Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00046
' :I* DEVELOPMENT r SERVICES 639 -4171 CES DATE ISSUED: 1/23/01
- 13125 SW Hall
PARCEL: 1S126C0-01107
SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D -1
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of 1 branch circuit.
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: 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 BACHOFNER ELECTRIC INC
P.O.BOX 21545 55 SE MAIN
SEATTLE, WA 98111 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 00044569
SUP 2808S
ELE 26 -451C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 1/23/01 $46.85 2720010000(
5PCT CTR 1/23/01 $3.75 2720010000(
Total $50.60
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 SIGNATU - / ISSUED BY: 455?4
OWNER INSTALLATION ONLY
The installation is being ade 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
) 9,,,, .1 Electrical Permit Application .
Date received: / 2Z. 0/ Permit no.: t^_ 2di -600
J'",,:lj City of Tigard Proiect/appl.no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no:
Phone: (503) 639 -4171 p �/
Fax: (503) 598 -1960 e 14 PZ000 - 00-397 / Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ►s Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION .
Job address: 5.41. £(4 5Q4'4 — 4, -
: . g. n. . Suite no.: Tax map /tax lot/account no.:
Lot: Block: I Subdivision: 97 s/
Project name :u,(p/S '7 ) odic- $9A ifiescription an. . . , ork on premises:
Estimated date of completion/inspection:
- - CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: Description Qty. (ea.) Total no. insp
Bachofner Electric New residential- single or multi - family per
Address: 55 SE Mai n dwelling unit. Includes attached garage.
City: Portland I State: nR I ZIP: 97214 Service included:
Phone: 233 -2006 I Fax;V.3f 0763 I E -mail: 1000 sq ft or less 4
C 26 -451 C Limited energy, residential 2
Each additional 500 sq. ft or portion thereof
CB no.: 44569 I
Elec. bus. l ie. no: _
City /metr.p hc. no.: Limited energy, non- residential 2
„ /Z /, Each manufactured home or modular dwelling
ignature of supervising electrician (req d) Date Service and/or feeder 2
Sup. elect. name (print): William Bachofner License no 2808S Services or feeders - installation,
alteration or relocation:
-- - - • PROPERTY OWNER - 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 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. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B Fee for branch circuits without purchase
of service or feeder fee, first branch circuit 1 2
Phone: Fax: E Each additional branch circuit
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of I &2 O Hazardous locauon Each sign or outline lighting 2
fanulydwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over600 volts nominal more residential units in one structure alteration, or extension* _ 2
O Building over three stones ❑ Feeders, 400 amps or more •Dcscnption.
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighungplan ❑ Other Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all lunsdictions accept creche cards, please call lunsdicuon for more informauon Notice This permit application
Permit fee $ 444, 85
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number 1 / within 180 days after it has been State surcharge (8 %) .... $ 3, 75
Expires accepted as complete TOTAL $ 5 ' 60
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 - 4615 (600 /COM)
•
Electrical Permit Fees: Limited Energy Fees: I .
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less $145 15 4 n Audio and Stereo Systems
Each additional 500 sq ft or
portion thereof $33 40 1 Burglar Alarm
Limited Energy $75 00
Each Manufd Home or Modular n Garage Door Opener'
Dwelling Service or Feeder $90 90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80 30 2 n Vacuum Systems'
201 amps to 400 amps $106 85 2 : -
401 amps to 600 amps $160 60 2 Other
601 amps to 1000 amps $240 60 2
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 s $66 85 2 Fee for each system $75.00
201 1 tion amps t to l 400 amps $100 30 2 (
200 amps (SEE OAR 918- 260 -260)
mps to
401 amps to 600 amps $133 75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above.
pi Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel n Boiler Controls
a) The fee for branch circuits
with purchase of service or .
feeder fee. Clock Systems
Each branch circuit $6 65 2 ` -
b) The fee for branch circuits n Data Telecommunication Installation
without purchase of service
or feeder fee. n Fire Alarm Installation
First branch circuit / $46.85 85
Each additional branch Grcud $6 65 n HVAC
Miscellaneous
(Service or feeder not included) n Instrumentation
Each pump or irrigation circle $53 40
Each sign or oaUine lighting $53.40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75 00 n Landscape Irrigation Control
Minor Labels (10) $125 00
Each additional inspection over n Medical
the allowable in any of the above
Per inspection $62 50 n Nurse Calls
Per hour $62.50
In Plant $73.75
Outdoor Landscape Lighting'
Fees: n
Protective Signaling
Enter total of above fees $
n Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required Licenses are required for all other installations
front of application
Total Balance Due $ Fees:
Enter total of above fees $
❑ Trust Account #
8% State Surcharge • $
Total Balance Due $
i \fists \forms \elc -fccs doc 10/09/00
P.?
CITE( OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested //___3/6 / AM PM BLD
Location 97f/ � 011# } • �- Suite. MEC
Contact Person i Ph PLM
Contractor %IPP ;i _ i Ph SWR
_ I �C OO / O6 0 /(
BUILDING Tenant/Owner. • Adif
ELC 2. — 5 �/ 7h
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 / -1
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
FAIL •
E CT
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4 . t 0 PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for r ' nspection RE: ] Unable to inspect - no access
ADA
Otheoach /Sidewalk Date Z 177 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.