Permit d i k CITY OF TI G A R D ELECTRICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: ELC99 -0132
n"t DATE ISSUED: 03/08/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111BA -00109
SITE ADDRESS...:1411O SW 97TH AVE
SUBDIVISION °TIGARDVILLE HEIGHTS ZONING:R -4.5
BLOCK LOT -028 JURISDICTION: TIG
Project Description: Add two branch circuits.
- -- 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/O SRVC OR FDR.: 1 PER HOUR - 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 1 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
10+0+ amp /volt ° 0 > =4 RES UNITS • ) 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
THOMAS D PARKER type amount by date recpt
14110 SW 97TH AVE PRMT $ 40.00 GEO 03/08/99 99- 313497
TIGARD OR 97224 5PCT $ 2.00 GEO 03/08/99 99- 313497
Phone #:
Contractor:
BOONES FERRY ELECTRICAL $ 42.00 TOTAL
PO BOX 628
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 Elect'l Service
Phone #: 682 -4936 Elect' 1 Final
Reg #..: 000884
. This permit 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 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-1 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987:
Permittee Signature: '1' ?1 Issued 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 : 0-1.0 - DATE: 3 ' -
LICENSE NO: 3/-7a
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day •
+ +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + +-++ ++, + + + + + + + + + + + + ++
•
a - - - - - -
1
CITY OF TIGARD RECEIVED Electrical Permit Application
Plan Check #
13125 SW HALL BLVD. MAR 0 8 1999 Recd By
. TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x3CMUNITY DEVELOPMENT Date to DST
Inspection (503) 639-4175 Print or Ty
Incomplete or illegible will not be accepted Permit # ° Q� -Dl 3.�
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Thomas Parker Service included: Items Cost Sum
Address 14110 SW 97th Ave . 4a. Residential - per unit
1000 sq. ft. or less $110.00
City /State /Zip Tigard , O R 97224 Each additional 500 sq. ft. or 4
Commercial El Residential ® portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only: -
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor BOO N E S FERRY ELECT R I C Installation, alteration, or relocation
Address P O Box. 628 200 amps or less $60.00 2
• T 201 amps to 400 amps $80 2
City WilsonvilleState OR Zip 97070 401 amps to 600 amps $120.00 2
Phone No. 682-4936 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3-223 C Exp.Date 1/31 / 9 9 Reconnect only $50.00 2
OR State CCB Reg. No. 8 ' 482 Exp.Date ?/? 3/99 4c. Temporary Services or Feeders
COT Business Tax or Metro 0.2851 Exp.Date 8/1 / 9 9 Installation, alteration, or relocation
200 amps or less $50.00
Si g n a t ure o f Supr. Elec' = � I� 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No 3170 S 1 Exp.Date 10/1 /01 see "b" above.
Phone Nr 682 -4936
A • i - 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 circuit 1 $35.00 ? - .. 0 0 2
The installation is being made on property I own which is not Each additional branch circuit 1 $5.00 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 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. Jr. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 40.00
5% Surcharge (.05 X total fees) $ 2.00
NOTICE Subtotal $ 42.00
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Pian Review if required (Sec.3) $
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 # $ 47 _ n n
Total balance Due
I I: \OSTS \ELC96.APP Rev 9/96
10
CITY OF TIGARD BUILDING INSPECTION DIVISION - - MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417
UP
Date Requested At q1-1 � �9 AM PM BLD
� al
Location r0 -I l AU-' Suite MEC
Contact Person Ph (Dg2 / � 93 PLM
Contractor Ph SWR -
BUILDING . Tenant/Owner ELC 99 - 0/ ?Z
Retaining Wall ELR
Footing Access:
Foundation 6 /4 4 _ /' a f?Cs'L.y?S j1' FPS
Ftg Drain �v ` .*� �� SGN
Crawl Drain Inspection Notes:
Slab 4 4/e_r SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall Drywall Nailing
Firewall
Fire Sprinkler / `"e e,,-f
Fire Alarm
Susp'd Ceiling •
Roof
Misc:
Anal
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab a
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
gaCTRI 2, - y-
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
l
ASS 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 1 1 - ? ff Inspector Ext
Final
PASS PART FAIL . D NOT REMOVE this inspection record from the. job site.