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Permit CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00353 41 0 DEVELOPMENT PMENT r (503) 639 -4171 RVICES DATE ISSUED: 6/22/00 - 13125 / PARCEL: 1S126C0-01107 SITE ADDRESS: 09637 SW WASHINGTON SQUARE RD SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of 2 branch circuits. Job No. 65527. 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+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PPR WASHINGTON SQUARE LLC TUALATIN ELECTRIC P.O.BOX 21545 PO BOX 655 SEATTLE, WA 98111 WILSONVILLE, OR 97070 Phone: Phone: 682 -2955 Reg #: LIC 00065650 SUP 3483S ELE 3 -26C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT DEB 6/22/00 $42.85 0003213 Elect'l Final �� 5PCT DEB 6/22/00 $3.43 0003213 \` _ Total $46.28 OgC 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 r -s adopte the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obt.• copies of these les or direct questions to OUNC at (503) 246 -1987 PERMITTEE'S SIGNATUREic 10111/ ISS ' 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 INST LATION ONLY SIGNATURE OF ELEC'N: ✓ �n C ' 4, l�L DATE: LICENSE NO: ( ✓ / 0 3 5 Call 639 -4175 by 7:00pm for an inspection the next business day 06/08/00 THU 12:58 FAX 503 598 1960 CITY OF TIGARD IA 001 CITA: TIGARD Electrical Permit Application Planc ar# �� 13125 SW HALL BLVD. Recd .__ • TIGARD OR 97223 Date Recd / '/ejavID Date to P.E. Phone (503) 839 - 4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # eL - 5 7 Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called • 1. Job Address: 4. Complete Fee Schedule Below: Name of Development ,, . :n ..r1 ., u1/4.3. Number of Inspections per permit allowed Name (or name of business) e• • Service included: Items Cost Sum 4 Address L SW . . _ . L51 4a. Residential - per unit City/State/Zip i' ∎ • c1/4r 010 ( V1 . 1000 sq. fL or less $ 117.75 4 Each additional 500 sq. ft. or Commercial is Residential ❑ portion thereof $ 26.75 1 Limited Energy $ 60 00 Each Manurd 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 Infomiatlon for COT data base). i Installation, alteration, or relocation Electrical Contractor - 1".,,q,10.4',,, E.1 LL ∎ L, 200 amps or less $ 64.26 2 Address PCt, f x (n55 201 amps to 400 amps $ 85.50 2 J 1$v City"V pr ' l �, State ©A Zip Cr/ 0-10 401 amps to 600 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. & -- 07c1'`7 Over 1000 amps or volts $ 363.75 2 Job No. Ic+�S&`1 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. bbG Exp.Date \ d I o0 4c. Temporary Services or Feeders OR State CCB Reg. No. b6( 5 Exp.Date c . Installation, alteration, or relocation COT Business Tax or Metro No. . Exp.Date 200 amps or less $ 53.50 2 - 201 amps to 400 amps $ 80.25 2 Signature of Sup'. Elec'n - 41111■4I 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, License No.. -l5'3S E .ate I tll» I eee °b" above. 4d. Branch Circuits Phone No. (=,(Na- a.9 "5 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 $ 5 35 2 Address b ) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit 1 $ 37.50 , _Q Each additional branch circuit I $ - 5.35 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 dreuit(s) or a limited energy 3. Plan Review section (if required):* * panel, Labels (10) or extension $ 00.00 f 1 . � / Minor Labels (10) $ 100 00 Please check appropriate Item and enter fee In section 58. 4f. 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 $ 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: l � 5a Enter total of above fees $ - i ( • * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ . Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 6a 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 # /l '�ll AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ L i ( . is \dsts\forms\clectric.doc rA CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line:. 639 -4175 Business Line: 639 -4171 BUP Date Requested 7fi AM PM BLD Location 9 40 3 ? Su) &lL 3/4A, Suite 1-0-co MEC Contact Person PAAJ Ph PLM Contractor Ph SWR BUILDING Tenant/Owner C Co-1A(4- ELC i 3 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl, Drain Inspection Notes: ,�� `� Slab _ ( l�/l clan/tee/ILL. �-IJ LS SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing • Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof / Misc: - / /// 4f [ 1\1 Final PASS PART FAIL PLUMBING Post & Beam - Under Slab Top Out - �f Water Service Sanitary Sewer • Rain Drains Final PASS PART FAIL MECHANICAL 05 14'1 Post & Beam Rough In • Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage PASS 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: [ ] able to inspect - no access ADA Approach/Sidewalk n Other Date t (J Inspect . ►���i / E x t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.