Permit 'CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00293
'i I DEVELOPMENT SERVICES DATE ISSUED: 06/05/2000
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 BC -00100
SITE ADDRESS: 08185 SW HUNZIKER ST A
SUBDIVISION: ZONING: I -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install two (2) branch circuits.
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: 1 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:
KNEZ, JOHN S SR + JEANNE M ALAN FITCH ELECTRIC
8185 SW HUNZIKER RD 25973 S MOEHNKE
TIGARD, OR 97223 BEAVERCREEK, OR 97004
Phone: Phone: 503 - 632 - 4784
Reg #: LIC 00106872
ELE 3 -387C
SUP 3721S
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT GEO 06/05/200C $42.85 0002680 Elect'l Final
5PCT GEO 06/05/200C $3.43 0002680
Total $46.28 ORIGINAL
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.
PERMITTEE'S SIGNATUR _ . ; ISSUED BY:
OWNER INSTALLATION ONL
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
.ONTRACTO INST LATION ONLY
SIGNATURE OF SUPR. ELEC'N: 11,1*.4I �I ' - ` - DATE: 6
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY O.F TIGARD Electrical Permit Application Plan Check# .
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit # co aeeo - e.0A-43
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Tro'pi w `► w ii t ¢ 1 -\ Number of Inspections per permit allowed
Name (or name of business) 3'e 'imt tit t ai *keg oAs Service included: Items Cost Sum 4
• Address V I 15S 31A) 1vtz-I k:Q.r- 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City/State /Zip 11041.41 Each additional 500 sq. ft. or
rr� portion thereof $ 26.25 1
Commercial L� Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base Installation, alteration, or relocation
Electrical Contractor ft-v0.0 t" M4 471 Lt--- 200 amps or less $ 64.25 2
Address 2.S zj , MvlE -%A) Lt.J ' 201 amps to 400 amps $ 85.50 2
,,� 401 amps to 600 amps $ 128.50 2
City p�
State Oa_ Zip 6 YE 601 amps to 1000 amps $. 192.50 2
Phone No. 7 3 j057 -- 4f 14 U Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 - 3i '- C_ Exp.Date '( (9 ^ V 1 4c. Temporary Services or Feeders
OR State CCB Reg. No. IV lvri1- Exp.Date (p -s -0 I Installation, alteration, or relocation
COT Business Tax or Metro o. Ex .Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n " t a i___• 7C' 401 amps to 600 amps $ 107.00 z
Over 600 amps to 1000 volts,
License No.
--. -7..), S Exp.Date t V f- 0 t see "b " above.
4d. Branch Circuits
Phone No. �(J�2 - New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit I, $ 37.50
Each additional branch circuit i $ 5.35 ,
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
(if required):* pane alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 397-09
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over it=le)'4e,
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: `
5a. Enter total of above fees $ 4 , g C
* Submit 2 sets of plans with application where any of the above apply. 124 X. Surcharge (.85.X total fees) $ 3 , s} .�j
Not required for temporary construction services. Gip Subtotal • OF $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 4b, Zef
i:\dsts\forms\electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location 3 I Suite MEC
Contact Person 1 Ph C4 0 y' Jz'/ � PLM
Contractor Ph SWR
BUILDING':.: ',A - Tenant/Owner ELC ;ZOO CZ vZ�
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
Drywall on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm _ef
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
ELECTRICALm , ,, ,, rn ° k
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
• S 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 reinspection RE: [ ] Unable to inspect no access
ADA
Approach /Sidewalk .
Other Date 1. Inspector _�� Ext
Final
PASS PART FAIL 5 0 NOT REMOVE this inspection record from the job.site.