Permit ELECTRICAL PERMIT
CITY OF TIGARD ELECTRICAL
ELC2001 -00142
A DEVELOPMENT SERVICES DATE ISSUED: 3/12/01
`�" 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01403
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Wire transformers for alarm panels on first and second floors
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: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amplvolt: . > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TICE ELECTRIC
PO BOX 15009
2139 SE BELMONT ST
PORTLAND, OR 97293 -5009
Phone: Phone: 233 -8801
Reg #: LIC 00000166
SUP 2586S
PLM 2586s
ELE 26 -126C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT CTR 3/12/01 $53.50 2720010000( Wall Cover
5PCT CTR 3/12/01 $4.28 2720010000( Elect'I Service
Elect'l Final
Total $57.78
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.
PERMITTEE'S SIGNATURE 0 j ISSUED BY:
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 7:00pm for an inspection the next business day
03/08/2001 11:25 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 01
mt.
yy,
Electrical Permit Application
• Datetoceived: Permit na: f rQ Iy2-
7.4.1 --- 1 111'
1 -- .ii1 City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard. OR 97223 Date issued: -. 0) - 1 Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
IVPF. OF P110111
0 1 & 2 family dwelling or accessory OCCommercial/industrial 0 Multi- family 0 Tenant improvement
O New construction OCAdditiodalteration/replacement Q Other: ❑ Partial •
JOB SITE INFUltn1ATION •
Job address: 9300 SW W - 'S•t .,. •t _ o - ; . Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: •
Project name: eier & Frank, I Description and location of work on premises: ]ell P F nefrvrmor fnr
Es1imatted.fate of completion/ins lion: • - ,Aleirrn
Job no: 99.4882 • Fee Max •
pesa4ption Qty. (es) Mahal ao. hasp
Business name: Ti ce 11 �'Crric Da Newtreddeattal -single or multi -famly per
Address: PO Box 15009 dwelling unit Includes attached garage.
City: Portland I State:(lR I Z -5Qf)q , Serviccinctadestc
1000 sq. R or less 4
Pholt603 -233 -8801 I F�503- 872 -8 ail: Each additional 500 sq. ft. or portion thereof
CCB no.: 1.66 • LFslec bus. lie: no: 26 --126C 1,imitrd resident; sl 2
• City / trolie. no.: 2014 Limilydenergy, nun- rrsidentlal 2
�yL, Each manufactured home or modular dwelling
Si e oftaupervIsing eleetricia/ (required) Date Service and/or feeder 2
,elect-name rut Joh / / / / J . M Llcen 25865 alteration or relocation:
200 amps or less 2
Name (print): Was 201 amps to 400 amps 2
Washington � J 401 amps to 600 amps • . 2
Mailing address: 601 amps to 1000 amps 2
City: [Stare: I ZIP: .. Over 1000 amts or volts 2
Phone: ------ IFax: . . I F-mail: Reconnect only _ I
Owner installation: The installation is being made on property I own Temporary services or feeders . :.2.
hotallanon, alterative, orrelocetlon:
which is nor intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: _ . A. Fez for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
Stale: ZIP- B. Foe for bmoch circuits without purchase
City: of service or feeder fee, first branch circuit: 1 2
Phone: Fax: E -mail: Each additional branch circuit 1
PLAN REVIEW (l'lea+c chrtk all that apple) Misc. (Service or feeder not lncluded):
• Hea lth -care facility O Service over 225 ampstommeraial y Each pump or irrigation circle 1 Each sign or outline lighting 2
O Service over 320 ampsiating of 1022 0 Hazardous location ' Signal c n or outline
or a limited en ergy panel.
familydweilings • 0 Building over 10.000 square feet four or g
O System over 600 volts nominal more residential units in one structure alteration. or extension* - 2
O Building over three statics O Feeders, 400 amps or more _ *Description:
O Occupant load over 99 persons 0 Manufactured structures w RV park Each additional Inspection over the allowable In any of the above
O Egress/lighdngplan 0 Other. • Per inspection I I 1 -1 ..
Submit _ sets of plans with any of the above. Investigation lee
The above are not applicable to temporary construction service. Other
Permit fee $ 53.50
.N all Judeliedans accept credit cards. please call jurisdiction far erase inrannarl . Notice: This permit application Plan review (at 9f,) $
O Visa 0 MasterCard • expires if a permit is not obtained
/ / within 180 days after it has been State surcharge (8%) ,..• S 4.28
creel) and number - s coml 57 _78 '
afp►roa TOTAL $
accep ap,
Name of audboide>r as abowo on credit card s Trust Acct 166
Cudh dy asimigte Amount 4104613 t6AtucOM)
03/08/2001 11:27 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 01
9 300 Sw Wash Sq Rd Contractor: Tice Electric CO EleeArical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee._.. _ .... .... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total l Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. R. or
portion thereof $93.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manned Home or Modular
Dwelling Service or Feeder $90,90 2 ❑ Garage Door Opener
Services or Feeders p Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less 580.30 2 n Vacuum Systems'
201 amps to 400 amps $106.85 - 2
401 amps to 600 amps 5160.60 2 11 601 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
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 -260 -260)
401 amps to 600 amps 5133.75 2 ..
Over 600 amps to 1000 volts, Check Type of Work Involved;
see "b" above. '
Branch Circuits ❑ Audio and Stereo Systems
New. alteration or extension per panel
El Boiler Controls
e) The fee for branch circuits
with purchase of service or
feeder fee. [l Clock Systems •
• Each branch circuit $6.65 2
b) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of Service
or feeder fen. 1 46.85 ❑ Fire Alarm Installation. •
First branch circuit 546.85
Each additional branch circuit j $6.65 6.65 ❑ HVAC
Miacellaneous
(Service or feeder not Included) ❑ Instrumentation
Each pump or Irrigation circle $53.40
Each sign or outline righting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel. alteration or extension $75.00
Minor Labels (10) $125.00 _ Landscape Irrigation Control'
Each additional inspection over ❑ Medical
the allowable In any of the above
Per inspection $62.50 0 Nurse Calls
Per hour _ $62.50 _
In Plant $73.75 ❑
Outdoor Landscape Lighting"
•
Fees: •
❑ Protective Signaling
• Enter total of above fees $
53.50
❑ Other
8% State Surcharge $
-4.28
25% Plan Review Fee Number of Systems
See - Plan Review' section on 5
front of application. ` No licenses are required, Licenses are required for all other Installations
Total Balance Due $ 57.78 Fees:
> Enter total of above fees $
® trust Account fit 166
8% State Surcharge $
Total Balance Due $
i:'dsts' orrnssolc- fccs.doc 10/09/00 '
/GLj4
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3 -/ / AM PM BLD
Location 9 ,3 4 1 0 5 C ''- 4 S /e Suite MEC
Contact Person � ►'✓ .Sa 3 Z 3 3 8 g
Co r!f �y �, •E- �✓ Ph ( PLM
Contractor '774 G 6 Ph /0/ SWR
BUILDING Tenant/Owner ELC .20U /
Retaining W all ELR
Footing Access:
Foundation q FPS
Ftg Drain are_ YGa4 s JCo.L I /c'Y''r SGN
Slab
Crawl Drain Inspection Notes: �— 75/
d SIT Qi/1-�-.,. _
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing C4
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
OK- "� Misc:
Final
PASS PART FAIL
PLUMBING
Post Beam
Undder r Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains ` C
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ECT
Rough In
UG /Slab
Low Voltage
Fire Alarm
ASS ART
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
Other Date /, O7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.