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Permit ., CITY OF TIGARD ELECTRICAL PERMIT _ 4 A DEVELOPMENT SERVICES PERMIT #: ELC99 -0115 � �' DATE ISSUED: 02/24/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-0171 PARCEL: 19135BA -00102 SITE ADDRESS...:1O164 SW WASHINGTON SQUARE RD #84 -1 SUBDIVISION •OAKBURG ZONING:C —G BLOCK LOT -001 JURISDICTION: TIG Project Description: Electrical TI - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS : 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0 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/O SRVC OR FDR.: 1 PER HOUR • 0 401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 7 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 LONG DRUGS type amount by date recpt 10164 SW WASHINGTON SO RD PRMT $ 70.00 B 02/24/99 99- 313207 TIGARD OR 97223 5PCT $ 3.50 B 02/24/99 99- 313207 Phone #: Contractor: SME INC OF SEATTLE $ 73.50 TOTAL 927 RAINIER AVE SOUTH REQUIRED INSPECTIONS SEATTLE WA 98144 Ceiling Cover Elect'l Service Phone #: 206 - 329 -2040 Wall Cover Elect'1 Final Reg #..: 122009 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 - 001-8010 through OAR 952-001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 -1987. Permittee Signature: Issued By: • 0.---- 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 : 01i1A 1 l 1Or DATE: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY►oF TIGARD Electrical Permit Application Plan Check # '13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd - 2- Date to P.E. Phone (503) 639 -4171, x304 Date to DST �► Inspection (503) 639 -4175 Print or Type Permit # Gi.. �1 i q r 5 Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: j / 4. Complete Fee Schedule Below: W Name of Development O-+h, n 5 4 ■ 3 ^ . 1 JG,P Number of inspections per permit allowed Name (or name of business) LO/ s Service included: Items Cost Sum Address / d IAV s, w, W9i11 , iixae_ -14' 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City/State /Zip 1 : n R. , q 72 a 3 Each additional 500 sq. ft. or Commercial El Li Residential portion thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) ( 4b. Services or Feeders Electrical Contractor - SAE E Inc_ D- Sec // /Q. Installation, alteration, or relocation 200 amps or less $60.00 2 Address 9k7 1�, 4•e r Ai... so. 201 amps to 400 amps $80.00 2 City Sec / State £4../4. Zip 9s i t" y 401 amps to 600 amps $120.00 2 Phone No. (a6i 3,2,9- "Intl 0 601 amps to 1000 amps $180.00 2 Job No. 746S t) / Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. 7- 7SSC Exp.Date OR State CCB Reg. No. l a.a.o09 Exp.Date • 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation - 200 amps or less $50.00 2 201 amps to 400 amps $75.00 Signature of Supr. Elec'n S �,L� �� ,� `' 401 amps to 600 amps $100.00 2 / / Over 600 amps to 1000 volts, License No. 3.9y/S / Exp.Date f D I d / see "b" above. Phone No. '2t A - 3 ... y--.a.Oy0 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circ $5.00 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. 3 1 First branch circuit ( $35.00 J 2 The installation is being made on property I own which is not Each additional branch circuit 7 $5.00 3 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $ 100 . 00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. 5. Fees: 7 Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ NOTICE Subtotal $ ?. 3 So 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 7 3 So Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �h o BUP Date Requested g / b / q AM ( PM BLD Location i 01 1L(skV Suite MEC Contact Person -rnm Ph 2e49';96 — 3)0.2 PLM Contractor Ph SWR (] BUILDING en Owner .04 S • (j - ELC Qq'01 jS Retaining Wall} 4 4 Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: , SGN Slab - - L SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation • Drywall Nailing Firewall 1 V / � 461? / Fire Sprinkler Per iwt (� O. E�+ C Q- Q O 9 L — Fire Alarm �- Susp'd Ceiling �— i C — 9 g. Q / J �� Roof Misc: Final PASS PART FAIL , / PLUMBING � S 60 i ,er111/1.5 Post & Beam Under Slab Top Out Water Service Sanitary Sewer —� Rain Drains � �S e .. _ _ . ,I - 4 _ Final PASS PART FAIL I rase MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL gaiZERIDALI Service Rough In UG /Slab Low Voltage Fire A 40 PASS 'ART 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 ` y' Ins Other Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.