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Permit CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00472 AA DEVELOPMENT SERVICES DATE ISSUED: 8/14/00 - JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1 15AB -01900 SITE ADDRESS: 16200 SW PACIFIC HWY D SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of 15 branch circuits. 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: 14 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 COCHRAN ELECTRIC BY FORUM PROPERTIES INC BROADWAY ELECTRIC FIVE CENTERPOINTE DR STE 290 626 SE MAIN LAKE OSWEGO, OR 97035 PORTLAND, OR 97214 Phone: Phone: 234 -6564 Reg #: LIC 77942 • SUP 3184S ELE 37 -546C FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT DLH 8/14/00 $112.40 0004465 Wall Cover 5PCT DLH 8/14/00 $8.99 0004465 Elect'I Final Total $121.39 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 ordirect questions to OUNC at (503) 246 -1987. ON ,9 - / 3 z- /e , 5 2- 770 - 71/4) PERMITTEE'S SIGNATURE /1,9-/ L ISSUED BY: 4152fi OWNER 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: 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. Rec'd By /h� / TIGARD OR 97223 RECEIV7" Date Rec'd e 7/0/e7) Date to P.E. Phone (503) 639 -4171, x304 Inspection (503) 639 -4175 Print o f Type AUG 10 2000 Date Permit DST Permit # E - 410 - 41097.2. �'ao00 �y7. Fax (503) 598 -1960 Incomplete or illegible wi Called 1. Job Address: 4. Complete Fee Schedule Below: - Name of Development Number of Inspections per permit allowed Name (or name of business) /Q/ 0 44/4 'S7Z IV n Service included: Items Cost Sum 4 ' Address 4104* `` . /! NAL _ A It 4a. Residential - per unit City/State /Zip 7'a •e ne. 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 2615 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 e). Installation, alteration, or relocation Electrical Contractor 200 amps or less $ 64.25 2 Address & VA. /VIM 201 amps to 400 amps $ 85.50 2 A 401 amps to 600 amps $ 128.50 2 City St to Zip 601 amps to 1000 amps $ 192.50 2 Phone No. .�S G.7 -4, 4- Over 1000 amps or volts $ 363.75 2 Job No. / 700 - 7 7oOto • Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 37.5(!. Exp.Date I O I / D� 4c. Temporary Services or Feeders OR State CCB Reg. No. 7294?.. Exp.Date ti 101 Of 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 Signature of Supr. Elec'n � 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, License No. vim) 8 4- S Exp.DateJaJa/ Al see "b" above. Phone No. (Sea 234 •,o 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owners Name Each branch circuit $ 5.35 2 b) The fee for branch circuits Address without purchase of service City State Zip or feeder fee. - Phone No. First branch circuit $ 37.50 � 1, Each additional branch circuit , $ 5.35 a 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 Owners Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy (if required):* panL alteration or extension $ 60.00 3. Plan Review section ( Minor Labels (10) $ 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: La/ 40 5a. Enter total of above fees * Submit 2 sets of plans with application where any of the above apply. .6°!o Surcharge (. �total fees) $ $ Not required for temporary construction services. Subtotal Ir $ / NOTICE 5b. Enter 25% of line 5a for Plan Review if required (Sec. 3) $ tit may( PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ /21. 37 IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ i:\dsts\forms\electric.doc GITY.OF TIGARD BUILDING INSPECTION DIVISION •' & MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7 Z AM PM BLD , Location / 6 2- UO 5 w Pa c ( 4 k Suite i7 MEC Contact Per op / Pj,,23 Av,,SG c/ PLM Contractor , O R / S ( . e - "cc _ Ph 2 fa - G i 7 Z-- SWR BUILDING Tenant/Owner ELC alzie -0 V? Z 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 Drywall Nailing Firewall N Fire Sprinkler " C Fire Alarm Susp'd Ceiling Roof Misc: Final (61 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 • f LEQTRI _ Service Rough In UG /Slab Low Voltage Fire alarm 410 PART FAIL 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 reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 9/i Z.- , Ins Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 8/22/00 Activities for Case #: ELC2000 -00472 4:29:40 PM Assigned Hold Updated Activity Description Date 1. Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 8/10/00 MAIL RECD No Hold DLH 8/14/00 ELCC003 Permit created 8/14/00 DLH DONE No Hold DLH 8/14/00 • ELCC700 Ceiling Cover No Hold DLH 8/14/00 ELCC720 Wall Cover No Hold DLH 8/14/00 ELCC799 Elect'I Final No Hold DLH 8/14/00 ELCC500 (F)Issue permit 8/14/00 DLH DONE No Hold DLH 8/14/00 • ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold ZZZ 8/22/00 Page 1 of 1