12285 SW MAIN STREET-2 IS NIVW MS S8ZZ6
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12285 SW MAIN ST
� ELECTRICAL PERMIT
CITY OF
TIGARD
PERMIT#: ELC2001-00378
' DEVELOPMENT SERVICES DATE ISSUED: 7/26/01
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S102AB-03600
SITE ADDRESS: 12285 SW MAIN ST
SUBDIVISION: ZONING: CBD
BLOCK: LOT : JURISDICTION: TIG
Prosect Description: Temporary service on power pole for Tigard Blast celebratelon.
RESIDCNTIAL UNIT TEMP SRVCIFEEDERS _ MISCELLANEOUS
1000 SF OP LESS: 0 - 200 amp: PUMPIIRRIGATION:
EACH ADD" 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: 1 W/SERVICE OR FEEDER: 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: >6(10 VOLT NOMINAL: —�
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREAISPEC OCC--
Owner:
CC:Owner: Contractor:
JOHNSON, WARREN W + BETTY TRS WILLAMETTE ELECTRIC INC
JOHNSON, REES C + MARYANNE G PO BOX 230,947
3112 SW SANTA MONICA ST TIGARD, OR 97281
PORTLAND, OR 97201
Phone: Phone: 624-3631
Reg#: LIC 75059
SUP 1965S
ELE 34-2830
FEES Required Inspections
Type By Data Amount Receipt Elect'I Service
PRMT CTR 7/26/01 $66.85 2720010000(
Clect'I Final
5PCT CTR 7/26/01 $5.35 272001(1000(
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Muricipal 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
L rules are set forth in OAR 952-001-9,010 through OAR 952-001-0080. You may obtain copies of these rules ordirect questions to OUNC at(503)
C 246.6699 or 1-800-332-2344.
Issued By:
Permit Signature:
0 _ OWNER INSTALLATION ONLY
U 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: _lis. l¢ 1' DATE:
LICENSE NO: — / 07 6- S-J —
Call 6394175 by 7:00pm for an Inspection the next business day
Electrical Permit Application
Daterot•elved: Permit no.:
City of Tigard TI(l, Project/app!.no.: Expire date:
Address: 13125 SW Ilan Blvd,Tigard,OR 97223 Date Issued: il—.f/t/J Receipt no.:
CiryaJTignrd Y'
Phone: (503) 639-4171
Pax: (503) 598-1960 Cele file no.: Payment type:
Land use approval:
11111010 M 110 1 w
U I &2 family dwelling or accessory U Commercial/induslrial U Multi-family U Tenant improvr.mer.t
U New construction U A(ldilion/alteration/replacement 10 Other. le'oql Set,.., U Partial
Job address; (2 5 rKj_ t „t!, ( Bldg.no.: FSuilc no.: Tax mnp/tax lot/account no.:
Lot: Block: Suhclivision: _ .
Project name: ig , ,,, R 1�,,i —Description and location of work on premises: I- A r SP ti
r —
Extimated date of completion/inspection: a; 7l 9 Moa 41... 1
Job no: /Y
Pee Rtax
Bus'�tcss nnntc: Description Qty. ea Total no.hes
Nese residential-.hate or aarNl-faarNy per
Address: /t 0 A -Z r `4 7- d»rlNngrrN.Inchrdmatlachedpror.
Oily: 1 r f 4—_ dale:(/, S"cefncinded:
-- L V_ 9 Itx►o sq,rt.or less 1
1'Ironc: b z sl S 4 r hnx: L? z eb [ mail:
— - Each additional SW sq.fl.or portion Uterrnf
CCB no.: jrSb C-`; I:Icr_.bus. lic.no: i�
�Z& ` Limnedenefit residential 2
City/metm lic_no.: _/`j y ( Limited ener y,non-residential 2
;7 - Each manufactured home or modular dwelling
Signature e�^ elcclrician(requited) Date Service and/or feeder 2
-- �' Services or feeders-Installation,
,)
Sup.elect.name(prinl): ,N ,, r, ^ IJcens�no: (g6 f S
altentlon or relocation: Q�-
200 amps or less ( fr 2
Name(print): 201 amps to 401 amps 2
---- - — 401 amps to 600 ams 2
Mailing address: __ 601 am s to 1000 amps 2
City: - Stale: ZIP: Over 1000 amps or volts 2
Phone: rax: I E-mail: Reconnect only t
Owner installation: lite inr,:allation is Ircing made on property I awn7] Ternpnnryaervkderkedera-
which is not intended for side,(case,rent,or exchange according to 200a amps
o less alteration,or relocation:
ORS 447,455,479,670,701. 200 amps rn leas — 2
201 amps to IW amps __ _ 2
Owner's signature: Date: 401 Ic 600 ams 2
Ilranch clreolis-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: Slate: ZIP: H. Eee for branch circuits without purchase
---- of service or feeder fee,first branch circuit: 2
Phone: fax: E-mail: Each additional branch circuit:
d Mhe.(Senlce er feeder not Included):
1�.. C.r S,mice over 225 amps-commercial U Health-corefacility Each pump or iRigaUon circle 2
N U Service over 320 strips-rating of l&2 U Hazardous location Each sign or nulline lighting 2
family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential nnitsinone structure alteration,or extension*
2
U Building over three stories U feeders.400 amps or more •DescriOat:
m U Occupant load nve,99 persons U Manufactured structures or RV park Each additional Inlpectlon river the allowable In any of the.bore.
Ur U E{res0ightingpien U Other: _._ per inspection
_j submit_sets of plans wlth any of the above. Investigation fee
The above are not applicable to temporary construction senlce. Other
No alljrirdicttan accept creat gird,,plow call JoHMicdnn for nxar l"(nm attee Notice:this permit application Permit fee.....................$ _ _
U Visa r`MasterCard expirs if a permit ig not obtained Plan review(al __ %) $
credit crd ra mhcc: _L within I RO days after it has been Stair,SIIfCharRc(8^5) ....$ _ S. i C
Ex res accepted as complete. TOTAA, .......................$
Name c I r rs sen on credit crd
_ S _
Crdlrotder siigi ria a Anwas, 440-615(M)OC'UM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: - 00
Restricted Energy Fee...................................................... =75.00
Number of Inspections per permit allowed (FOR ALL SYSI-EMS)
Service Included: Items Cost Total Check Type of worst Involved:
Restdentlal-per unit
1000 sq.8 or less $145.15 4 Audio and Stereo Systems
Each additional 500 sq.If or
portion"red _ $33.40 1 ❑ Burglar Alarm
Limited Energy _ — $75.00
Each Manurd dome or Modular Garage Door Opener'
Dwe"Service or Feeder _ —_ 390.90 ____ 2
Services or Feeders ❑ Healing,Ventilation and Air Cond,lioning Sysl-ni'
Installation,afleratlen,or mtocallon
200 amps or less $00.30_ 2 Vacuum Syslerns'
201 amps to 400 amps _ _ 3106.85 _ _ 2
401 amps to 600 amps _ _ _ $160.60 2 (� Outer
601 amps to 1000 amps $24060 2 Lll
Over 1000 omps or volts -- $45465 2Reconnect only only 366.85 _ 2
Temporary Services er Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation .... $75.00
200 amps or Mss 2_ SE0.85 Fes for each system......................................................
201 romps to 400 amp- $100.30 2 (SEE OAR A16-260-260)
401 amps to 60x1 amps $133.75 2
over 600 amps to 1000 volts. Check Type of Work Involved:
see"b"above.
Audio and 5lereo Systems
Branch Circuits
N",alteration or extension per panel U Baler Controls
a)The fee for branch circulls
with purchase of service or
feeder fee. Clock Systems
Each branch circuit _ 36.65 2
b)The lee for branch circuits Uala Telecommunication Installation
without purchase of serv/ce
or feeder fee. Fire Alarm Installation
First branch circuli $46.05
Each additional branch clrrutl $6.65 HVAC
Miscellaneous
(Service or feeder not Included) Instrumentation
Each pump or Irripnllen circle $53.40
Each sign or outline IlghfWV $53.40 intercom and Paging Systems
Signal circull(s)or a limlled energy
panel,alteration or extension $75.00 _
Minn.Labels(10) — _ $125.00 ❑ Landscape Irrigation Control'
Each additional Inspectlon over Medical
the allowable In oily of the above
Per inspection $62.50 _ ❑ Nurse Calls
Per hour -- $62.50
In Plant $73.75 ❑
Outdoor landscape Lighting'
Fees:
Q. � Protective Signaling
Enter total of above fees $
rz
Other
N 6%Stale Surcharge $
_ —`'lumberofSystems
25%Plan Review Fee
See Tian Review"section on3 ' No licenses are required. Lkences aro required for all off ,W Inslatlallons
ro
Irons d aFp!icalkx►. — _____
W Total Balance Due $ _ Fees:
J Enter total of above fees
❑ Trust Account N
8%State Surcharge
Total Balance Due
l:\d%ts\fenmklc-fas.doc IOM/00
CITY OF TIGARD BUILDING INSPECTION DIVISION - , MST
24-Figur Inspection Line: 639,4175 Business Line: 639-4171 —
BUP
Date Requested AM PM BLD
Location j Z z - �7�.�-,,, Suite MIEC
Contact Person r Ph (D �1 y—�(o�/- PLM _
Corns actor . '���_i?4 -re s.. Ph _ SWR
BUILDING _ Tena-it/OwnerELC o U L 3
Retaining Wall ELR
Footing
Foundation ACGeSSj] *Z� L ,yt,- 7e-OL FPS _
Ftg Drain LL. / SIGN
Crawl Drain Inspection Notes:. --
Slab SIT
Post& Beam
Ext Sheath/Shear Z
Int Sheath/Shear �J .
Framing . --�1- ->ILc.y► 7_ _-��
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Coiling --. —
Roof
Misc:
Final —
PASS PART FAIL -- — _
PLUMBIN—7 --
Post& Beam —
Under Slab
'op Out
Water Service
Sanitary Sewer
Rain Drains
Final --
PASS PART FAIL.
MECHANICAL —
Post& Beam -- -- -- --- -— --- ---
Rough In
Gas Line
Smoke Dampers
Final -- —
PASS PART FAIL
TRICAL —
a- Serve —
'� Rough In
F- UG/Slab
Low Voltage
F'
J incl
m PASS RT FAIL ---
W SITE
-'� ding
i ry Sewer
Storm Drain [ J Reinspection fee of$ required before n pection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ J please call for reinspection RE:_ J Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the Job site.