Permit CITY T I G A R D ELECTRICAL PERMIT
Eiji
DEVELOPMENT SERVICES DATE SSUIED; E6 / 0 0 00 -00008
0
'= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102BC -THP03
SITE ADDRESS: 12745 SW WATKINS AVE
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION:
Project Description: Install 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:
CAPITOL CITY ELECTRIC INC
1020 NORTHWOOD DR NE
SALEM, OR 97301 -2221
Phone: Phone: 503 - 371 -8353
Reg #: LIC 119338 ORIGINAL
ELE 24 -346C
SUP 4219S
FEES Required Inspections
Type By Date Amount Receipt
Elect') Service
PRMT KJP 1/6/00 $37.50 00- 320966 Elect'I Final
5PCT KJP 1/6/00 $3.00 00- 320966
Total $40.50
This Permit is issued subjed 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 SIGNATURE -, Q 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: DATE: 1/6/0
LICENSE NO: 90 /
Call 639 -4175 by 7:00pm for an inspection the next business day
U/1.)/ yy Iwo LU. U f a t>v vvv vvv a...... ..
CITY OF TIGARD Plan Check d
Electrical Permit Application ` Recd By
13125 SW HALL BLVD. Date Recd
TIGARD OR 97223 Date to P E.
Phone (503) 639-4171, x304 t Date to DST
Inspection (503) 639 -4175 Print of Type Permit a £ L. C 2 ova - ao clog
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
`--- Number of inspections per permit allowed
Name of Development •1' Name (or name of business) a l J / �,� y / Service included: Items Cost Sum
Address / 9i// 5 L//a.T - 1C N _ "L.,:: ®i per unit $ 117.75 4
City/StatelZip -74R_41, Dp . Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial ❑ Residential 14 JAI OOO $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: COMMUN IMbr ENT ceder $ 72 75 2
(Prior to pear* Issuance. applicants must provide contractor license 4b. Services or Feeders
irdormatlon for COT data base). G z G Irrataiiation. alteration, or relocation
Electrical Contra C a 1 r G e / lie fe /Ci -`c 200 amps or lass $ 64.25 2
Address 2 0 �n YiWe .- lU 201 amps to 400 amps $ 85 -SO 2
401 a to 600 amps
City State l__ _ Ztp 9-T 0 / -ZZZ l 601 amps to 1 000 amps - $ i 192.50 128.50 2 2
Phone No. 79/ �� s' Over 1000 amps or vows $ 2
Job No. Reconnect only
Dec. Cont. Lice. No. • Exp. Date /O.-O / - v ° 4c. Temporary Services or Feeders
OR State CCB Reg. No. /i9 3 e Exp.Date If 2 Installation• alteration, or relocation
COT Business Tax or Metro No. Exp.Date -- 200 saga or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
r • 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec n dl ...i�'t� �/ Over 600 amps to 1000 volts.
/�� /0 /-� � " see "b" above.
License No `r ) -a 4d. Branch Circuits No. ��� 3/, `$ S 3 New. alteration or extension per panel
a) The fee for brandi circuits
2b. For owner lasts atlons: with purchase of service or
haler fee.
Print Owner's Name branch shalt $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City ,: Zip or feeder ha.
Phone No. Feat branch c"ralt / $ 37 50
Each additional branch &cull $ 5.35
The installation is being made on property I own which is not 4e. hescallaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Each sign or outline lighting $ 42.76
Owners Signature Signal circuit(s) at a limited energy .
panel, alteration or extension $ 60.00
3. Plan Review section (if required):* Minor Labels (10) $ 107.00
Please check appropriate item and enter fee In section 5B. 4f. Each additional Inspection over
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Pram $ 59.00
Classified area or structure containing special occupancy as 5. Fees:
described in N.E.C. Chapter 5
w. Enter total of above tees $ 7 SC
a submit 2 sets of plans with application where any of the above apply. 4 VD446•S (.05 x total fees) $ 3. a d
Not required for temporary construction services. sb Subtotal
or rrre fa for
Plan Review if reoulred (Sec. 3) $ 4
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal
IS NOT COMMENCED WITHIN 160 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS 0 Trust Account # r / n �v
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 174
r W sa \fonns\electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST g99- 0 334
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location J 2 Sti) L G . -iiS Suite MEC /99? - Do
Contact Pers // Ph 5 74 S•6 33 PLM
Contractor ,,ta ( g Ph SWR
BUILDING Tenant/0 ne , :7 L r ELC v - 6 - M '
Retaining Wall ELR
Footing Access: p(4ase coN1~ -4-J //:.3e)-4-
Foundation (1 FPS
Ftg Drain 13t) ^ do KM aryu. C- 'QX -6 `_ 1/`26 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall "1" - Fire Sprinkler � I 3 _ ,
Fire Alarm
Susp'd Ceiling
Roof Mfg < g - ;
Misc:
Final
PASS PART FAIL
PLUMBING (3�` 2.6191) — D
•
Post & Beam
Under Slab
Top Out
Water Service 7;Ai
Sanitary Sewer
Rain Drains
Final
P • = = • • RT FAIL
ti
Rough In
Gas Line
Smoke Dampers
Fin.
t P: FAIL
. 1 X11.1111 Po>
Rough In
UG /Slab
Low Voltage
F.- alarm
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 - Z i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.