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Permit
CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00043 Pftative DEVE PMENT r S O ERVICES ) 339 - 4171 DATE ISSUED: 1/22/01 PARCEL: 2S101 BD -00103 SITE ADDRESS: 07805 SW HUNZIKER ST A SUBDIVISION: ZONING: I -L BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of one branch circuit for sewage pump. 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: H G M CO MAPLE LEAF ELECTRIC BY NORRIS BEGGS + SIMPSON 15754 S REDLAND RD ATTN: BLAKE HERING OREGON CITY, OR 97045 PORTLAND, OR 97204 Phone: Phone: 503 - 505 - 1708 Reg #: ELE 3 -429C LIC 127256 SUP 4373S FEES Required Inspections Type By Date Amount Receipt Wall Cover . PRMT CTR 1/22/01 $46.85 2720010000( Elect'l Final 5PCT CTR 1/22/01 $3.75 2720010000( Total $50.60 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 copiesof these rules.,ordirect questions to OUNC at (503) 246 -1987. \\ PERMITTEE'S SIGNATURE ��'J� ISSU D BY: — �J,� / /r /!! OW_NSTALLATION ONLY ' –'f- 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 p. ELEC'N: �G�'c %`G / DATE: LICENSE NO: I/3736 Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application • D received: /-,q --d/ �GL� mat t , 4) , + ,..� 1 City of Tigard oject/appl. no.: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 ate issued: Receipt no Phone: (503) 639 -4171 Fax: (503) 598 -1960 ase file no.: e: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory 1L Commercial/industriiall CI Multi-family CI Tenant improvement ❑ New constructiont1 .Addition/alteratio eplacemen ❑ Other: ❑ Partial JOB SITE INFORMATION • Job address: 7 .05 SW 4 t.4., 2JXc p S 1 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: 'Subdivision: .1-51 01 ii' O 0 brv3 Project name: I Description and location of work on premises: . Estimated date of completion/inspection: • CONTRACTOR APPLICATION ' "'"•;;: FEE SCHEDULE Job no: Fee Max Business name: /..t.t -P, J,� Se}..Ycci: f • Description Qty. (ea.) Total no. insp New residential - single or multi - family per Address: tr71 S. !Ze...! ,,,...r R✓ dwelling unit. Includes attached garage. ' City: c - ciV C: I State:t4-- I ZIP: ' 7pk5 Service included: Phone: ;j ,6w i 7 ps-- I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: 1,2 I Elec. bus. lic. no: 3 ��1-� $ Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: i *5tp Limited energy, non- residential 2 '114A4.--L ,� , Each manufactured home or modular dwelling Signature of supervising el e [clan (required) Date Service and/or feeder 2 Sup. elect. name (print): Mkr i - License no: LE 3 7? 5 Services or feeders — installation, alteration or relocation: • PROPERTY OWNER • 200 amps or less 2 Name (print): 201 amps to 400 amps 2 ' 401 amps to 600 amps 2 Mailing address: • 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ' • ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of . Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase • of service or feeder fee; first branch circuit: E. 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑. Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 O Hn7ardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection I I I I . Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa . ❑ MasterCard expires if a permit is not obtained. Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card • $ Cardholder signature Amount 440 -4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: Com lete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY /� Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 . 1 n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener' Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less . $80.30 2 n Vacuum Systems 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 . Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: • Over 600 amps to 1000 volts, see "b" above. I I Audio and Stereo Systems Branch Circuits Boiler Controls New, alteration or extension per panel ' a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service (P � n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 HVAC • Miscellaneous I I Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 T7 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 � Medical Each additional inspection over I I the allowable in any of the above n Nurse Calls Per inspection $62.50 - • Per hour $62.50 In Plant $73.75 _ n Outdoor Landscape Lighting • Fees: / � t< Ij Protective Signaling Enter total of above fees $ ' / J h Other i 8% State Surcharge $ ' 75 Number of Systems 25% Plan Review Fee * No licenses are required. Licenses are required for all other installations See "Plan Review" section on $ front of application. $ �b �� Fees: Total Balance Due Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ • • Total Balance Due $ • i:\dsts \forms \elc- fees.doc 10/09/00 • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested ' � - © / AM PM BLD Location OS LL) ,v Li Suite MEC Contact Person / Ph PLM Contractor /,4 -AVG_ Lam—/ Ph SWR BUILDING` Tenant/Owner ELC — 060 VT 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 Misc: Final PASS PART FAIL Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHAN,ICALn °: , , Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL (LE °,TRICA Service Rough In UG /Slab Low Voltage Fire larm •A ' PART FAIL SITE4 .. E 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 F- o l Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.