Loading...
Permit CI OF TIGARD ELECTRICA — T • COMMUNITYDEVELOPMENTDEPARTMENT PERMIT #: ELC96-0064 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (5o3)e39-41n DATE ISSUE': 2/ /96 PARCEL: 1S135DB-03800 SITE ADDRESS...: 11420 SW 92ND AVE SUBDIVISION...,: DOGWOOD RIDGE ZONING:R-4.5 BLOCK..........: LOT.............:11 Project Description: ELECTRICAL PERMIT FOR 200 OR LESS MP SERVICE/FEEDER AND 6 BRANCH CIRCUITS PJ�/ / «� �� �� _ �6 ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS----- 1000 SF OR LESS... . : 0 0 — 200 amp. ...... : 0 PUMP/IRRIGATION....: 0 EACH ADD'L 500SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY.. ... : 0 401 — 600 amp..... .. : 0 8IGNAL/PANEL-.... . .. : 0 MANF. HM/ SVC/FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (1G) . . . : 0 ----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS--- — 200 amp......: 1 W/SERVICE OR FEEDER: 6 PER INSPECTION... .. : 0 201 — 400 amp......: 0 1st W/O SRVC OR FDR. : 0 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 DAVID CRAIG type amount by date recpt 11420 SW 92ND AVE PRMT $ 90.00 JMH 02/01/96 96-275589 5PCT $ 4.50 JMH 02/01/96 96-275589 TIGARD OR 97223 Phone #: Contractor: ----- -----_ _______ ^ --------- $ 94.50 TOTAL �����^J �J�i)���J REQUIRED INSPECTIONS Ceiling Cover Elect'l Service Phone #: Wall Cover Elect'l Final Reg #..: This peroit is issued subject to the regulations 'contained in the / Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature applicable laws. All work will be done in accordance with approved plans. This peroit will expire if work is not started ` within 180 day� of issuance, or if work is suspended for oure C�L,�lA^4� • than 188 days. gy sued By — 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 N8: . Call for inspection - 639-4175 /��� � L/[� Cn ^�� Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # q6 00 /4.110,1'• Date Issued (Wig b i P h one (503) 639 -4171 CITY OF TIGARD FAX (503) 684 -7297 TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development DOC JO RI-Jut-E.- Number of Inspections per permit allowed Address 0 `/ 2 - O 4 Z4%tv0 A v F Service included: Items Cost(ea) Sum City /State /Zip 11 4.4 i20 (512 c7 Z a ' 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 Name (or name of business) b au t 0 CR..ift.l c Each additional 500 sq. ft. or portion thereof $25.00 Commercial ❑ Residential Q Limited Energy $25.00 1 Each Manufd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Electrical Contractor Installation alteration, or relocation $ 60.00 200 amps or less 1 '� ®" 2 Address 201 amps to 400 amps $80.00 2 0.00 2 City State Zip 401 amps to 600 amps $12 0.00 00 2 601 amps to 1000 amps Phone No. Over 1000 amps or volts $340.00 2 Job NO. Reconnect only $50.00 2 contractor's license NO. 4c. Temporary Services or Feeders Contractor's Board Reg. No. Installation, alteration, or relocation 2 Signature of Supr. Elec'n 200 amps or less 2 License No. Phone No. 201 amps to 400 amps $50 2 401 amps to 600 amps $75 00 Over 600 amps to 1000 volts $100.00 . 2b. For owner installations: see "b" above. 4d. Branch Circuits Print Owner's Name 'b" t b G R At G. fl A New, alteration or extension per pane Address 1 t' Z0 SL.,) �'f Znio IAN/ i . a) The fee for branch circuits with City Ti (n.; y r} At Oa... State Zip 97 Z a 3 purchase of service or feeder fee. 2 Each branch circuit ['CZ $5.00 3 0. o O Phone No. b) The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 $ 5.00 not intended for sale ease or rent. _ First branch circuit $ 2 e-A-er Each additional branch circuit $5.00 Owner's Signature 4e. Miscellaneous / (Service or feeder not included) 2 3. Plan Review section (if requir d): Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00 4 or more residential units in one structure Minor Labels (10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per inspection $35.00 Per hour $55.00 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: 5a. Enter total of above fees (), 00 NOTICE 5% Surcharge (.05 X total fees) $ H. s0 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 91. so AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. wordlcomdevleec- ❑ Trust Account # $ prm.app Balance Due $ 9 q. .c O ~ Permit #: 96' 6 •.,, w `,0 Address: //2D � ?2d 6/C N T I ssue d b y : / - 4 : te: 02-61 f 5 � Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ri 1. I own, reside in, or will reside in the completed structure. n 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale I ' before or upon completion. ri 3A. My 'general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 1'\I 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owner about Construction Responsibilities on the reverse side of this form. 2- l - ?6 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) fnfor alio -, Notice to Pr® ,terty O n =ors - - A .,it Construction F'a spo ns�B�00'l�u�S Note: This. Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYE RESP•NSIBIUTQES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim -costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will , be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1- 800 - 829 -1040. OT t IEf RESPONSB� GU T ES AND A EAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. • Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own .pm4 1 /94 .- Gt CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 6 /mss 4 I A.M. K MST: Location: I I 2-0 _Sr—(A) eP-rl BUP: Tenant: I_ �-t h Suite: Bldg: MEC: Contractor: J Phone: Co 70 _0 (j 6-, 1 PLM: Owner: � � 3 V/ OA K�l/{�\ Phone: � �Q ' ��'n�UlJl 19-6— ELR: I �! 1 /� `G V� U S G`/ I BUILDING BLDG (con't) PLUMBING MECHANICAL E SITE � Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In et mg, Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Approved Appr /Sdwlk Not Approved Not Approved Not Approved `o proved Not Approved FINAL FINAL FINAL __...) FINAL (V.Z.C.,L. ,.�92 ,-"( cL e. 9C - (0626 / - aZoo,s .f 67 2 144 as- id.dz- e.:r.., ,)17.1 �i.��-� r ,44.41i I &' 96 * c'049' ,fit= p J e s 1 f -Y re— 4) C 2. F. a • r • /0,-u /e, 4.f-/ cz) 1,0 >zh/ orec • O Call for reinspection (J Reinspection fee of $ required before next inspection O Unable to inspect Inspector: ( i i i L�� . AO Date: t ° 2 r- 9P Page of (leo/wry... e CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: ( /a5 /91 A.M. SO K MST: Location: 1 142-0 S, -(jt) —1 L 11(/ 1( e BUP: Tenant: /_ (L/ Suite: / Bldg: MEC: Contractor. �- httA Phone: CO 70 —Q ((p / PLM: cc � Owner: f P \ Phone: _ L� ef n p —O 3 f -HUA,I2 SLR: e, / / / "l t� /941---- Q BUILDING BLDG (con't) PLUMBING MECHANICAL E ' 1 SITE � Site Post/Beam Post/Beam PostBeam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In el mg, Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approv:. Approved Appr /Sdwlk Not Approved Not Approved Not Approved ' o ved Not Approved FINAL FINAL FINAL <'IN ro FINAL (` ew_A_ '.A,, ." cL e. 9G •- 6526y - Joya. .f- 6 c.,,_ L /24 as iddLe-. AA- %-s5 iae'M, / A' G L 96 - © o 6 4.‘ i ems+ s Sri uus r ,_, G d e- _ s� : L a. F'. a • r . pr..-74 � et iv/ -4 C2) log9t7 fee- f —/-cam O Call for reinspection 0 Reinspection fee of $ / required before next inspection O Unable to inspect Inspector: 4 "0 4 Date: - 2J 9P Page of