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12658 SW NORTH DAKOTA ST ,�
CITY OF TIGARDELECTRICAL PERMIT
DEVEMPMENT SERVICES Pr-RMIT #: r.LC1-)7•-0 47
19125 SW HoltBIvd.,llprd,OR 97W (50)M4111 DATE ISSUED: 08/12/97
PARCEL: 1S133AD-0 `"i0N
S I Tr ADCRESS. . . : 12GOS SW NORTH 5AKOTA ST
SUBDIVISION. . . . : ZONING.R7
SL.00K. . . . . . . . . . s LOT. . . . . . . . . . . . . . JURISDICTION: Tia
P1 o j ect De script ,ions Kindercare
--RE,iDENT IAL UNIT _.---TEMP SRVC/FEEDERS._- .. — - -._--MISCEL.LANEOUS-
1000 SF OR LESS. . . . : 0 0 — L:00 amp. . . . . . . s 0 RUMP/I RR I CATION. . . . s Ib
EACil Al)D' L- 5001Sr'. . . : 0, 201 _. 400 amp. . . . . . . : 0 STGN/OIJT LINE L_TG. . s 0
LIMITED ENERGY. . . . . : 0 401 — E00 amp. . . . . . . s 0 SIGNAL/PANEL. . . . . . . : 0
MANN-. FIM/ 5VC/rDR. . : 0 6011 amps- 1000 volts. : 0 MT.NOR LABEL (10) . . . s 0
----.SERVICE/FEEDER----_ _ -•----SRANCH CIRCUITS------ -----ADD' L INSPECTIONS-..._-
0 200 amp. . . . . . s 0 • W,'SrRVIrC OR rECDE_R: 0 PER INSPECTION. . . . . : 0
eel - 400 Imp. . . . . . s 0 1st W/O SRVC OR FDR. : i PER HOUR. . . . . . . . . . . s T
401 6017 -mp. . . . . . s 7i E'A ADD' L DRNCH CTR(': 0 IN PL-ANT. . . . . . . . . . . .. 0
601 10100 amp. . . . . : 0 ..______------____---PLAN REVIEW SECTION-----------------
1000-1 amp/valt. . . . . : 0 ) -4 RE^., UNITS. . . . . . . . .. ) 500 VOLT NOMINAL. . :
Reconnect only. . . a . % 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPCC OCC. :
Oalrler. - _ ....__-_. _____. .____ ._.___.�_...,_.__.___._--.--_ __ _._, FECS
KINDER CART` LRNC type amt)Ltnt by date r-e+cpt
?302 MARTIN ST. PRMT f 353. 00 Jr,D 08/11/97 97298157
# 460 5PCT f 1. 75 J5D Or-1/11/S7 97-P-98157
IRVINE CA 92715-0000
Phone #
ALL.STAR CLErTRI_ INC. ;3x. 75 TOTrI
rO PDX 7069
RE=QUIRE:D Itd�GECT15NS
ALOHA OR 97007-7069 Ceiling Cover Elect' 1 Service
Phune #: 649--6-354 Wall Cover Elect' 1 Ficial
Reg #. . .- 000920
'his permit is :slued sdbject tr the regulatiors co-'ained it the Tigard Municipal Code, State of Oregon Specialty Codes and al; other
applitatts laws. All work will be Cone in accordant with approved plans. This permit will expire if work is not started within too
days of issuance, or if worN is suspended for sore than IN days. ATTENTION: Ongan law regio es you to follow the rules adopted by
the Oregon Utili+y Notification Cent Er. ?hose rules are set firth ir, OAR through ORI, 952-181-087. You say obtain a copy
of these rules or direct :,lestinns to W, by railing (513)246-1987.
IL
a a Mi 1:+e e ",i y � ,', 1 hA af' ....__.__ I s s u e ri By
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_____...— OWNER INSTALLATION
111t� installation is being mac.1� ot) pi oper,ty T crt•,n which is not inte:ldecl fill-
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ill-
m ,,:AIet lease, nr" r"011t. s
W r1W�)rR' S 8I ONATURE: d'K _ DATE t
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__. CONTRACTOR iMSTA1_LOTION ONL.Y_...._...._...__ _..._...
_.._.._._....
7.I77NATLIRF OF SLJ^R. FL_FC' N: DATE:
T CENOE NO•
+++4-+++4+4+.144++4+4-4 r l-mss 4-++4+-1 4++4 4-+*.+-h+++++++-t-++++4-+++4-+++44.4-F+4++4-; ►+4 4*++F 4
Call G39--41.75 by 6:710 p., m. for an ; n43pection deeded the next busing -ss 11Ay
a,T i a.a�.a s•�;
rr :;..
erry OF TIGARD Electrical Permit Application Plan Check r
13125 SIR' HALL BLVD. Recd ey_
TIGARD OR 97223 Date Rec'd-
S�S Date to P.E.
Phone(503)639-4171,x304 L t L Print or Type Data to DST_
Inspection(503)639-4175 1 Incomplete or illegible will not be accepted Pefnit"--��c
977 -0
Fax(503)684-7297 I Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Number of tnspectlons per permit allowed
Name (or name of business)�Kj A Cam Service Included: Items Cost Sum
Address � ��7 ,l1�y 4s. Residential-per unit
1000 aq.R.or less :110.00 4
City/State/Zlp_ ' A Q
.J Each additional 500 sy,ft.or
Commercial Residentia;❑ portion thereof -_ $25.00
Li1
mited Energy $25,00
Each Manul'd Home or Modular
Dwelling Srrvice or Feeder 688.00 _ 2
2a. Contractor installation only:
(Attach copy of all c rrent"nonses r 4b.Services or Feeder
Electrical ntrector_ Installation.alteration,or relocation
Address �U• 200 amps or less $60.00 _ 2
201 amps to 400 amps $90,00 _-� 2
City State diL Zip per _ 401 amps to 600 amps :120.00 2
Phone o. 4y3_b4 1,- �aA 4 bol amps to 1000 amps _ $180.00 2
,lob No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec.Cont. Lice. No._y it 34,x_Exp.Date _
OR State GCB Reg. No. R20 7s- Exp.Date 4c.Temporary Services or Feeders
COT Business TeX or Metro No. _Exp.Date-- Installation,alteration,or relocation
200 amps or less _ $50.00 2
'7
201 amps to 400 amps $75.00 2
Signature of S..ij. 4%- - 401 amps to 800 amps $100.00 2
C-or 800 amps to 1000 volts,
License No.. 't S �Exp.Dat- •)e"b^above.
Phone No._. -
- 4d.Branch Clrculte
New,alteration or extension per panel
2b. For owner insiallation•s: a)The fee for branch Arcults with
purchase of ser dee or
Print Owner's Name_ _ leader foe.
Address Each branch circuit $5.00 2
---- b)The fee for branch circuits
City _ State_ -Zip - without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 �� C20 2
The installation is being made on property I own which is not Each additional branch circuit-_ $5.00 2
intenoed for sale,lease or rent. 4s.Miscellaneous
(Service
Owner's Signature- Eachpump c gallon circle Included)
$40.00 2
Each sign or outline fighting $40.00 2
3. Plan Review section(if required):" Signnl cirrult(s)or a limited energy
L panel,alteration or extension $40.00 - 2
C Minor Libels(10) $100.00 _
Please check appropriate Item and enter fee In section 5B.
_ 4 or more residential units In one structure 4f.Eer:h additional Inspection over
Service and feeder 225 arnps or rlore the ellowpble In any of the above
3 _ System over 600 volts nominal Per Inspectior,
Classified area or structure contain ng special occupancy Perhour $55.00
0 as described In N.E.C.Chapter 5 In Plant A- 555.00
LIJ
Submit 2 soft of plans with application where any of the shove apply. Jam. Fees:
Not required for temporary construrtlon aer-0, e. 5a.Enter total of above fees $
5%Surcharge(.05 X total fees) $ --
PSTlct subtotal $
5b.Enter 25%of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTIO14 AUTHCRIZED IS Plan Review(}Legu1M(Sec.3) $
NOT COM! AENCED WITHIN 180 DAYS,OR IF CONSTRU%.TION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account It
To tat balance Due tt
1ADSMELC98.APP nev 9196 9
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour InspeWon Line.639-4173 Business Phom-�:639.4171
Date Requests:: p�� / __ A.M. P.M. MST:
00
Location:_ (05 [] �, Q J KIP: —�
Tenant:__— kJAJDF _ — suite: B14 hm:
Contractor: JJ Phone: �' 6 PLM:
Owner: '�C�C� Phone.:
ELI:
31T:
BUIID BLDG(cosi) PLUMBING MECHANICAL BI.)<CTRICAL SITZ
Site Past/Beam Post/Beam Post/Been `hose 3ewer/starm
Footing Rogf UndFI/Slab Rough-In Wdor Lim
Slab Framing Top Out Gas Line Uta Spm
Foundation Insulation Sewer Hood/Duct Vault
Bunt Damp Drywall storm Furnace Temp Service 11HS1C,
Masonry Ceiling Rain Drain A/C UG SW
Shear/Sheath Fire 801r/Alm Crawl/Found Dr Heat Pump
Approved Approved _ Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved
FINAL MAL FINAL. FIMAL FINAL
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0 Cell for reinspection O Reinspection fee gf S required before next inspection O Unable to inspect
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Inspector:/ _ ! C dC Dater ~^— Page—jof