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Permit CITY OF TIGARD ELECTRICAL PERMIT _ D EVELOPMENT SERVICES PERMIT #: ELC98 1004 '� '�n�i�t l ` DATE ISSUED: 08/19/98 " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25103DC -00813 SITE ADDRESS...: 11205 SW GAARDE ST SUBDIVISION....: ZONING:R -3.5 BLOCK........... LOT......... .... JURISDICTION: TIG Project De scr i pt ion : Alteration of electrical service to residence. - -- 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 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 ° 1 W /SERVICE OR FEEDER: 4 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 ------ - - - - -- BRUCE ANDERSON type amount by date recpt 11205 SW GAARDE ST PRMT $ 80.00 DLH 08/14/98 98- 308287 TIGARD OR 97224 SPCT $ 4.00 DLH 08/14/98 98-308287 Phone #: 639-0013 Contractor: - -- -- BRUCE ANDERSON $ 84.00 TOTAL 11205 SW GAARDE ST REQUIRED INSPECTIONS TIGARD OR 97224 Rough -in Elect'l Final Phone #: Elect'l Service Reg #... 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. Permittee Signature: /1s}7Z-6 — 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: 07/ /9"/it / e_ DATE: 07/9" CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' N : /3/49 DATE: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639-4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY ,O'TIGARD Electrical Permit Application Plan Check # 1 SW HALL BLVD. Rec'd By -Z-/' TIGARD OR 97223 Date Rec'd 8�/y� 9, Date to P.E. Phone (503) 639 -4171, x304 ` Date to DST Print or Type Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit #LC9�P; /,00 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) 13 Y'LLCC ANci 5o JO Service included: Items Cost Sum I Address 1 t 2 bS -7� S 41) • GA - ra e 4a. Residential - per unit ' City/State/Zip l 1.3 i' r,L ( + • ci z II 1000 sq. ft. or less $110.00 4 ry / p j a Each additional 500 sq. ft. or Commercial I=1 Residential portion thereof $25.00 1 Li mited 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 Installation, alteration, or relocation 200 amps or less I $60.00 66,bC) 2 Address 201 amps to 400 amps $80.00 2 City State Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Exp.Date OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 Signature of Su r. Elec'n 201 amps to 400 amps $75.00 2 g p 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. Exp.Date see "b" above. Phone No. 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with f purchase of service or Print Owner's Name ruck �C1 eAr -50tJ feeder fee. 20, c0 Address ` , l l X 20 . 5. W . 6�}, -,.dP Ir Each branch circuit 4 $5.00 2 may- c State ©v- Zip q Zze b) The fee for branch s circuits Ci ty tv/ P without purchase rc Phone No. 6,39 - ©O( 3 service or feeder fee. First branch circuit $35.00 2 • The installation is being made on pro own which is not Each additional branch circuit $5.00 2 intended for sale, lea e rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signatur ,LeP 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 check 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. 5. Fees: Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ ',61:7)°0 NOTICE Subtotal $ ' per 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan 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 # C 34,00 Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / ,, p 9 g AM PM BLD Location f I .O L S l'.J� qaj' , Suite MEC Contact Person L lA1e Ph C31-cy713 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC -( D ~ O(C(:) C i Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: ((�� f - ,,I Slab t9 i /ST- 97'0150 l"11��2 t 8 "n SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall Fire Sprinkler r,/(/ 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 ECT Service - Rough In UG /Slab Low Voltage Fir- Alarm ; eig. 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 r-inspection RE: ] Unable to inspect - no access ADA Approach /Sidewalk Other Date - � Inspector �` — , Ext Final PASS PART FAIL D • NOT REMOVE this inspection record from the job site.