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Permit
CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00440 414 401 6 D EVELOPMENT SERVICES DATE ISSUED: 7/20/99 44- At' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115AB -01900 SITE ADDRESS: 16200 SW PACIFIC HWY A SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: First branch circuit RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 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: BIT HOLDINGS LTD PARTNERSHIP JARMER ELECTRIC INC BY FORUM PROPERTIES INC 5105 SW 45TH AVE FIVE CENTERPOINTE DR STE 290 PORTLAND, OR 97221 LAKE OSWEGO, OR 97035 • Phone: Phone: 246 -5381 Reg #: LIC 00006924 SUP 3488s ELE 26 -144C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT BON 7/20/99 $37.50 99- 316995 Elect'l Final 5PCT BON 7/20/99 $2.59 99- 316995 ORIGINAL Total $40.09 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Permit Signature: NA , ?A.'" Issued By: (V12411l(/ • WNER 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: 01E\ Are l LeICA (1� DATE: LICENSE NO: • Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Check 13125 SW HALL BLVD. Recd By _ j.F O.4 - 1. -- Date Recd 7 TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit# ELC1 60'I t f 0 Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: - Name of Development Number of Inspections per permit allowed Name (or name of business) n CA , Service included: Items Cost Sum Address ) 43 Z 0 © 5 t,.) OR, C t "�'1�G .! q 4a. Residential - per unit City/State /Zip ! c oted Oil c 7 7-2-If 1000 sq. ft. or less $ 117.75 4 JJ Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial ® Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data ) Installation, alteration, or relocation Electrical Contractor /r Yl r. 200 amps or less $ 64.25 2 Address AO (, -a 201 amps to 400 amps $ 85.50 2 Zip 9727- t 401 amps to 1000 amps $ 128.50 2 City State Zi 601 amps to 1000 amps $ 192.50 • 2 Phone No. c ' 6- 3 g/ Over 1000 amps or volts $ 363.75 2 Job No. J8 i. / Reconnect only $ 53.50 2 Elec. Cont. Lice. No. - Exp.Date A .4c. Temporary Services or Feeders OR State CCB Reg. No. Exp.Date 0 Installation, alteration, or relocation COT Business Tax or Metro Nom.x7 /3 /Z- Exp.Date 3/O0 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 k- 401 amps to 600 amps $ 107.00 2 Signature of Supr. Elec'n Over 600 amps to 1000 volts, see "b" above. License No. 4 /0 1/4/ ` S o p. ate /V 0/ 4d. Branch Circuits Phone No. o? S/(o 3 O / New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 Address b The fee for branch circuits without purchase of service City State Zip or feeder fee. /nJ�� Phone No. First branch circuit / $ 37.50 0� 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 circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension $ 60.00 Minor Labels bels (10) $ 107.00 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 Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ * Submit 2 sets of plans with application where any of the above apply. 7" Surcharge (.05 X total fees) $ Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ i 9,9 i:\dsts\forms\electric.doc 8/16/99 Activities for Case #: ELC1999 -00440 • 8:38:51 PM Assigned Hold Updated Activity Description Date 1 •Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC003 Permit created 7/20/99 BON DONE No Hold BON 7/20/99 ELCC001 Application received 7/20/99 BON DONE No Hold BON 7/20/99 ELCC730 Elect'I Service 7/20/99 7/20/99 No Hold BON 7/20/99 ELCC799 Elect'l Final 7/20/99 7/20/99 7/26/99 • CD PASS No Hold AKJ 7/26/99 add fl. fixtures (4) and replace some existing ELCC500 (F)Issue permit , 7/20/99 BON DONE No Hold BON 7/20/99 ELCC800 Case Finaled 7/26/99 AKJ DONE No Hold AKJ 7/26/99 • • • • • • • • • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 //-- BUP Date Requested — 2- - 111) [ AM PM BLD Location (02 1)( � G�. /12L Suite A MEC Contact Person Ph (Q7 1) '16 ( PLM Contractor Ph SWR BUILDING enan Owner / I � _ / /A / ELC 1911,03q q0 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Ate /C avr (L0 Drywall Nailing `-+ �f �V I�� S Fire wall Fire Sprinkler 1 �e , / � /}'G Fire Alarm Susp'd Ceiling Roof 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 PASS PART FAIL ICACj Service Rough In UG /Slab Low Voltage Fir m PAS ) PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for re'nspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date - 9 Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.