Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00474
" , P `i a DEVELOPMENT SERVICES DATE ISSUED: 7/30/99
"-' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
A � PARCEL: 1S135DC -02000
SI T AVE 004 ORIGIN tll1 SUBDIVISION: VILA 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: —- Issued (�Gl�
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: � Q � / (� i�i� DATE:
LICENSE NO: o S
• Call 639 -4175 by 7:00pm for an inspection the next business day
•
Community DevelopnitmbEIVED ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. li
Tigard, OR 97223 JUL 2 9 1999 Planck/Rec. #
/��� = Permit # €tA.4�i9 i - op 7 �
;) I Phone (503) 639 -
I,L
PI lr UNITY DEVELONEIRate ISSUe 7- 3o-77
FAX (503) 684 - • CITY OF TIGARD TDD No. (503) 684 -2772 Issued by 13.,
Inspection (503) 639 -4175
1. Job Address: i'‘,-4,;,,,,- '�` G
4. Complete Fee Schedule Below:
Name of Development tVii) a-J Re-/>--)/---) Number of Inspections per permit allowed
Address / / 9 d . 5-� c.�/ 9/ � ✓ - Service included: Items Cost(ea) Sum
City /State/Zip 4-... ?7ZC2 3 4a. Residential - per unit 4
�/' • ,O 1000 sq. ft. or less $11 0.00
Name (or name if business) /C QJ (((/// � Each additional 500 sq. ft. or
\ portion thereof $25.00 1
Commercial !i- Residential ❑ Limited Energy $25.00
- Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation onl 4b. Services or Feeders
Installation, alteration, or relocation
2
Electrical Contract. _;,_.., - . . 200 amps or less $60.00 2
Address //g/7 F_, 4 ( --S , 201 amps to 400 amps $80.00 2
City A7, Lidi /1„ fl 1 a state zip 9 p 401 amps to 1000 amps 600 amps $120.00 2
/ r p / �9 G �Z 601 amps to 1000 $180.00 2
Phone No. 6.3 -- // ,, - - &5'3- Over 1000 amps or volts $340.00 2
Contractor's License No. e-3-/Fir- Reconnect only $50.00
Contractor's Board Reg. No - 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n / - 200 amps or less $50.00 2
License NQ'?) - Phone No. _ 201 amps to 400 amps $75.00 2
- 65-i6.--4049 � 401 amps to 600 amps $100.00
s er 600 amps to loco volts
2b. For owner installations - see •b• above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or leader lee. 2
Each branch circuit $5.00
Phone No. b) The lee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder lee. ��. ,D 2
not intended for sale, lease or rent. First branch circuit . `off � c32 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: Q
NOTICE 5a. Enter total of above fees $ .37 56
5% Surcharge (.05 X total fees) $ �( '
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. ❑ Trust Account # $
Balance �Z ,�J $ " sffi_'
wortkandov\akcprm.app /,, `�
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
®�
j BUP
Q Date Requested '- / ! AM PM BLD
Location ) 1 - 10 S 9 I S1 Suite 9 MEC
Contact Person C (! 7 eA Ph PLM
Contractor Ph (Q 3"ggQ3 SWR
BUILDING, a Tenant/Owner V( I l am, Pa:2_ ELC 199q• q7 y
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 �/ l
Drywall Nailing ' �•l� �IJ �.� ' � _
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
L EC- TAL�
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm 01.( PAA SS 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 Date ? Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.