Permit CITY O F TIGARD E.E R I T I c ALE ,c317-f LI 053,
i9�,,,7di DEVELOPMENT SERVICES DATE ISSUED: 08/07/97
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL; 1S1 C4CD -0 i 8 *2,
SITE ADD RESS... 2 11 770 SW KATHERINE ST
SUZDIV:SICN....gLERCN HEIGHTS NO. 3 ZONINS A R- -40 5
BLOCK..........: LOToes- ..,.oaa..s.451 JURISDICTION; TIC
Project D e s c r i p t i o n ; Rdd first branch circuit.
--_.- RESIDENTIAL UNIT...___- -- -- -.TEMP SRVC/FEEDERS---- - - -... - - .MISCELLANEOUS_- _._.......
1000 SF OR LESS....: 0 0 - 200 amp.. - a . e . e 0 PUMP/IRRIGATION....: 0
EACH ADD' L 500SF. o . a 0 201 - 400 amp, .. a a , v o 0 SIGN /OUT LINE LTC —c 0
LIMITED ENERGY--; 0 401 - 600 amp.......: 0 SIGNAL/PANEL.......: 0
MANF. HM/ SVC /FDR.. a 0 601ramps -1000 volts.; 0 MINOR LABEL (10) . j = o 0
--- .--..- .SERVICE /FEEDER - - - -. - - -- BRANCH CIRCUITS -- -AID?' L INSPECTIONS--
0 - 200 asnpa n .. , . n 0 W /SERVICE OR FEEDER 0 PER INSPECTION,.,., i
201 -- 400 amp, o o - .. ;i 0 1st W/O SRVC OR FDR. a 1 PER HOUR. n .. a c s a o _ . 0 0
401 - GOO amp--; 0 EA ADD' L. SRNCH CIRC; 0 IN r a . L a n o a . ; 0
601 -- 1000 amps .... 0 0 -- -- PLAN REVIEW SECTION -•
1000+ amp/volt.....: 0 >-=4 RES UNITS...... , . x > GOO VOLT NOMINAL — o
Reconnect on l y.. o . n ; 0 SVC/FDR > 225 AMPS..: CLASS AREA /SPEC OCC,
LEONARD CURRIER type amount by date recpt
11770 SW KATHRINE PRMT $ 35:00 CEO 08/07/97 57• -29804
TIGARD OR 97223 5 (' 1.75 GEO 08/07/97 97- 298041
Phoney
Contractor: -- -- ---- -------
WESTS I DE ELECTRIC $ 38075 TOTAL
7518 SW MACADAM AVE
REQUIRED INSPECTIONS -- __._ --
PORTLAND OR 97219 Rough -in Elect' 1 Service
Phone fiL; 245-3385 Underground Cove Elect' 1 Final
Reg #.. x 000133
This pernit 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 pernit will expire if work is not started within 18
days of issuance, or if work is suspended for gore than Ha days. ATTEENTION Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in ORR 9.. - S1 -M:Oi through ORR 952-M-1987. You uay obtain a copy
of these rules or direct questions to DIM by calling (5%3 -:987. •
Per i tt ee Si Issued By . ______, /..
---
--------- _..--- _. -._ -_- _._.OWNER INSTALLATION ONLY- -. ------------------
The installation is being made on prbperty I own which is not intended For
sa:xe lease, or rent.
OWNER'S SIGNATURE: DATE n
__ -_....___._ .__.__.._.- .._.__.__.._- ._. - -_- .CONTRACTOR INSTALLATION ONLY -__.
S I GNATU RE OF SUPR. ELEC' N �V f DATE F v 9-q7---
LICENSE NO / - 6 .' - - - - -- - -- - - - -
- T- '"6-- 6- -1 -. -•_ -4 qr-t - - -c- , -6° . -: -F• . . -i` 4. - .- 4- -',.- :•-6-- 1-4-i- F '[- . -e e-•i- •#- -1--'r•-{_.}... - 4.J.- 6-- 1 -i--1- i- -6- -6--h -i- :- it -:-•' +-t- h.+4 -H-+4. ti-:.+-:
Ca.11 .639 -4175 by 8;00 p.m. for an inspection needed the next business day
+4-ti :-+- i-4--;•• v- 9-• 9-- r•-;--!-- 5-+^;-- I_.{-_ i.•-i••.:- -9--6- ••T•-}••i'-F-I• •-s^-!^-1--f-- - t•+- F-1-- F- i-°! --[--!- -1--t•-F-f--t~-i--: ^-k•+ +- t•- 1- i---- F- 1-- Fi--}.. l--h-d--i--1-•f-l- +-I__6_-d_-i _;-_:-
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # ELL ° 47 - 05:35
Fax (503) 684 -7297 Incomplete or illegible will not be accepted. Called
1. Job Address: 4. Complete Fee Schedule Below:
•
Name of Development a p Number of Inspections per permit allowed
-
Name (or name of business) Ze0r1Q/r CiirriPr� /���l0 Service included: Items Cost Sum
Address //7/ 0 y � Ka /1Z, - /A.2 J. ^ 4a. Residential - per unit -
1000 sq. ft. or less $110.00 4
City /State /Zip 7:252,4 AT/ Each additional 500 sq. ft. or
Commercial ❑ 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 tl�i 4b. Services or Feeders
Electrical Contractor 1�.r7- r7- CQ Z/L Installation, alteration, or relocation
Address 2C/c? L41,i cf .>7 200 amps or less $60.00 2
/ � 201 amps to 400 amps $80.00 2
City State OR Zip 1 72/ 9' 401 amps to 600 amps $120.00 2
Phone No. 4 ' Yr 601 amps to 1000 amps $180.00 2
Job No. .tDf - 00/ Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. ZG- -17S - 6 , Exp.Date
OR State CCB Reg. No. /3301- 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 l.�.S GS Exp.Date see °b" above.
Phone No Z S! S' - .332.S
4d. Branch Circuits
P. New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
• i
purchase of service or
1,
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. / First branch circuit / $35.00 •3 C 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature 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: r
Not required for temporary construction services. 5a. Enter total of above fees $ 3-5- 75
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
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 Su tai $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY 7
TIME AFTER WORK IS COMMENCED. uuu Trust Account #
Total balance Due $
A
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 //2,1 "'9 AM PM BLD
Location ! /77 StJ lkq- `74 /71Ew / Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
Bl71 . ° Tenant/Owner
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
PLUMBING e . W.. , .s.
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL: °" > r
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS —PART_ FAIL
E
Service
Rough In
UG /Slab •
Low Voltage RA
Fir- alarm
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 99 Inspector (2..Z.-e--Z Ext
Final
. PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
L.