI M ELEMENTARY SCHOOL ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (3) receptacles in garden.
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: 2 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:
SCHOOL DISTRICT NO 23J ATLAS ELECTRICAL CONTRACTORS
13137 SW PACIFIC HWY 4403 SE ROETHE RD
TIGARD, OR 97123 MILWAUKIE, OR 97267
Phone: Phone: 659 -2212
Reg #: SUP 2581S
LIC 1532
ELE 3 -2C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 07/23/2001 $60.15 2720010000( Elect'I Final
5PCT CTR 07/23/2001 $4.81 2720010000(
Total $64.96
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 -6699 or 1 -800- 332 -2344.
Permit Signature: Issued By: ��p elk
C;t�� l CPt� / try? Issued
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: G' - x.( - Z 1IY1 DATE: _
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
RECEEAIED
.. • Electrical Pern 10 on
Datereceived: 7 20 10 i Permit no.: I:4 rte/ —
„Ail, `��'I'�' City of Tigard t '
s - .7 ProjecUappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigar .0 ', ' Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 121 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 8048 SW _Schafer Lane SicIlifif( Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: Durham Elementary 'Description and location of work on premises: Provide (3) receptacles in gars en.
Estimated date of completion/inspection:
' CONTRAC "hOIZ APPLICATION FEE SCIIEDLLE
Job no: 8819 Fee Max
Description Qty. (ea) Total no.insp
Business name: Atlas Electrical Contractors, Tnc. _
Address: 4403 SE Roethe Road . dwelling unilnclt�attachedgarage�
t per
City: Milwaukie I State: OR I ZIP:97267 Service included:
Phone: 659 -2212 I Fax: � 59 -4944I E -mail: 1000 sq. ft. or less 4
CCB no.: 1532 Elec. bus. lic. no: 3_2C Each additional 500 sq. ft. or portion thereof •
Limited energy, residential 2
City /me o lic. no.: 24 Limited energy, non- residential 2
-
N[" ` i ' /(J/a.*i1 7/17/01 Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): L eonard H Warnke Li no. Services orfeeders - installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 am 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - . .
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 201 amps to 400 amps 2
Owner's signature: - Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
- or extension p:r panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: r $46. 35 2
Phone: Fax: E -mail: Each additional branch circuit: -
S13. 3()
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not Included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension' 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or 1W park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other. Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 60 . 1 S
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
• Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 4 81
Expires accepted as complete. TOTAL $ 64 .96
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Fees: .
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `, - Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manuf'd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $90.90 • 2
Services or Feeders n Heating, Ventilation and Air Conditioning System"
Installation, alteration, or relocation
200 amps or less $80.30 2 ❑ Vacuum Systems
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 _ 2
601 amps to 1000 amps _ $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2 .
Reconnect only $66:85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918-260 -260)
201 amps to 400 amps $100.30 2 -
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ri Audio and Stereo Systems
•
' Branch Circuits El Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign outline lighting $53.40
Signal circuit(s) or a limited energy El panel, alteration or extension $75.00 Landscape Irrigation Control
Minor Labels (10) • $125.00
El Medical
Each additional inspection over
the allowable in any of the above Nurse Calls •
Per inspection $62.50
Per hour '$62.50
In Plant $73.75 . ❑ Outdoor Landscape Lighting
•
Fees: ❑ Protective Signaling
Enter total of above fees $ I I Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
,
front of application.
- Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
•
i:',dsts\fomu\elc- fees.doc 10 /09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested I AM PM BLD
Location 0 g Suite MEC
Contact Person Ph PLM
Contractor Ph S j— Z 2.1 Z SWR
BUILDING Tenant/Owner � _ _ 4J „` ELC r 003 '7
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 `� e c e fro /o C, l / e
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final O /�
lo C7 y
P ASS 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
- o g 1I
U Slab
Low Voltage
Fire Alarm
41110 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
Approach /Sidewalk It E / other D F Inspector ��, �. , �_ /i L Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP ,
Date Requested ? —/ a_._ AM PM 13LD
Location g b l u ,9/ Suite MEC
Contact Person Ph PLM
Contractor Ph ' S c7-- Z, SWR
BUILDING Tenant/Owner II • J _l . �„ - -, ELC c -O / -� �j 7/
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
Firewall
Fire Sprinkler
Fire Alarm / Q.
Susp'd Ceiling � � Y� ✓ �
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 tek
PASS PAR FAIL
AL
Service
�—Reag
UG /Slab
Low Voltage
Fire Alarm
PASS PART FAIL
SITE
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
Approach /Sidewalk
Date 2 —0 Ins ector a A
Other D P i / = Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.