Permit CITY OF TIGARD ^ ELECTRICAL PERMIT
,���i�,� DEVELOPMENT M � SERVICES DATE ISSUED /
ES PERMIT LC98 �66�
— 13125 PARCEL: 2S112AC -02100
SITE ADDRESS...:14915 SW 72ND AVE
SUBDIVISION :FANNO CREEK ACRE TRACTS ZONING:I -L
BLOCK • LOT •047 JURISDICTION: TIG
Project Description : Installation of 1 branch circuit. -sob abl°5 -' LIi
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS ° 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 - 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 - 600 amp • 0 EA "ADD'L BRNCH CIRC: 0 IN PLANT 0
601 - 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
IMAGEMAX type amount by date recpt
14915 SW 72ND AV PRMT $ 35.00 DEB 11/02/98 98- 310509
TIGARD OR 97224 5PCT $ 1.75 DEB 11/02/98 98- 310509
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 36.75 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS
TIGARD OR 97223 Elect' 1 Service
Phone #: 684 -3600 Elect'1 Final
Reg #..: 000522
This persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This persit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon 1.w re.uires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in ORR 952 '0'. 1A0 through 1'' 952 -001 -1987. You say obtain a copy
of these rules or direct questions to OUNC by calling 503)246 -1987. •
Permittee Signature: v N�ae% C Ise -d By: 4 1 °
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 INSTAL LATION ONLY
•
SIGNATURE OF SUPR. ELEC'N: ! � Ca- l�Ga -cti DATE: / - ? 'W
LICENSE NO: 4 7 / z/!� s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
FAX NO, 15036843611 P. 02
NOV -02 -98 MON 04:44 PM PHOENIX ELECTRIC CO
CITY OF TIGARD Electrical Permit Application Plan c : .
13125 SW HALL BLVD.
TIGARD OR 97223
bate :`'..,�,!�& A
Phone (503) 639 -4171, x304 ale Reed / - a '
Date to P. E.
Inspection (503) 639 -4175 Print or Type Date to DST
Fax (503) 684-7297 Incomplete or illegible will not be accepted Permit a L�
Called
1. Job Address:
4. Complete Fee Schedule Below;
Name of Development
Number of Inspections per permit allowed
Name (or name of business)
Address l Is 5 LU '7 , 1 R., ■
4a. Residential - per unit
City /State/Zip ` • , v\ L,• _ . ,` 1000 sq. It or less
•
Each additional 500 sq. It. or 5110.00 4 • Commerci rid Residential ❑ portion thereof
Limited Energy 525.00 1
�2.
` VN• Each Manuf'd Home or Modular
.00
2a. Contractor installation only: Dwelling Sorvico or Feeder $B8
(Attach copy = : , current !icons = 2
Electrical Contracto �iL�.. r -> Ins Services or Feeders - A.• - sS Installation, alteration, or relocation
�� MN. 200 amps or less
City S ate 201 amps to 400 amps $60.00 2
Phone NI , V Zip 401 amps to 600 amps
580.00 2
Job No. 11&4111141 1• � 601 amps to 1000 amps $120'00 2
• - 33 Over 1000 amps or volts 5340.00 2
Elec. Cont. Lice. No. , Vaal. e, . .Date Reconnect only $340.00 2
OR State CCB Reg. No. ) S $50.00 2
COT Business Tag or Metro No Exp•Date 4c. Temporary Services or Feeders
t'zxp.Da Installation, alteration, or relocation
Signature of Supr. Eleen 200 amps or less 5100.00
201 amps to 400 amps $75,00 2
-- 2
401 am 00
amps to 600 amps S 100.
License No. / O Exp,Date Over 600 amps to 1000 volts, - 2
Phone No. eeo "b" above.
4d. Branch Circuits
2b. For owner installations; New, alteration or extension per panel
a) The fee for branch circuits with
Print Owner's Name purchase of service or
Address feeder fee.
City Each branch circuit $500
State Zip b) The foe for branch circuits 2
Phone No . without purchase of
service of feeder lee.
The installation is being made on property (own which is not First branch circuit I $55000 ..,..S vv 2
Each additional branch circuit $5.00
intended for sale, lease or rent. 2
4e. Miscellaneous
Owner's Signature (Service or feeder not Included)
Each pump or Irrigation circle 540.00
3. Plan Review section (if required):* Signal crcult(s) f or a limited energy $40.00 ~^ 2
2
Please check appropriate item and enter fee in section SE panel, alteration or extension 540.00
Minor Labels (10 3100170 2
4 or more residential units in one structure -
Service and reactor 225 amps or more
41. Each additional Inspection over
System over 600 volts nominal the allowable in any of the above
Classified area or structure containing special oceu Per inspection 535.00
as described in N.E.C. Chapter 5 �� Per hour 555.00
In Plant $55.00
* Submit 2 sets of plans with application Where any of the above apply. 5. Fees: `-
Not required for temporary construction services,
5a. Enter total of above foes . K 7 e
TIC 5% Surcharge (.05 X total fees) $ SL
Subtotal $ _IOWA.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 5b. Enter 25% of lino 5a for
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK SIB Rovlew if u ir . (Sec.3) $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ubrofal $ --
TIME AFTER WORK IS COMMENCED. / Trust Account # 5 � � h
Total balance Due a
I: 1 OS TS 1 4LC9c.APf. Roy 9M. 6
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
ate Requested — AM PM BLD
Location q15
84) Suite MEC
Contact Person ____ / Ph yy-3zeo PLM
Contractor #' /157,51r if v Ph SWR
BUILDING Tenant/Owner
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
Drywall on
Drywall Nailing �/.�ACiGCT Ci//J �.cti./7
Firewall
Fire Sprinkler et '
Fire Alarm //
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab `
Top Out
Water Service �V J
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P FAIL
'ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk
Other D 1/?Ae Inspector Ext
Other L
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.