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Permit CITY OF T I G A R D ELECTRICAL PERMIT 1 ti PERMIT #: ELC2000 -00092 1 DEVELOPMENT SERVICES DATE ISSUED: 3/3/00 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S136AD-06502 SITE ADDRESS: 10925 SW 69TH AVE SUBDIVISION: WAY LEE ZONING: C -G BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Electrical TI 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: WAY W LEE TUALATIN ELECTRIC GENERAL CONTRACTOR PO BOX 655 5210 SE 26TH WILSONVILLE, OR 97070 PORTLAND, OR 97202 Phone: Phone: 682 -2955 Reg #: LIC 00065650 SUP 3483S ELE 3 -26C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 3/3/00 $37.50 0000437 Elect'l Final 5PCT BON 3/3/00 $3.00 0000437 Total $40.50 0RPGI1A 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. PERMITTEE'S SIGNATURE . 1' .I) ISSUED BY: ` c 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: P Y ` 9n ft < Or Prl \ DATE: LICENSE NO: 1 Call 639 -4175 by 7:OOpm for an inspection the next business day 11/29/99 MON 12:44 F.A.[ 503 598 1980 CITY OF TIGARD lZ 002 •- CITY OF TIGARD r! 13125 SW HALL BLVD. Electrical Permit Ap plication Plan c c Reed By f30k TIGARD OR 97223 Date Recd 3 - 3 -24z1-) Phone (503) 639 - 4171, x304 Date to P.E. Date to DST Inspection (503) 639 -4175 Print of Type Permit# - _C 2tre - GLYJ '7 L 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 f business) pt r-k �4 Service included: Items Cost Sum y Address O S� (. 4a. Residential - per unit City /State/Zip 1 i C5o.� � 1000 sq. ft. or less Li $ 117.75 4 J Each mited addidonal Energy 500 sq. ft. or Commercial E1 Residential ❑ portion thereof $ 28.75 1 $ 60.00 Each Manurd Home or Modular 2a. Contractor Installation only: Dwelling Service or Feeder 5 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). 1 , • Installation, alteration, or relocation Electrical tractor -- 7%.,,a1 . *N cN rL C L. 200 amps or less $ 84.25 2 Address �� r p)( ( 201 amps to 400 amps $ 85.50 - 2 City W r 1 :Srly ; k IC State Zip q, n C 401 amps to 600 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. b� - . :S.-- Over 1000 amps or volts Job No. t_ S Q -- 1 Reconnect and $ 353.50 2 Y $ 53.50 2 Elec. Cont. Lice. No. ,a�Ac.._ Exp.Date 101 \' 4c. Temporary S or Feeders OR State CCB Reg. No. 45(75 Exp.Date Mf Installation, alteration, or relocation COT Business Tax or Metro No. , -ii p 200 amps or less $ 53.50 2 / / ! / 201 amps to 400 amps $ 80.25 2 Signature of Supr. Eiecn ; /` 401 amps to 800 amps $ 100.00 2 Over 800 amps to 1000 volts, License No. AN aaS /Exp.Date IIO)'i I 0 see °b ° above. Phone No. 6 : a - - • 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch drcults 2b. For owner instal ations: with purchase of service or feeder fee. Print Owner's Name _ Each branch dreult $ 5.35 2 Address b) The fee for branch druids City State Zip wltrout purchase of service or feeder fee. Phone No. First branch circuit k $ 37.50 31 e 5 Each additional branch dreuit $ 5.35 The installation is being made on property I own which is not 4e. IYOaceOaneous 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 IIgMIng 5 42.75 Signal drxrlt(s) or a limited energy 3. Plan Review section (if required): * Minor or extension $ 60.00 ( ) $ 100.00 Please check appropriate item and enter fee In section 58. 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 at above fees $ 3 . S * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total tees) $ 3, pc• • Not required for temporary construction services. Subtotal $ • bb. Enter 25% of line 6a for NCB 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 FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due - $ 4 0, 5v l:\dsts\tbrms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 34 AM PM BLD Location / &' 2S (D g Suite c MEC Contact Person P J Vi l Ph (D g 2''2 JS � PLM Contractor '7U AW4 ,L,, ���. Ph X SWR BUILDING Tenant/Owner (2 Y7 ) ELC 2o( -OOO 9 Retainin Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: �� Slab SIT Post & Beam l Ext Sheath /Shear 1 � ; / '� Int Sheath /Shear ppp Framing Insulation Drywall Nailing Firewall Fire Sprinkler (444,4 6)&-A5 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 PAS RT FAIL . ECTRI Service Rough In UG /Slab Low Voltage Fire larm 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 Other Date 3 � Inspector _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.