Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00378
liA DEVELOPMENT SERVICES DATE ISSUED: 7/6/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107
SITE ADDRESS: 09534 SW WASHINGTON SQUARE RD
SUBDIVISION: H -12A ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Protect Description: One service /feeder, twenty additional branch circuits
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: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 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:
VIKING ELECTRIC INC
4326 SE WOODSTOCK
STE 518
PORTLAND, OR 97206
Phone: Phone: 775 -3479
Reg #: LIC 00056527
SUP 3088S
ELE 26 -569C
FEES Required Inspections
Type By Date Amount Receipt Rough - in
PRMT BLD 7/6/00 $171.25 003510
5PCT BLD 7/6/00 $13.70 003510
Total $184.95
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 -1987.
PERMITTEE'S SIGNATURE / / ISSUED BY: _ i
OWNER INSTALLATION ONLY
The installation is being ade on prop- y 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
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 HALL BLVD. Recd By
TIGARD OR 97223 Date Rec' �/'�-
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit # E.1..6.-,2-4,06 - O037g
Fax (503) 8 - 190 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
m - or name of business) L f t o y FoDT L O C A Service included: Items Cost Sum
- ,&(,ro u1 S[? S41 ti - 12 4 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
C • t a , t p 1 11 !7 Each additional 500 sq. ft. or
portion thereof $ 2625 1
Commercial g Residential ❑ Limited Energy $ 60.00
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
information for COT data base). P� � In alteration, or relocation
Electrical Contractor V' Kl sU L7 E L EC / t 1 C 200 amps or less / $ 64.25 6 lb Zs 2
Address I'S 6 SE. 4)oo ,55Tcc r PH'1. S7 g 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128 50 2
City -p062T1 el PI) State Oa_ Zip 3 7 206 601 amps to 1000 amps $ 192.50 2
Phone No. $03 77g - 34-le/ Over 1000 amps or volts . $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 26 - 56 Exp.Date /0 - i - 0 0 4c. Temporary Services or Feeders
OR State CCB Reg. No. 5 7 Exp.Date 5 -02, Installation, alteration, or relocation
COT Business Tax or Metro Noa)ct b 4'0 7. < E .Date 12-1 -Do 200 amps or less . $ 53.50 2
//�� 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n I/�Dh 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. 30g 8" S Exp.Date see "b" above.
p 4d. Branch Circuits
Phone No. 7 75 3 7 4 9 New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit AO $ 5.35 /07 2
Address • b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting - $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 487769
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over OA 00
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50 00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N E C Chapter 5 5. Fees:
d 71
a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. rio **Surcharge ( 1 X total fees) $ 13 . 70
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # �
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ I D 4 /'.
i \dsts\forms\electric.doc
CITY OF TIGARD•BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 Z AM PM BLD
Location 5"3 (,� ) Sy, (J;Sy L c /c) Suite f> i z MEC
Contact Person / Ph ,3 /, 86 “- PLM
Contractor nP Ph SWR
BUILDING Teriant/Owner ELC 2 - 0 '-3 7f
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 _ gist _ -
Fire Alarm
Susp'd Ceiling f ) "�` /
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 f
•
Low Voltage
Fire Alarm
Fina .
4� 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 [ ] Please call for reinspection RE: ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk ,. -
Other Date %er) Inspector �_ – — Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
P ,
CITY OF TIGARD BUILDING INSPECTION DIVISION
•
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested 7-_ z. s/ AM PM BLD
Location „Sc. �' M S f , Suite // / Z MEC
•
Contact Person Ph 3 9 F4'4 PLM •
Contractor Ph SWR
BUILDING Tenant/Owner ELC Ziidv -cU 37r
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 net" Drywall Nailing e��
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 ART FAIL
CTRICAL
Service •
•
Rough In L
UG /Slab C t v e „
Low Voltage
Fire Alarm
Fi•-
PART FAIL
BBaac /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 7 ,2 Ven Inspector 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 / AM PM BLD
Location 9 ) 3) 5 41, 6.4)4 Sf d 'f Suite tY / MEC
Contact Person Vt‘,.t Ph „3/ f 66 (P PLM
Contractor 6 - - Ph SWR
BUILDING Tenant/Owner ELC e Z vv -00 37.r
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
Susp'd Ceiling
Roof
Final 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
CTRIC�]
•
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm •
• S • PART FAIL
Silt
Backfill /Grading -
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay - - ity Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for r inspecti n RE: 41. Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date �' Df� Inspector re � Ext
Final
PASS PART FAIL D 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 F-- / AM PM BLD
Location q.7 3 f Ws 34 S Lli J 1 6 Q'( Suite # / 2 MEC
Contact Person Ph 3/y n' PLM
Contractor Ph S
BUILDING Tenant/Owner LC 2" " -0 ' 3 7sr
. 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
Fire Sp e : /'A
Fire Sprinkler 0
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
PAS FAI L
ELECTRIC
Service
Rough b C
UG/Slab '/ (
b
Low Voltage
Fire Alarm
F'
P S 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
Other Date g 9 - 00 Inspector 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 — AM PM BLD
Location q > > '( CL 01, Suite /i - ► Z MEC
Contact Person Ph ..3( - PLM
Contractor - • e Ph SWR
BUILDING Tenant/Owner M , •. / , a� ELC 0 2vvU - 6:PU 3 7 V
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
Fire wall
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
(ECEETRI
Service
UG /Slab
w Vo tage
Fire Alarm
Final
PASS PART r
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
Other Date Inspector Ext
Final
PASS PART FAIL O NOT REMOVE this inspection record from the job site.