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9050 SW BURNHAM ST. __
CITYO r T I G A R D ELECTRICAL PERMIT
DEVELOPMENT SERVICES DATE i3SUIED: EL/0 000-00013
13125 SW Hall Blvd.,Tigard, OR 972;3 '3
9-41719-4171 PARCEL: 2S102AC-00100
SITE ADDRESS: 09050 SW BURNHAM ST
SUBDIVISION: BURNHAM TRACT' A
L ZONING: CBD
BLOCK: LOT : 004 JURISDICTION: TIG
Project Description: Installation of one 200 amp or less service or feeder and 6 branch circuits
Job No. 3030-10
RESIDENTIAL. UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
00 SF ORLES9:_- 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTV:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: 6 --iFhK INSPFCTION:—�
:01 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR-
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
6PI - 1000 amp: PLAN REVIEW SECTION
1000+ amplvolt: ---> RE DAIT�- 'WVOU �� --
Reconnect only: _ SVCIFDR>= 22.i AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
LEE, STEPHEN AND PHOENIX ELECTRIC CO
LEGER, DAVID AND 7379 SW TECH CENTER DR.
LONGAKEK, BARBARA M E-rAL TIGARD, OR 97223
BANKS, OR 97106
Phone: Phone: 684-3600
Reg#: LIC 00052288
SUP 4140S
ELF 34-247C
FEES __ _ Required Inspections
Type By Date Ameunt Receipt _ Elect'I Service
PRMT DEB $96 35 00-321006 Elect'I Fina!
5PCT DEB 1/7/00 $7 07 00-32100E
-- Total $103.42
This Permit is issued sub!ect to the regulations contained in the Tigard Municipal Code,State of OR.Spc�;iaRy Codes and all other applicable laws All
work will be done in accordance with approved plans This permit wil!p,nire if work is not started within 180 days of issuance,or N worts is suspended
for more than 180 days. ATTENTION Oregon law requir3s you to folk,::rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 throigh OAR 952-001-0080 You may obtain copies )f these rulcs or direct questions to OUNC at(503)246-1987.
PERMITTEEISSUMBY
S SIGNATURE � Wc=
O 'PER INSTALLATION ONLY _
The installation is being rude on property I cwnwhiich is not intended for.,ale, tease, or rent
OWNER'S SIGNATURE: _ DATE: ____.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. E EC'N: % DATr_:
LICENSE NO: 1
Call 639-4175 by 7:00pm for an Inspection the next business day
CITY OF TIGARD RECEIVE%cttrcal Permit Application Plan Ch k#_ I --7�
13125 SW HALL BLVD. Recd By l _pj1�
Date Rec'd
TIGARD OR 97223 i JAN 0 7 70011 Date to P.E. '
Phone 1503)6'9-4171, x304 Date to DST
Inspection (503)639-41-175 1i1N11� 1rk.ruUYMLNT Print of-Type Permit# g'-GCo'! D -'06513
Fax(503) 598 1960 Incomplete or illegible will not be accepted Called
t .lob Address: 4. Complete Fee Schedule Below:
Name of Development� '^�-�� Ll� _-- Number of Inspections per permit allowed
Name(or name of business) Service included: Items Cost Sum
Address C�L�� �1 Cr YL �r 4a. Residential-per unit
-- -- 1000 sq fi or less $ 117.75
City/State/lip 9050 - Each additional 500 sq.ft.or -
portion thereof _ _ $ 2625
ornmerciaz Residential ❑ Limited Ener y V— _ $ 60.00 _
(� c ,c,�> ,hC_ Each Mani rd Home or Modular
� J, \_ �t k;``' \ � ` Dwellirg Service of r-eeder $ 72 75 1
2a. X;ontractor i tallation only:
Prior to permit issuance,applicants must provide contractor license I 4b.Services or Feeders
information for COT data base). I Installation,alteration,or relocation
Electrical Contrarrto � �_ _ 200 ainpa or less _ $ 84.25
AdoWSS yQ` 201 amps to 400 amps $ 85.50 2
401 amps to 800 amps $ 128.50 2
City` State = zip 60; amps to 1000 amps _ $ 192.50 _ 2
Fhone N �� c _ __ Over 1000 amps or volts $ 363.75 2
Job No. s _ Reronnert only $ 53.50 2
Elec. Cont. Lice.. hlo = � E p.Date __ 4c.Temporary Services or Feeders
OR State CCF3 Reg. No -a� EXp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. Iggy� _Exp.Date 200 amps or less — $ 535020'.
201 amps 10 400 amps $ 8025
401 amps to 800 amps _ $ 107 u0 _
Signature of Supr Elegy;n�2� «-- ___ over 600 amps to 1000 volts,
see"b"above.
License No. D Exp.Date 4d.Branch Circuits
Phone No._ �� - New,a'teration c. tension per panel
a)The fee for r.. h ch 's
2b. For owner installations: with purchaau ofaervrce or
feeder lee.
Print Owner's Name Each branch circuit ��� $ 535 /� 7
— --- — -- b)The fee for branch circuits
Address _ without purchase of service
City
Stag- p ZI or fe-der fee.
------ -------- — ------
Phone No __ _ First 5ranch circuit _ $ -11 50 -
-- - — - Each additional branch circuit $ 5 35
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or rent (Service or feeder not Included)
Each pump or Irrigation cycle $ 42 75
Ownef 5 Signature _-�_ Each sign or outline lighting _- $ 42 75
Signal circuits)or a limited energy
panel,alteration or extension % 60.00
3. Plan Review se.tion (if required).* Minor Labels(10) s 107.00 — "-
Please check appropriate item and enter fee in section 5B. 4f.Each addlUnnal inspection over
4 or i lore residential units in one structure the allowable In any of the above
--- Per inspection $ 5000 —
_Servi;e and feeder 225 amps or more Per hour $ 5000
Sysrem over 600 volts nominal In Plant _ 5 59.00 _
Classified area or structure containing special occupancy as
desr,ibed in N E C.Chbpter 5 Jam. Fees!
5a.Enter total of above fees $ •��
* Submit 2 sets of plans with uppli"tion where any of the above apply. 5%Surcharge(.05 X total fees) $ --�
Not required for temporary construction services. Subtotal $ /
6b.Enter 25%of line 6a for
NOTICE Plan Review if required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSI RUCTION AUTHORIZED
Subtotal $
IS NOT COMMENCED WITHIN 190 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account#_
AT ANY TIME AFTER WORK I'3 COMMENCED Total balance Due $
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any OF TIGARD BUILDING INSPECTION DIVISION
MST
24 Hour Inspection Lino: 639•-4175 Business Line: 639-4171
BLIP
_Date Requested _ _ANI PM BLD
Location 1_ ' ��Jr �-' /J --�-.� � Suite MEC ---�– -—
Contact Person Ph PLIv�
Contractor .., �- Ph SWR
BUILDING –� Tenant/Owner – {_ ELG l OD 7
Retaining Wail _ ELIR l
Footing Access:
Foundation FPS
Ftg Drain _ —
Crawl Drain I inspection Notes. - SGN
Flab
_.---------- --------- -------------.-- SIT
Post cZ -----
Ext Sheath/Ghees
Int Sheath/Shear I -
Framing - _ ----------- -- ---
Insulation �1 /
Drywall Nailing Run L. -__ C
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling h _
Roof
Mise: - ------ --
Finnl � - -------
PASS PART FAIL ------ ---- ------- —
PLUMBING
Post R Seam --
Undei Slab
Top Out
Water Service
Sanitary Sewer ia es
/ /L
Rain Drains �� /�',� 1ctL —1`111 "' 4 P.
Final ('
PANS PART FAIL
MECHANICAL �� / _ ,, �(=1� /
Past 8 Beam e:w a 1tJ GM -�4�4 !yl ep 42'<C2SG2!'ti M 0y _�d 15
�
Rough In
Gar.Line ��J�'Ll�' /ilr +�, if7
��-'� -�.•
Smoke Dampers
Final
PASS PART FAIT_ I -
ELECTRICAL �"_i —--- --- — -- .---_-_ -- - —
Service - ---.- — - -- - ----
Rmigh In
UG/Slab ----
Low Voltage
Fire Alarm -- -� -------.___-. _ -_--
PASS PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I J Please call for reinspection RE:` J Unable to inspect no access
ADA �r
Approach'Sidewalk Date ��� ^. �r Inspector Fxt
Other — . _ _.
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
ELECTRII"AL PERMIT _
CITYOF TIGARD – PERMIT#: ELC1999-00467
PEVELOPMENT SERVICES ORIGrm-UED:
7/28/99
13%•'5 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 2S102AC 00100
SITE ADDRESS: 09050 SW BURNHAM ST ZONING: CBD
SUBDIVISION: BURNHAM TRACT
LOT : 004 JURISDICTION: TIG
BLOCK:
Proiocl Description: Installation of one branch circuit. Job No. 2068-149.—
RESIDENTIAL UNIT —TEMP SRVC/FEEDERS MISCELLANEOUS _—
11000 F,FR OLESS. 0 - 200 amn: PUMP/IRRIGATION:
EACH ADDT. 500SF: 201 - 400 amp: SI^N/OUT LINE L.TG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL./PANEL.:MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABE'_ (10):
SERVICEIFEED -R _BRANCH CIRCUITS _ _ ADDT INSPECTIONS_
0 - 200 amp: W/SERVICE OR FEEDER:! PER INSPECTION:
1st W/O SRVC OR FDR: 1 PER HOUR:
20'1 - 400 amp: IN PLANT:
401 - 600 arrrp: EA ADD'L BRNCH CIRC:
60'1 1000 amp: _ _ PLAN R_REVIEW SECTION
=4 RES UNITS: —— > 600 VOLT NOMINAL:
1000+ amp/volt: CLASS AREA/SPEC OCC:
—Reconnect only__-_._ __
SVC/FDR>=225 AMPS: .__— —
Contractor:
Owner- PHOENIX ELECTRIC CO
LEE, SCOTT &
7379 SW TECH CENTER DR..
LEGER, DAVID &
LANGAKER, BARBARA TIGARD, OR 97223
BANK:.,, OR 97106 Phone: 684-3600
Phone:
Reg #: LIC 00052288
SUP 41405
EI_E 34-2470
_ FEES Required Inspections –
Typo By Date , Amount Receipt Elecl'I Service
PRMT DEB 7/28/99 $37.50 99-317200 Elect'I Final
5PCT DER 7/28199 $2.62 99-317200
— Total $40.12
J
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. AT Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
001-0080 You may obtain copies of these pules or direct questions to OUNC at(503)
rules are set forth in CAR 952-001-0010 through OAR 952
?46-19
� � ���{ �'` Issued B
S �Y
per mit Signature: L� c —
OWNER_INSTALL 1TI0AONLY -
1 he installation is boing ma6e on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ---- -------- --
DATE:
CONTRACTOR INSTALLATION ONLY-
DATE:_. —
SIGNATURE OF SUf'R. I=LEG'N: —
LICENSE NO: _� ---- --- --------------------------------
Call 639-4175 by 7:00p.n for an inspection the next business day
JIIL-28-99 WED 07;06 AM PHOENIX ELECTRIC CO FAX N0, 15036843611 P. 02
CITY OF TIGARD Electrical Permit A' plication Plan eco
13125 SVI HALL BLVD. Rec'i 13Y
TIGARD OR 97223 Date Rota L9
Phone (503)F 3g-4171, x304 Dal"to P E.
Data to DST
Inspection (503)639-4175 Print of Type Permit# £LCI 99'O�
Fax(503) 598 1960 Incomplete or illegible will not be accepted Galled _
1, Job Address: 4 ComFtlete Fee Si:hedule Below:
Name of Devolopment _ —Number of Inspectior•s per mrMit allrnved
Name(ornarie o bu�Inwh} .r pec- — Service included: Items Cost Sum
Address S�., f,�� u w t/+� A% Residential-per unit
City/Slate/Zip �� 1000 sq.1t.or lest _ $ 111 i, 4
Fact.addlUona(900 sq.ft,or
portion thereof S 2e
Commercia Rewdential ❑ Limited Energy $ 60 on -
e � ^ �}tr� Each Manuf d Home or Modular
/IT/ACtOnstallaticaon LSo, nly: Dwelling Service or Feeder y 7P 7!, p
(Prior to permit Issuance,applicants must provide contractor-license, 4b.Services or Feeders
Infwmatlon for COT, tease). Installation,al:cralion,or relocalton
Electrical Contractorz 200 amps or test s 64.25 2
Address` ) Tc e -_ •, 201 amps l0 400 amps - S 813.50 2
- 401 amps to 600 amps $ 17.9,50 2
City_ f, State Zip�-�^a- _ 601 amps to 1000 amps 5 192.50 _ 2
Phone Nb _ Over 1000 amps or volts b 363.76 2
Job N0. % << __ Reconnect only ! $3.90 2
Hpc, Gant.Lice. No._ "_ �'_Exp Date ,_-- 4c.Temporary Services or Feeders
OR State CCB Reg No. Exp Date _ _ Installation,alteration,or relocation
COT Business Tax or Metro No,�_ L-ith - w 200 amps or leas - ,P 53 5o z
201 amps to 400 amps $ 0n 25 ?
.Signature of Supr. Elec'n cr 401 amps to 600 amps $ 107 n0 2
- -- Over 600 amps to 1000 volts.
License No, Exp,Date sae"b"above.
L - ---" Id.Branch C Ucults
Phone No. _ 0_nl) New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: w/fh purchase of service or
feeder foo,
Print Owner's Name Each branch circuit S 5 15
Address - b)The:fwu for branch circuits
- - without purchase or service
City -Stale Zip — _ or feeder for.
Phone No._ _— Firat branch dreult _�_ $ 37.50
Each additional branch circuit _ S 5 35
The installation Is being made on property I own which Is riot 4o.11111■cellaneous
Intended for sale, lease or rent. (Service or feeder not Included)
Each pump or Irrigation circle S 42'75
Owner's Signature -� — Each sign or outline)Iphtin0 $ 4275
-!-`—- Signal circuit(a)or a limited energy -
* pone;,allarstion or oflension S 6000
3. Plan Review section (if required): Minor Labels(10) % 107.00 -
Please check appropriate Item and outer fee In section 58. 4f.Each additional lnspeclirm over
or more residential units in one structure the allowable In any of the above
Service and feeder 225 amps or more Per Inspection 9 50.00
S
_5yalem over 600 volts nominPer hour 5000 In Plant S $9,00
_ Classified area or structure contaihine special occupancy as -_-
described in N E.C.Chapter 6 b. Fees: 7
So.Enter total of above fees $
+ Submit 2 sets of platin with application where any of tho above apply, 58A Surcharge(.05 X Intal fees) 3
Not required for temporary construction services. Subtotal S
TICS Bb,Enter 25%of line 54 for
�-- Plan Rc,Icwv Ig reaVir(Sec,3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtota.'
IS NOT COMMENCED WITHIN 160 DAYS,OR IF CONSTRUCTION OR '
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trutt Are.our,t 0��
AT ANY TIME AFTER WORK IS COMMENCED. — rotal balance Due - - -- $
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