Permit , - , . .
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ELECTRICAL PERMIT . 14. , E { � i � ; i� DEVELOPMENT SERVICES P /03997 Hall Blvd., Tigard,
PARCEL: 2S112DD- 01600
. ,SITE ADDRESS:.. :15195 SW SEQUOIA PKWY #BShIN '
SUBDIVISION ZONING:I - P '
BLOCK • LOT JURISDICTION: TIG
' Project Description: instl 2 service /feeders & 6 branch circuits in basement .
storage room ,
- -- RESIDENTIAL UNIT, - - -- -- -TEMP SRVC /FEEDERS - - -- , MISCELLANEOUS
1000 SF OR LESS : 0 '0 7 200 amp • 2 PUMP /IRR'IGATION, 0
EACH ADD'L 5O0SF....': 0 , 201,- 4OO.arnp • 0 SIGN /OUT LINE LTG...: 0
LIMITED ENERGY • 0 40.1 - 600 amp • 0 SIGNAL /PANEL ' : 0,
MANF. HM/ SV'C /FUR, .' : 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:' 1 PER INSPECTION • 0
201 - 400 amp ' • 0 1st W /.0 SRVC OR FDR.: 0 PER HOUR : 0
401 - 600 amp. ' • 0 EA ADD'L BRNCH CIRC: 5 '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 ,
PACIFIC CORPORATE 'CENTER,- • - -- - type amount by date' rcpt _
15495 SW SEQUOIA PKWY PRMT $ 150.00 TAT 04/03/97 97- 292683
TIGARD OR 9,7223 5PCT $ ' 7. 50 'TAT 04/03/97-97-292683
Phone #: , , - . ' - '
Contractor: ' -
BACHOFNER ELECTRIC, INC. $ 157.50 TOTAL .
55 SE MAIN '
REQUIRED INSPECTIONS
PORTLAND OR' 97214 Ceiling Cover . Underground Cove
Phone #: 233 -2006 Wall Cover Elect'1 Service'
Reg #.. : 000445 .
This permit is issued. subject to the regulations contained in the' _ 9
Tigard Municipal Code, State of Ore.. Specialty Codes and all other Permitt Signatur
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 1 � � , _ . IZatLI _ _
than I80 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 : C, /- ( - [•L yU DATE: .
LICENSE, NO: 6?8C8S
Call for inspectipn,- 639 -4175 ,
• Community Development ELECTRICAL PERMIT APPLICATION .
J 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # al'.97 019
&A,-4. u! l Ph one (503) 639-4171 D ate Issued /- 3 - 7
FAX-(503) 684 -7297 Issued by l .
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: � 4. ,Complete Fee Schedule Below:
Name of Development H .L . Green Number of Inspections per permit allowed
Addfess15495 SW Sequoia Parkway Service included: Items Cost(ea) Sum 7
City/State/Zip Tigard, OR , 4a Residential - per unit 4
1000 eq It or less $11000
Name (or name of business) Pacific Corporate Each addilisnel 603 w1 "•°r r2500 1 - portion thereof Center Limited Energy 1x500
Commercial Residential ❑ 'Ea Limited
Manrfd ire or Modular 2
• Deering Service or Feeder $68.00
2a. Contractor Installation only: . 4b. Services or Feeders
I rrctaAetion, aReratiwr, or relocation 2
Electrical Contractor Bachofner Electric 203 ems or lose 2 NO CO 1 20.00 2
Address 5 5 SE Main 201 amps to 400 amps $80.00 2
Portland State OR /21 4 4o $12
tampeto600 000 2
City Portland 601 amps b 1000 amps $180 00 2
Phone No. 233 -2006 Over 1000 amps or volts $340 00 2
Contractors License No. 26-451C • Recaned only $50.00
Contractor's Board Reg. No. 44569 4 Temporary Services or Feeders
Instattation, alteration, or rebcati n 2
Signature of Supr. Elec'n d 200 amps or less $5000 2 - License No. 2808S Phone No. 23 -2006 201 an to 400 amps I 401 amps to 600 amps $75.00 2
$10000
Oeer 600 amps to 1000 volts
2b. For owner Installations: see If ab01e
4d. Branch Circuits
. Print Owners Name New. alteration or extension per p=er
Address a) The lee for brand, circuits with 2
City State Zip branch circuit service or Seeder hoc id 1 $5 00 5. 0
Phone No. b) The lee for branch circuits without
The installation is being made on property I own which is . P'°chie1 or service or feeder Aso 2
Feat branch circuit $35.00
not intended for sale, lease or rent.
Each additional branch arwd $5.00 L D . 0 0
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section .{if required): Each pump ":ligation ode $40.00 2 -
Each eign or outfi a fighting 840 00
Signal cloaks) or a boiled energy 2
Please check appropriate Hem and enter fee In section 5B. panel, alteration or extension $40.00
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4 or more residential units in one structure Minor rebels (10) $100.00
Service and feeder 225 amps or snore
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.C. Chapter 5 Per irspeebon $35.00
Per four $55 00
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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:
Sa. Enter total of above fees $ 150.00
NOTICE 5% Surcharge (.05 X total fees) $ 9 5 7 . 5 0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account a $
1-5
Balance Due $
/ P4 t
. . • CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: A.M. P.M. MST:
Location: ,! ' BUP:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: 33 -C _- ) Q PLM:
Owner: Phone: ELC: C 7 - 7 —0 t
- re,,. —1 c.. S (Z.) ELR:
(o - Ct X. a/ ..ii• $fit irlem -,-� SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab .
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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O Call for reinspectio 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: Date: - 7 — 7- 97 Page of
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