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15200 SW HALL BLVD.
CITY OF TIGARD BUILDING INSr'FCTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
13UP __-- —• ----
Date Requested___ ' AN ri___ PM _ BLD _-. ----___--
Location 2, i__., d �s�,�� Suite MEC _
Contact Person �� � ��.�_—.. Ph — 1-� + PLM
Contractor Ph SWR
BUILDING Tenant/Owner .. 'T� I _ -- ELC
RetaininggWell- =LR - -
Footing Access: L FPS
Foundation
Ftg Drain
Crawl Drain InspectionNotes:
Slab ----- ---- --- - .--- -- SIT --
Post&Beam
Ext Sheath/Shear --
Int Sheath/Shear
Framing - - - - - - -----
Insulationi
Drywall Nailing __-_--
Firewall
Fire Sprinkler --- ------- -�--- -
Fire Alarm
Susp'd Ceiling -----
Roof `'E--
Misc: --- - ------ -- --- -
Final
PASS PART FAIL -�
PLUMBING _
Post&Beam
Under Slab _--_ ---- -
Top Out
Water Service -
Sanitary Sewer
Rain Drains -- ------
Final
PASS PART FAIL _ - - - --- - ----- ------__—_.-.__
MECHANICAL
Post&Beam _ - - _----------- ---- -------------------
Rough In
Gas Line - -- ---- -- ---- --------
Smoke Dampers -
Final
P PART FAIL --- - -- --- --- �- - -- _-`_
Service - ---- --- -- ------ _-
Rough In
UG/Slab -_ -_--- -- - --
Low Voltage
FiritAlarm
PASSt PART F11 -- -
Backfill/Grading — —
Sanitary Sewar
Storm Drain ( j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please call for reinspection Rr: ( ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 'It _ Inspector �`, �., Ext
Other
Final
PASS PART FAIL DO NOT REMOVE thin inspection record from the job site.
CITYOF T I GA R D __ ELECT► CAL PERMIT —
PERMIT M LLC1999-00648
DEVELOPMENT SERVICES DATE ISSUED: 11/1/99
13125 SW Hall Blvd.,Tigard, OR 97223 '503) 639-4171
PARCEL: 2S112CB-01070
SITE ADDRESS: 15200 SW HALL_ BLVD TRAFFIC LIGHT
SUBDIVISION: GOOD ACRESOR � A �URISDICTION:NTIG
93LOCK:
Proiect Description: 30 Pimp overhead service for TCI and one branch circuit. Service located on PGE pole#1486, pole is on
north side of Sattler,just west of Hall Blvd.
_
RESIDENTIAL UNIT _ _ _TEMP SRVC/FEEr)ERSMISCELLANEOUS
:
1000 SF OR LESS0 200 amp _ PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 6014•amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS_
0 200 amp: 1 W/SERVICE OR FEEDER: 1 PER INSPECTION:
201 400 amp 1st W/O SRVC OR FDR: 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:
MCDONALD, LYNN B + MONICA R ANDERSONS INTEGRITY ELECTRIC
8340 SW ROSS S-1 18435 SW PACIFIC HWY
TIGARD, OR X17223 STE D
TUALATIN. OR 97062
Phone: Phone: 524-4681
Reg #: SUP 3770S
LIC 00091410
EI.E 34-363C
FEES _ Required Inspections_______ _
Type By Date Amount Receipt
_ Elert'I Service
PRMT DEB 11/1/99 $69.60 99-318440 Elect'I Final
5PCT DEB 11/1/99 $5.57 99-318440
Total $75.17
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 worts will be done in accordance with approved plan I T permit will expire if work is not started within 180 days of issuance,or rf work is
suspended for more than 180 days ATTENTION 0 gon la requires you to follow rules adopted by theOregon Utility Notification Center Those
rules are set forth in OAR 952.-0 Xl0 through OA 952-0 0080 You may obtain copies of these rules ardirect questions to OUNC at(503)
246-1987 '\ %��
PFRMITTEE'S SIGNATURE _-_ -- ._ I� UED BY: A
L-, ril(�J :,::E
_ OWNER INSTALLATION P LY
f'A
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE — _ .._ DATE:
� ON TO INSTALLATION ONLY,
SIGNATURE OF SUPR. ELEC'N:
LICENSE NO: ��� ----- — --- ----------
Call 639-4175 by 7:009m for an inspection the next business day
1
rfY OF TIGARDElectrical Permit Application Plan hark#
13125 SW HALL BLVD. Ret sy
Date Red '"�!
i IGARD OR 97223 Date to P.E.
Phone(.503)639-4171, X304 ,!?o✓ "T" C I Date to DST
Inspection (503)639-4175 2,0&4 ttiP 0�,, Print of Type Permit# � � � '�
Fax
�--
(503) 598-1960 Incomplete or illegible will not be accepted Caned
1. .Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name(or name of business) d14") Service included: Items Cost Sum
AddressN w C•'-� i to ' Ed ° nrj SraT 4a. Residential-per unit
Ci /Stat i ►� PGt Poo d I yb 1000 sq.ft.or less _ $ 117 75 - ^
H p o Each additional 500 sq 6.or
�y portion thereof _ $ 26.75 1
Commercial{ R- es d n a- Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor Installation only: Dwelling Service or Feeder $ 7275 2
(Prior to permit Issuance,applicants must provide contractor license 4h.Services or Feeders
information for COT da baso). Installation,alteration,or relocation LS
Electrical Contractor___ , 200 amps or less �- $ 84.25 �� 2
Address l 8 q s _Sc.. 'u CL - 201 amps to 400 amps $ 85.50 2
401 amps to 800 amps $ 128.50 2
Cit)/�Ir-�r v State QC ..Zip 61 7 O G T_ 601 amps to 1000 amps $ 192.50 2
Phone No. G 9 r- Cz0 7 Over 1000 amps or volts _ $ 363.75 2
,lob No. Reconnect only $ 53.50 2
Elec, Cont. Lice. No.3 GI-3G 3 Exp.Date 4c.Temporary Services or Feeders
OR State CCB Reg. N0. (cif f a Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. Exp Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
L-_� _ __ 401 amps to 600 amps S 100.00 2
SignaWre of Supr. Elec,n-
Over 800 amps fn 1000 volts,
t+ea"b"above.
License No.3'7 7 o S _-__Exp.f:ate --- 4d.Branch circuits
Phone No. (g 'I j. Co?6 --- New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder lee. 3
Print Owner's Name-- Each branch circuit $ 5.35 a
b)The fee for branch circuits
Address _ --- without pumbese of service
City _State_ --Zip _ or feeder Iee.
Phone No. First branch circuit $ 37.50 _
Each additional branch circuit $ 5.35
The installation is being made on property I own which Is not 4o.Miscellaneous
intended for sale,lease or rent (Service or feeder not included)
Each pump or Irrigation circle $ 42 75
Owner's Signature_ Each sign or outline lighting $ 42 75
- Signal circulf(s)or a limited energy
* panel,alteration or extension $ 6000
3. Plan Review section (if required): Minor Labels(10) - $ 10000
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 Pnr hour $ 50.00
_-System over 600 volts nominal In Plant _ $ 5900
,-Classified area or structure containing special occupancy as
described in N E C Chapter 5 5. Fees:
5a.Enter total of above fees 5 �_
Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(08 X total fees) $ r
Not required for temporary construction services. Subtotal $
5b.Enter 25%of line 6a for
NOTICE Plan Review If required(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal
IS NOT COMMENCED WITHIN 180[LAYS,OR IF CONSTRUCTION OR rr,,
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS u Trust Account# 7
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ ��•
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