Permit -- CITY OF T E LECTRICA E
ERMIT #: L PERMIT
O419
^ . 1 �� DEVELOPMENT SERVICES DATE ISSUED: 07 /24/98
.10 Imfr ''n- 13125 PARCEL: 1S126C0 -01107
SITE ADDRESS...:O9469 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING:C -G
BLOCK • LOT . JURISDICTION: TIG
Project Description : Installation of sign lighting
- -- 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..: 1
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.: 0 PER HOUR • 0
401 - 600 amp ° 0 EA ADD'L BRNCH CIRC: 0 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
HEALTH HAUS type amount by date recpt
9469 SW WASHINGTON SO PRMT $ 40.00 DEB 07/24/98 98- 307652
TIGARD OR 97223 5PCT $ 2.00 DEB 07/24/98 98- 307652
Phone #:
Contractor:
HEIL ELECTRIC CO $ 42.00 TOTAL
8425 SE STARK ST
REQUIRED INSPECTIONS
PORTRLAND OR 97216 Ceiling Cover Elect'l Service
Phone #: 255 -4074 Wall Cover Elect'l Final
Reg #..: 000003
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- 801 -0010 throu h OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by callin (503)246 -1987.
e� lln
Permittee Signature: .")..U..a.a'lAB 40 Issued B : .G404....Mbak
OWNER INSTALLATION ONLY
The installation is being made on property II own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY /
SIGNATURE OF SUPR. ELEC' N : ,, u) ,..,do i1 �X C8-t'' 8 DATE : 7 -a'f
LICENSE NO: fl
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development EL TRICAL PERMIT APPLICATION
ahlo 13125 SW Hall Blvd. s� °r�
Tigard, OR 97223 Permit #
'd., Date I EL 9 0 /i9
ued 7-94 t(S
� �I' Phone (503) 639 -4171
FAX (503) 684 -7297 1)
CITY OF TIGARD '
T DD No. (503) 684 -2772
Inspection (503) 639 -4175 , . , . . .
1. Job Address: 4. Complete Fee Sched Below:
Name of Development l 1 1 (� Number of Inspections per permit allowed
Address 99 � /.q0) S, h /. INKS t+� n h i3S ? D * � l� Service included: Items Cost(ea) Sum
City /State /Zip �l BSc, .-e,„( C 4a. Residential - per unit
L 1000 sq ft. or less $110 00 4
Name (or name of business) 1 t. (�e�rt t1 n 4 ►as 5N10,-.Q.. Each additional 500 sq. ft. or
portion thereof $25.00
Commercial Residential El Limited Energy $2500 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
. 1���� Installation, alteration, or relocation
Electrical Contractor e i v 200 amps or less $60 00 2
Address , Li.. 6 S • y 201 amps to 400 amps $80.00 2
Cit 1 . . w,� State ON Zip `j)�]k- 401 amps to 600 amps $120.00 2
y p 601 amps to 1000 amps $180.00 2
Phone No. ASS- go2N Over 1000 amps or $340.00 2
volts - $50.00 2
Job NO. X3/.,6 Reconnect only
contractor's license NO. ,, -6 b C/ 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 3 7 . Installation, alteration, or relocation
Signature of Supr. Elec'n 6 1, ) L 200 amps or less 2
License No. k )O S one No. 55 -L/09Y 201 amps to 400 amps $so 00 2
401 amps to 600 amps $75 00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5 00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
Fac a
not intended for sale, lease or rent. t ddch ar $35 00
Each additional l b branch cvcult $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or imgation circle $40.00 / 2
Each sign or outline lighting J $40.00 aio
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40 00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35 00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees 10•
-
$ `
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 9 Z.
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordcomdeaelec• ❑ Trust Account #
prm app
Balance Due } )a (PJ
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (� AM PM BLD
Location ! �7' ( � c' �-- `l Q• /� D • Suite MEC
Contact Person Ph PLM
Contractor L � i� Ph 7. 5- <101 4 7 1 SWR G �1
BUILDING Tenant/Owner (1- ELC F0 ( l
Retaining Wall ELR
Footing Access:
Foundation Q FPS
I /
Ftg Drain ��,�, 4(
Crawl Drain Inspection Notes: / V/ SGT
Slab ' - —� ,Le9t e Ol
�� SIT -
Post & Beam
Ext Sheath /Shear G/
�_ L, V r
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
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
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
Approach /Sidewalk Date / L! 9 Inspector
Other D Ext
Final
PASS PART FAIL. DO NOT REMOVE this inspection record from the job site.