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Permit CITY TIGARD ELECTRICAL PERMIT Alk‘ PERMIT #: ELC1999 -00336 _AVIV DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: 6/7/99 PARCEL: 2S113AB-00300 SITE ADDRESS: 16075 SW UPPER BOONES FERRYRD SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L BLOCK: • LOT : 036 JURISDICTION: TIG Project Description: Electrical TI 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: 1 W /SERVICE OR FEEDER: 10 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: NORTHWEST LANDSCAPING INC WILLAMETTE ELECTRIC INC 16075 SW UPPER BOONES FERRY RD PO BOX 230547 TIGARD, OR 97224 TIGARD, OR 97281 Phone: Phone: 624 - 3631 Reg #: LIC 000750 SUP 1965S ELE 34 -283C FEES Required Inspections Type By Date Amount Receipt Elect! Service PRMT CTR 6/7/99 $117.75 99- 315924 Elect I Final 5PCT CTR 6/7/99 $5.89 99- 315924 Total $123.64 ORIGINAL 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 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 -1987. Permit Signature: nn Issued By: n e (WV IA 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: (�Y . k -, DATE: • LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day RECEIVED CITY Of TIGARD lectrical Permit Application Plan Chec 19125 SW HALL BLVD. JUN 0 3 1 99U Recd By TIGARD OR 97223 Date Recd /0-- � - Phone (503) 639-4171, x3 COMMUNITY DEVELOPMENT Date to P.E. ( ) Date to DST Inspection (503) 639 -4175 Print or Type Permit # �C 1 -- (163SLt Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development • L / Number of Inspections per permit allowed Name (or name of business) Ak,... rAwesT ck crlr(ff /n,oiu / Service included: Items Cost Sum I Address / 16 IS S J (Or"- 1147 A/el ' ,Z .r,c y /(- 4a. Residential - per unit 1000 sq ft. or less $110.00 4 City /State/Zip rips Q n 0./v 91 Z Z y Each additional 500 sq. ft. or Commercial g J Residential ❑ 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 Li _Z 5 Electrical Contractor 13 , /( rf. tit c gee 74#c /ti L Installation, alteration, or relocation /� A 23!/ Sy 200 amps or less _L $60.00 2 Address PQ C 201 amps to 400 amps $80.00 2 City 7 , S n n State _o.".. Zip 9 Z6 / 401 amps to 600 amps $120.00 2 Phone No. `i 2J/ - 36 3 ( 601 amps to 1000 amps $180.00 2 Job No. SS-3 Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. 1 'V - 2..$3 C Exp.Date /O - 7 OR State CCB Reg. No. -1s6 S Exp.Date fr 9 4c. Temporary Services or Feeders COT Business Tax or Metro No. / S y 6 E p. Date 8-/ `Y 9 Installation, alteration, or relocation 200 amps or less $50.00 2 Signature of Supr. Elec'n p r 201 amps to 400 am $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No M c- 5 Exp.Date i6-/ - Q / see "b" above. Phone No 67 ' i ' ?/ 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or 7-j, Print Owner's Name feeder fee. Address Each branch circuit /0 $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 $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 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: I Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ _S�� 5 ' 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 # 4 Total balance Due $ nip ' I: \DSTS \ELC96 APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 241.Hour Inspection Line: 639 -4175 Business Line: 639 -4171 I_ QQ BUP Date Requested (o - (O' C -/ AM PM BLD Location cp01 S ft;iry iv) Suite MEC Contact Person (,tl�I h (Q24 ' D?) ( PLM Contractor Ph SWR '/ nMr� BUILDING Tenant/Owner ELC � qg 9 —t3 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 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 Final P RT FAIL ECTRI Service Rough In UG /Slab Low Voltage F' - • larm PASS PART FAIL SIT 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 D ! 2 — VY Inspector /� : xt Other P - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.