Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00473
L e_�1/ DEVELOPMENT SERVICES DATE ISSUED: 7/30/99
--" 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 1
SITE ADDRESS: 11905 SW 91ST AVE 002 (JO 1 GIN PARCEL: 1 S135DC 02000
SUBDIVISION: VILLA LA PAZ ZONING: R -7
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one branch circuit.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
VILLA LA PAZ LIMITED PARNERSHI (GARY) COOPER ELECTRIC
COMMUNITY PARTNERS /AFFORDABLE 11845 SE 34TH ST
HOUSING INC, POB 23206 MILWAUKIE, OR 97222
TIGARD, OR 97281 -3206
Phone: Phone: 653 -8803
Reg #: SUP 2965S
LIC 00042918
ELE 3 -191C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 7/30/99 $37.50 99- 317277 Elect'I Final
5PCT DEB 7/30/99 $2.63 99- 317277
Total $40.13
This Permit is issued subject to the regulations contained in the Tigard Municipal 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: 1etj t e ,_,,,_ Issued By , r/ "
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: -- � `,-' ` A 6- DATE:
LICENSE NO: `94P5
Call 639 -4175 by 7:00pm for an inspection the next business day
Community DevelopmtCEIVEDELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. o c1
Tigard, OR 97223 JUL 2 6 199�'ermit # � L �` l 1 / - D0 �7 3
/�Nr� /I�IPIVH� Date Issued 7 - A9 -11
Phone (503) 639- 4 v7MMUNITY DEVELOPMENT
° FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1, Job Address: 4. Complete Fee Schedule Below:
Name of pevelo.. ent _ _ I i t� Number Of Inspections per permit allowed
_
l
Address T
I. ; ` i / / . •x/1,1,4 /> = Service included: Items Cost(ea) Sum
City /State /Zip 1 t a... gd 6 N. g 7a 2 3 4a. Residential - per unit
s
y / , n 1000 sq. ft or less $11
Name (or name of business) V,I .2„ 4
fa.. /' Each additional 500 sq. ft. or
portion thereof $25.00
Commercia Residential ❑ 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
//�1. tr� r
r / JtJ < f
Installation, alteration, or relocation
Electrical Contractor 3/71-. / f1l' / i' i 200 amps It less $60.00 2
Address / `� // .s 201 amps to 400 amps $80.00 ////// � -•� $120.00 2
City �! �! �(/! , ♦ f � i P Statep Zip ! . c �7 401 amps to 600 amps 2
p / C $180.00 2
601 amps to 1000 amps
Phone No. „S",3- .2?8i9 �� 4-, 5g - / /t, f1 Over 1000 amps or volts $340.00 2
lob-414€1. /=;•51)( / 5 %[ /!/D n Reconnect only $50.00 2
contractor's license NO. N . 3 - -- / - " 4c. Temporary Services or Feeders
Contractor's Board Reg. No. _ _ I alteration, or relocation 2
Signature of Supr. Elec'n i` 'Ar , _ _ 200 amps or less 2
License No../ ?6, ' Phone No. 201 amps to 400 amps $50.00 2
4 0 1 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 New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00 2
��11
Phone No. b) The fee for branch circuits without ,3./'
p urchase of service or feeder fee. 2
The installation is being made on property I own which is /
First $35.00 °-- 2
Each additional not intended for sale, lease or rent. at ddch circuit l branch circuit
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 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: 3 7 , 7 a
5a. Enter total of above fees %;
NOTICE ,7q1 , rs Surcharge (.05 X total fees) t� tp ;�
PERMITS BECOME VOID IF WORK OR CONSTRUCTION ! Subtotal $
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. wordlcomdeNeieo- ❑ Trust Account # •
.
prm.app 13$ ,. 4. .
Balance Du • 70 $ j∎ • : ` �
10 a
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
pC� BUP � ll%LH:U
Date Requested , � ' ! / AM PM BLD
Location I i Gc /c q (S ��V` Suite MEC
Contact Person COOPeA, Ph PLM
Contractor Ph (p S3 -g,803 SWR Q
BUILDING ' Tenant/Owner V t I l & Pet, ELC )qq % �r q 7 j '
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
Insulation
Drywall Nailing �/fij,l-1 !n
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
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
CTR
Service
Rough In
UG /Slab
Low Voltage
•
Fire Alarm
AZ> 4100
PART
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date ZO /? Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / b -1 3 AM PM BLD
Location fife) S c / it Suite 4A ,L• z MEC
Contact Person Ph 6;,' ' f/i/ PLM
Contractor Ph 51 6 SWR
BUILDING-
ELC /Q Gt' I73
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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof ICW
Misc:
Final
PASS PART FAIL
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
LECTRI
- ice
Rough In R f
UG /Slab
Low Voltage
Fire Alarm
F . ' 1 0 6. V 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 C4 l-T /rz3 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.