Permit �/4 CITY OF T I G A R D ri"
� ELECTRICAL PERMIT
RMIT , , I DEVELOPMENT SERVICES u A DATE SSU I � E SSU EDD E : 9/110/99 0/99 00549
,,,
r�' I 4 13125 SW Hall Blvd.. Tigard. OR 97223 (50 -4171
PARCEL: 1 S 126C0 - 01403
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD • • -
SUBDIVISION: ZONING: C -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Temporary electrical service of less than 225 amps for a special tent event.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: 1 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: 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:
MAY DEPARTMENT STORES COMPANY WEST SIDE ELECTRIC CO INC
ATTN: PROPERTY TAX DEPT 1834 SE 8TH AVE
611 OLIVE STREET PORTLAND, OR 97214
ST LOUIS, MO 63101
Phone: Phone:
231 -1548
Reg #: LIC 13306
SUP 1556s •
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 9/10/99 $80.25 99- 318223 ' Elect'l Final
5PCT DEB 9/10/99 $5.62 99- 318223
Total $85,87
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 se rules or direct questions to OUNC at (503)
246 - 1987. PERMITTEE'S SIGNATURE ` � , Jl d�-� ISSUE BY: ' - Oa , 010
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: J . x10 9 .a�. tte C* - ^� — DATE:
LICENSE NO: 1 5 YY VVVV
Call 639 -4175 by 7:00pm for an inspection the next business day
SEP -09 -99 04 :47 Pm WEST SIDE ELECTRIC 503 736 0677 P. 01
• CITY Electrical Permit Application Plan Che
1312 SW HALL BLVD. PP Recd By FA
Date
TIG D OR 97223
Phon (503) 639 -4171, x304
d
n Date :Roc: P.E.
Date D ST
Insp lion (503) 639-4175 P Ty ELCi9?r - 055/7 Fax ( 03) 598 -1960 incomplete or llegible rint of will pe not be Permit C
accepted Called
,
1. J b Address: 4. Complete Fee Schedule Below;
Name o Development / l U gigk- V' f Aar) 4 Number of Inspections per permit snowed
Name ( r name of business) Nv.11V../ + tkru 'SF .irh , Service included: items Cost Sum ''
Address crboo 56J VASWIPateto.1 SCOW 4a. Residential - per unit
City /Sta e/Zip TZC.Mli 1000 sq. tt. or less $ 117.75 4
Each additional 500 sq ft. or
portion thereof S 26.25 1
Comme'cial Residential ❑ Limited Energy $ 80,00
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
Informed )n for COT data base). / Installation, alteration, or relocation
Electric.$ I Contractor / I Q C ` e'/ L 200 amps or less $ 84.25 2
Addres , r 1/i 'Le 201 amps to 400 amps $ 85,50 2
ON /Ci / 4 late j,) / ' 401 amps to 800 amps $ 128.50 2
P 801 amps to 1000 amps $ 192.50 2
Phone Ivo. 7. 3/' / f y Over 1000 amps or volts 5 363.75 2
Job No. r{ Oq - Qom' Reconnect only $ 63.50 _ 2
Elec. Cord. Lice. No. 26- /_3 c Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. /330 Exp.Date Installation, alteration, or relocation •
COT Business Tax or Metro No. Exp.Date 200 amps or lees S 53.50 2
201 amps to 400 amps I $ 80.25 5 045 _ 2
Slgnatur of Supr. Elec'n 401 amps to 600 amps S 107,00 2
C Over 600 amps to 1000 v Ire,
License o. f �S- S Exp.Date _ u• "b° above. S � G
Phone . 2 31- /S y47 4d. Branch Circuits /odd
New, alteration or extension per panel ?-?-17 Q'. s4 /�'''
a) The fee for branch circuits 734-6 .
2b. F r owner installations; with purchase of Ben/CO or
feeder fee,
Print O ex's Name Each branch circuit $ 6.35 2
Address b) The fee for branch circuits
without purchase of service
Oily State Zip or feeder fee.
Phone •. First branch circuit $ 37.60
Each additional branch circuit S 5.35
Time Inst. Ilation is being made on property I own which Is not 4e. Miscellaneous
Intende•I for sale, lease or rent. (Service or feeder not included)
Each pump or Irrigation circle $ 42.75
Owner's • ignature Each sign or outline lighting 5 42.75
Signal clrwit(s) or a limited energy
, panel, alteration or extension $ 60.00
3. Pi n Review section (if required). y, Minor Labels (10) $ 107.00
Pleas check appropriate Item and enter fee In section 513. af. Each additional Inspection over
•
4 or more residential units in one structure the allowable In any of the above
Service and feeder 225 amps or more Per inspection S 50,00
Per hour $ 5000
$ 69,00
System over 800 volts nominal In Plant
5. Fees:
Classified area or structure containing special occupancy as
described in N.E C. Chapter 5 p
6a. Enter total of above fees $ __L
' Subml 2 sets of plans with application where any of the above apply. .896'�urNarpe (. ees ...7_______z ) � $�
Not re ired for temporary construction services. Subtotal $
$b. Enter 26% of line Si for
NOTICE Plan Review If reoulred (Sec. 3) • 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR �� 2 /
WORK IS OR ABANDONED FOR A PERIOD OF 180 DAYS L1a Trust Account* /33 n
AT ANY T ME AFTER WORK IS COMMENCED. Total balance Due $ f5,la 47
i'd' I Or1vi Irir it i
CITY OF TIGARD BUILDING INSPECTION DIVISION & MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
6 iqq3
Date Requested jl /l91 AM PM J ' BLD
Location q 3 50) LikS 4M, Suite MEC
Contact Person :cal 1 Ph ;0 PLM
Contractor Ph SWR
/ n ' ELC \g — d 0 CLVA
BUILDING Tenant/Owner µxc� `f' rr
Retaining Wall ELR
Footing Access:
Foundation cr.)L� \6 1 6 &S FPS
Ftg Drain V l�
Crawl Drain Ins • ec iQn N tg eS: �� ., CA/14_, S T
Slab P �C C�t.( SIT
Post & Beam
Ext Sheath /Shear - e--/
Int Sheath /Shear
Framing
Insulation ( / / /
Drywall Nailing �- / — _ �� .1%. _ �:._
Firewall {, / �~ —
Fire Sprinkler `t� 601e, �d (D — — _ P ` = — ,
Fire Alarm r — •
Susp'd Ceiling - ∎��k1 - -- — '
Roof /
Mi 4 . _ .Z iL __/ L — . ! �_I
4 j. PART' FAIL / ' _ /� �^� Q
i BI \ �/ C \Wiel - D0 60� ( & Beam rr '� � � L ^
Under Slab iC./ O t/\7\ .Q j 1 ZU 7.t CAN—e--rg
Top Out
Water Service ke ./ ' \ , s - HZ .'a
Rain Drains Sewer S , �� �� L. 1 �; c L
Rain Drains ` J (Lai' NP -
Final i �--
PASS PART FAIL b ( '
MECHANICAL I V eCV ic b 6 - - ( 4�Gj A5 ) - 10,4.. u% )-1.1/4-z. -
Post & Beam (� I r °�
Rough In Gas Line C� V" AC\C D° J I — -W\ 0
Smoke Dampers E V P V� cicl - 0 (Y"2% ,G
‘'- '1/V\�
Final
PASS PART FAIL q olv , I u 0 7.---q ( — rW v ei ).--S-
ELECTRICAL M /, � Service d v - Q 4— GOO (1 —
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 \ V 2- ` I
Other Date Inspector "� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. r-