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Permit
CITY OF TIGARD PERMIT PERMIT #: ELC1999 -00310 mo I DEVELOPMENT SERVICES D ATE ISSUED: 5/25/99 �� 13125 SW Hall Blvd., Tigard, OR 97223 (503).639 -4171 PARCEL: 1S135DB-04300 SITE ADDRESS: 11285 SW 92ND AVE SUBDIVISION: DOGWOOD RIDGE ZONING: R - 4.5 BLOCK: LOT : 1 - JURISDICTION: TIG Project Description: 200 amp or less service 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: 1 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: WILLIAM WEBBER CHRISTENSON ELECTRIC INC 11285 SW 92ND 111 SW COLUMBIA TIGARD, OR 97223 STE 480 PORTLAND, OR 97201 Phone: Phone: 241 - 4812 Reg #: LIC 000458 SUP 3289S PLM 2468S ELE 26 -34C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 5/25/99 $60.00 99- 315646 Elect'I Final 5PCT BON 5/25/99 $3.00 99- 315646 Total $63.00 ORIGINAL This Permit is issued subject to the regulations contained in the Tigard Munidpal 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: (0 411 l _ Issued By: 6 • 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: 61/\ ((KA t/TVA DATE: LICENSE SE NO• Call 639 -4175 by 7:00pm for an inspection the next business day RECEIVED CITY OF TIGARD lectrical Permit Application Plan Check 13125 SW HALL BLVD. �Iq' 2 5 19 9 Rec'd By Date Rec'd S TIGARD OR 97223 Phone 503 639 -4171, x30 MMLINITY DEVELOPMEN Date to P.E. ( ) Date to DST Inspection (503) 639 -4175 Print or Type Permit # ( �7p Fax (503) 684 7297 Incomplete or illegible will not be accepted Called 1. Job Address: EMERGENCY BACKUP FOR HOME 4. Complete Fee Schedule Below: Name of Development RESIDENCE Number of Inspections per permit allowed Name (or name of business) WILLIAM WEBBER Service included: Items Cost Sum Address 11285 SW 92ND TIGARD 4a. Residential - per unit v 1000 sq. ft. or less $110.00 4 City /State /Zip TIGARD OR 97223 Each additional 500 sq. ft. or Commercial ❑ Residential ® portion thereof $25.00 1 Q CONTACT Li E nergy $25.00 RELIABLE POWER (NWNG TOM KOSMAS 260 -4269 Each ing Service Home o Feeder ede Dwelling Service or Feeder r $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b an or Feeders Electrical Contractor CHRISTENSON ELECTRIC, INC. Insta a ion, - Iteration or relocation Address 111 SW COLUMBIA, SUITE 480 200 amps or less 1 $ 80. . 00 60 . 2 201 amps to 400 amps $80.00 2 - City PORTLAND State OR Zip 97201 -5886 401 amps to 600 amps $120.00 2 Phone No. 503 241 -4812 601 amps to 1000 amps $180.00 2 Job No. 60 -04914 Over 1000 amps or volts - $340.00 2 Elec. Cont. Lice. No. 26 -34C Exp.Date 10/99 Reconnect only - $50.00 2 OR State CCB Reg. No. 00458 Exp.Date 5/03 4c. Temporary Services or Feeders COT Business Tax or Metro No.5246 Exp.Date 12/99 Installation, alteration, or relocation 200 amps or less $50.00 2 201 amps to 400 amps _ Signature of Supr. E -c' _ - ��� 401 amps to 600 amps $10 2 .. 2 600 amps to 1000 volts, License No. 873S Exp.Date 10 /01 see "b" above. Phone No. 503 241 -4812 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 - b) The fee for branch circuits City State. Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required) :* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 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 fees $ 60. 5% Surcharge (.05 X total fees) $ 3. NOTICE Subtotal $ 63. 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ 63 . NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # Total balance Due $ 63.00 / I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIV - .* N MST 24 -Hour Inspection Line: 639 -4175 Business L' e: 63N171 - Date Reques`fed \ \! (Q ctt) A , PM BLD Location 11 ? S 92fte t Suite MEC Contact Person Ph PLM Contractor 7-197-€ Ph Z-620 -- yzt, SWR (, BUILDING Tenant/Owner ELC 19q9 9 -00 2(Q Retaining Wall ELR Footing Access: Foundation e Q© FPS Ftg Drain Crawl Drain Inspection Notes: j � o� SGN Slab �' ` � S �.l l SIT • Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL C 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 ELECTRICAL ..� Service Rough In UG /Slab Low Voltage Fi� rm T 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 rr nspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date f i .0 Inspector Ext Final PASS PART FAIL D • NOT REMOVE this inspection record from the job site.