Permit Ai CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00700
s4a�jl� DEVELOPMENT SERVICES DATE ISSUED: 12/19/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1 12BD-00700
SITE ADDRESS: 14655 SW 76TH AVE 001
SUBDIVISION: MARCIENE II ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one branch circuit for new bathroom fan.
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:
BRENDA REILLY ELECTRO WIRE INC
7524 SW ELMWOOD 18857 SE SUNNYSIDE RD
TIGARD, OR 97223 BORING, OR 97009 -9271
Phone: 503 - 246 -7908 Phone: 658 -8136
Reg #: ELE 26 -667C
LIC 67879
SUP 2717S
FEES Required Inspections
Type By Date Amount Receipt
Wall Cover
PRMT CTR 12/19/00 $46.85 2720000000( Elect'I Final
5PCT CTR 12/19/00 $3.75 2720000000(
Total $50.60
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 - .: • • the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain • •ies of these rul s ordirect questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE 44l.( / ISSU .' BY Lek'
OWNER INST LLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
�/ CONTRACT R INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N• ✓` / e /- DATE:
LICENSE NO: 0 i' 7 S
Call 639 -4175 by 7:OOpm for an inspection the next business day
( w/ ..te- ittte__GrGvt -_ ic14 ;4-- 460t, -y, it
4. Electrical Permit Application . .
. . ,
Date received: 4P--/ 9 _ »y Permit no.: -DO 7
iti; 1 1 " C of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
;, TYPE OF:PERMIT., °` w' t , « '
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ! Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
:JOB:SITE'INFORIVIATION "
Job address: , 55 ,,,,!.Q ? • - Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision: •
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
. r CONTRACTOR :A PPLICATION : ! t k' : ' t
h1✓E SCHEDULE: ;•
Job no: Fee Max
Business name: Description Qty. (ea.) Total no. insp
Z New residential - single or multi - family per
Address: 1 ,S%, E ,,; . .,_ dwellingunit .Includes attached garage.
�ta .r
State: p ZIP: - 46 • Service included
Phone: , S , - ,Fax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof __
CCB no.: ., ; - • •1 /0 Elec. bus. lie. no: 2.1, - ( ,
Limited ener energy, residential ��� 2
City /metro lic. no.: / Limited energy, non- residential _EMI _ 2
. " i, , , I 4, • Each manufactured home or modular dwelling
.Signature of supervising electrician (required) A Date , — /-O/ Service and/or feeder ■■. 2
Services or feeders
Sup elect. name (punt) 2_ 7 1 A,/ /Wil cense no 7/ 7 5 alteration or relocation:
' t;, : PROPERTY O1%'NEft , 200ampsorless 2
Name (print): A2,1 2 c /, ,' 1 9 201 amps to 400 amps MEMO 2
{ 401 amps to 600 amps _E_ 2
Mailing address: 5LL a.. / 601 amps to 1000 amps _M_ 2
IEErri f j ZIP: 2 7" _Sri Over 1000 amps or volts ___ 2
Phone:•. r io ,41353MOUrfi E-mail: Reconnect only _� 1
Owner installation: The installation is being made on property I own Temporary services or feeders - •
which is not intended for sale, lease, rent, or exchange according to installed° ration,orrelocation:
200 amps or r l lessess II 2
ORS 447, 455, 479, 70 70P.) 7 • i I/1 (/v 201 amps to 400 amps MIME 2
Owner's g s si nature• „-'. , , _; _ ; ' /i _ $ te: _ z 401 to 600 amps MME 2
i ., :,: ENGI? ;r, Branch circuits- 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: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: i% ■ 2
Phone: Fax. E -marl: Each additional branch circuit: IM__—
PLAN
225 amps
A REV ` (Please check ,all that apply)! Misc. (Service or feeder not included):
❑ Health -care facility Each pump or irrigation circle e■
❑ Sernce ov
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting ME__ 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ■■■
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Descri . tion:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection ___—
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa Cl MasterCard expires if a permit is not obtained Plan review (at _ %) $ - 7 �
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $ 50 . lid
Name of cardholder as shown on credit card •
$
Cardholder signature Amount 440 -4615 (6IOOICOM)
Electrical Permit Fees: Limited Energy Fees:
- TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: • Restricted Energy Fee $75.00
Number of Inspections per permit allowed - (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ . Burglar Alarm
Limited Energy ' $75.00 •
Each Manufd Home or Modular n Garage Door Opener •
• Dwelling Service or Feeder $90.90 2
Services or Feeders n Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 n Vacuum Systems*
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 ❑
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders • TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved: •
Over 600 amps to 1000 volts,
see "b" above. Audio and Stereo Systems •
Branch Circuits Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit ' $6.65 ' ' 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits .
without purchase of service Fire Alarm Installation
• or feeder fee.
First branch circuit ' $46.85 .
Each additional branch circuit $6.65 n HV '
Miscellaneous 0 Instrumentation
(Service or feeder not included) 1
Each pump or irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.40 n
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 n Landscape Irrigation Control
Minor Labels (10) $125.00 n
Each additional inspection over Medical •
the allowable in any of the above Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
Fees: D Protective Signaling
Enter total of above fees • $ n Other
8% State Surcharge $ Number of System
25% Plan Review Fee
•
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees: • .
•
Total Balance Due $
Enter total of above fees $
• ❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts \forms \elc- fees.doc 10/09/00 • _
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1-- Z ' AM PM BLD —, .
Location /c / (5 Suite 00/ MEC
Contact Person Ph 1 y � - 7J( a 8 PLM
Contractor �D Ph / SWR
BUILDING Tenant/Owner Cali 0. 4 7 vvs �r /P� d ELC & ar -G-)7c'
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
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: C:1
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
C€CT
Service (Val/ CG ✓ tti
Rough In 6 UG /Slab Rio-
Low Voltage
Fire Alarm
in
PART. FAIL
471, ackfill /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
Other Date . Z 7, C9 Inspector / Ext
Final
PASS PART . FAIL DO OT REMOVE this inspection record from the job site. . .
•