Permit CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97 -0619
DATE ISSUED: 09 / 18 / 97
-- "T
13125 SW Hall Blvd., Tigard, OR 97223 (503)® ED PARCEL: 2S1O3BD -05100
SITE ADDRESS...:12583 SW 116TH AVE
SUBDIVISION °HUNTER'S GLEN ZONING:R -4.5 PD
BLOCK LOT :007 JURISDICTION: TIG
Project Description : Add first branch circuit to existing single family dwelling.
- -- 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 6O1+amps -1000 volts.: 0 MINOR LABEL (1O)...: 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: 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
MICHAEL SCHLACTER type amount by date recpt
12583 SW 116TH AVE. PRMT $ 35.00 GEO 09/18/97 97- 229372
TIGARD OR 97223 5PCT $ 1.75 GEO 09/18/97 97 -29372
Phone #:
Contractor:
WRIGHT 1 ELECTRIC INC $ 36.75 TOTAL
5618 SE 135TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97236 Rough —in Elect'1 Service
Phone #: 760 -8522 Underground Cove Elect' 1 Final
Reg #..: 000097
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- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246-1987.
P e r m i t t e e Signature: ' -,/ Issued By: All
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 SUP R. ELEC' N: DATE: M- ,5/97-
LICENSE NO: 3 905 S !
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
4 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # fli , Phone (503) 639 -4171 Date Issued
F ""' FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: 14. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address '11 ')1� t 1 1. 7-s -Rae_ Service included: • Items Cost(ea) Sum
-
City /State/Zip ` \ C F p.Jj 4a. Residential - per unit 4
1000 sq. ft or less $110.00
Name (or name of business) �� X61 t� ox, Each additiona 500
l l � sq. ft. or -
portion thereof $25.00 1
Commercial ❑ Residential r4 Limited Energy i , __ $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
C Installation, alteration, or relocation 2
Electrical Contractor
\ry - 111 1- t ElE ._ 200 amps or less $60.00 2
Address .. i.-6-1-7.1 201 amps to 400 amps $80.00 2
City pa x State0FL Zip q►" ( , 401 amps to 600 amps $120.00 2 -
`� p 601 amps to 1000 amps $180.00 2
Phone No. ' 45 Over 1000 amps or volts $340.00 2
Contractor's License No. - 2,?j"?, _. Reconnect only $50.00
Contractor's Board Reg. No. Ct r1 c ri 4c. Temporary Services or Feeders
� Installation, alteration, or relocation 2
Signature of Supr. Elec'n e�-'K - p - ,.'Les 200 amps or less $50.00 2
License No. Phone No. r A -c ;4, ::-; _ 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
1 ` C \ a � s h j 4d. Branch Circuits
Print Owner's Name ► ` G �GI Z?� New, alteration or extension per panel
Address 1 5 S c� , om
t a) he fee for branch circuits with
City l 4.-ret State Gig Zip 922 23 purchase of service or feeder fee. 2
Each branch circuit $5.00
Phone No. wr1t-- 62'4- 70 b) The tee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35.00 ?a 2
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): 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 inspectio $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:
NOTICE 5a. Enter total of above fees $ ` .---c)
5% Surcharge (.05 X total fees) $ •"1"J
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ?' (c 'l=1
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. ❑ Trust Account #
$
Balance Due $ riS
wo d'c ,, d.V.4. n, app
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ' q I y AM PM BLD
Location Alpe .,. rojr >_�
. S W /'�-- Suite MEC 4 - 0 1r0
Contact Person Id-s 6" Ph PLM
Contractor A. /P/ f F2 ,/e' . Ph '7470 – 2;Z--- SWR
BUILDING p ".'_ ` Tenant/Owner /Me gc./— 5&71Z.,44,746-12 ELC - db�/7
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg. Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam r
Ext Sheath /Shear / — er 6' el,2
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall a ,
Fire Sprinkler _��� -� _ _ _ '. ��+ �. ��_ _
Fire Alarm
Susp'd Ceiling M.G..: _- mil' ' L.
Roof
Misc: _ _
-
Final
PASS PART FAIL
PLUMBING', � Q 639- i7/ e - a -
Post & Beam
Under Slab Ii/ f ,„ Adtar
Top Out A
Water Service ( ./�j / A .,.,i .?.9 ■- g-/P1.4
Sanitary Sewer
Rain Drains
Final
T FAIL
MECHANICAL ')
Po & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
IICTRICA
,L
Rough In
UG /Slab
Low Voltage
Fire Alarm
m
PASS PART FAIL
SITE
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 5 7 - 97 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
5/30/00 Activities for Case #: ELC97 -00619
2:58:37 PM '''�
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 9/18/97 GEO RECD GEO 9/18/97
ELCA003 Permit created 9/18/97 GEO PASS GEO 9/18/97
ELCA730 Elect'l Service 9/18/97 GEO 9/18/97
ELCA799 Elect'I Final 9/18/97 VLN NOTE VLN 3/9/99 Inspection request for research
to Chuck D. 3/9/99.
ELCA500 (F) Issue permit 9/18/97 GEO PASS GEO 9/18/97
ELCA920 Miscellaneous action 3/17/99 WDJ MAIL WDJ 3/17/99
ELCA920 Miscellaneous action 4/28/99 AKJ DONE No Hold AKJ 4/28/99 inactivity letter sent
ELCA799 Elect'I Final 5/9/99 5/9/99 5/7/99 CD NOTE No Hold JT 5/28/99 Left note: records indicate no
insp were ever called for
regarding a/c wiring or mech,
please call to schedule insp
According to Chuck, this permit
was issued to wrong address.
Should be 12586 116th Ave
When researching, I noted that
there had been an address
change
ELCA845 Request inspection research 3/27/00 JMT DONE No Hold JMT 3/27/00 SECOND REQUEST
ELCA580 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00 —.
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