Permit C I lY OF T I GARD ELECTRICAL PERMIT
PERMIT # #: EL.C96- 0613
DATE ISSUED: 09/26/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 1 S 1260C -01 107
' SITE ADDRESS...: ta WASHINTON SQUARE RD
SUBDIVISION ° 940° ZONING :C -G •
•
BLOCK LOT
Project Description: Installing 7 branch circuits and limited energy panel.
--RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- - - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 - 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD' L 500SF...: 0 201 - 400 amp 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 - 600 amp ° 0 SIGNAL /PANEL 1
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/0 SRVC OR FDR.: 1 PER HOUR : 0
401 - 600 amp ° 0 EA ADD'L BRNCH CIRC: 6 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 - - - - -- - --
WASHINGTON SQUARE INC type amount by date recpt
700 FIFTH AVENUE, SUITE 2600 PRMT $ 105.00 CJS 09/26/96 96- 284321
5PCT $ 5.25 CJS 09/26/96 96- 284321
SEATTLE WA 98104 -8521
Phone #: 206 -223 -4500
Contractor:
OMNI ELECTRIC OF OREGON $ 110.25 TOTAL
PO BOX 1788
-- REQUIRED INSPECTIONS --
LAKE OSWEGO OR 97035 Wall Cover Elect'l Service
Phone #: 503 --635 -4306 Underground Cove Elect'1 Final
Reg #..: 41789
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Signature
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. Issued 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 INSTALLATION ONLY -- -- - - --
SIGNATURE OF SUPR. ELEC'N: 01c-oiled DATE:
LICENSE NO:
Call for inspection - 639 -4175
•
FRI'1 : OMN I ELECTRIC PHONE NO. : 503 635 1391 Sep. 23 1996 04: 41PM P1
C6mmunity Development ELECTRICAL PERMIT APPLICATION
,_A 13125 SW Hall Blvd.
Tigard, OR 97 Planck/Rec. # Cc - ag <<Li a
Permit # ELc q6- 0613
�� 1i Phone (503) 639 -4171 Date Issued -a6 - 46
� FAX (503) 684 -7297 - [[ /�
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by a r - /E s S/1 midi"
Inspection (503) 639 -4175
1. Job Address: JOB NO . Z 1(¢4 - 4. Complete Fee Schedule Below:
C*�
Name of t)evelopmentl b►s47 115*' Q Number of Inspections per permit allowed
b+terSio.es-lo v. SV4dK d Service included: Items Cost(ea) Sum
Address gsver, 4.W /r ,..+P1SI.t �
City/State2ip - 7,i.543.-J k Oi k
•
4a. Residential - per unit - 4
Target District Mqr ,'s 1 oo0ay.h.erle� 0
Name (or name of business) Office n. er t4 M vyn x.
s d 500�''.n.or rime o0
Commercial Residential ❑ Each l Energy $25.00
Each Engir Home or 1bduiv 2
Dueling Service or Fonder $88.00
2a. Contractor installation only: 4b. Services or Feeders
/� ht ( i 'e _ I }'fC _ r �t! le0aton. aoato, or reation 2
Electrical Contractor f' OT 6N 200 amps or lass $60.0e 2
Address P o, tad rise 201 am to 400 amps $80.00 2
City /rake C)sucJO State )ft Zip 4Z �JS ��e'+wetosonamps 1120.00 2 - C amps to 1000 amps 1180.00 2
Phone No. 635 -4306 Over 1000ampe aeons $340.00 2
-
Contractors License No. . S Reconnect only $50.00
Contractor's Board Reg. •. ic) All 4c. Temporary Services or Feeders
Signature of Supr. Elec'n Po Installation. alteration, or »location 2
200 amps or toss 150.00 2
License No.2 (SS Pho r o. (3s- j 34 201 amps to 400 amps 575.00 2 - 401 amps so 000 amps $100.00
Over 600 amps to 1003 volts
2b. For owner installations: see 'le abate.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a ) The lee for brymh circuits with
Purchase of aerriee Of MOWN OIO. 2
City State Zip Each brar, h circuit $5.00
Phone No. b) The for for branch circuits wffheut
The installation is being made on property I own which is Lhasa ofsorra or eeai. f• 2
not intended for sale, lease or rent.
First !march era'' not � _ , 2
E at+ additional brand+ circuit , 1 $5.00 Vi +Si
Owner's Signature 4 e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or i^ ion circle $40.00 2
Each sign or outline righting 140.00
• Signal circult(s),or a limited energy 2
Please check appropriate item and enter fee in section SB. panel, alteration or *Mansion $40.00 1O,iro
4 or more residential units in one structure Minor Labels (10) $100.00
-
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.G. Chapter 5 Per irw $35.00
355,00
Per he
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees S 1
5% Surcharge (.05 X total fees) . :5 -...S1 2a5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal - $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OA ABANDONED FOR Plan Review if required (Sec.3)
A PERIOD OF 1130 DAYS AT ANY TIME AFTER WORK IS Subtotal $
$
COMMENCED. ® Trust Account a S( 110.25 )
Balance Due $ -U-
/'r o
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: eD L44 /
Date_ /0 — / ` f — q A.M. ' P.M. Entry.: -
Addre�s:/ �J a U `� -- — -. � l -S -
Tenan : ► �+ M - � Ste: MST:
/� ,q,_ � BUP:
Con /Own: l �., 7 / l /!" 1 -4UC MEP:
6 35 =g37 ELC: — D&1 3
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: Date:
_APPROVED DISAPPROVED /CALL FOR REINSP. CF / CO
Y
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL
Foundation Water Line aillirii sp - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: / 2/3 / / /, A.M. P.M. Entry: Rol Address: 9 'f O C) G
¥t) i4 , J Q .
•
Tenant: 1 Ste: MST:
BUP:
Con /Own: i MEC:
PM_
ELC: - 1, O /ir
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
-.a � ..• - I_- ri
2 . 6P e znC1E i -2 0 1 - —i �/ �� —P
/ i ii -P �'e T{' / ,1 - �C12 /,'A'-,
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y i ..2 e�I—I` C'c? e.e 1 1 CQ /l-e---
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Inspectori� ' // /7(4 r (R e ` Date:, **13/ ?(
O ROVEkt DISAPPROVED /CALL FOR REINSP. CF CO