Permit - ,
CITY OF T ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98-0344
~�=~ � m~u~��" omn"�"� " ~�=~" u� "~�°�~� DATE ISSUED: 06/25/98
"�� '''!.� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S111CD-09600 .
SITE ADDRESS...:09890 SW KIMBERLY DR
SUBDIVISION....:KERWOOD ESTATES ZONING:R-4.5
BLOCK..........: LOT.............:030 JURISDICTION: TIG
Project Description: Bostwick
_ _ _ __________
---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 (169)...: 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
0 — 200 amp......: 0 W/SERVICE OR FEEDER: 0 PER INSPECTION.....: 0
201 — 400 amp......: 0 1st W/O SRVC OR FDR.: 1 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 —
PHIL BOSTWICK type amount by date recpt
9890 SW KIMBERLY DR PRMT $ 35.00 JSD 06/25/98 98-306832
TIGARD OR 97224 5PCT $ 1,75 JSD 06/25/98 98-306832
Phone #:
•
'
Contractor:
.
WESTSIDE ELECTRIC CO INC $ 36.75 TOTAL
1834 SE 8TH AVENUE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Rough—in Elect'l Final
Phone #: 231-1548 Elect'l Service ____ ___
Reg #..: 000133
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 t will expire if work is not imtod within 180
days of issuance, or if work is suspended for more t T[NTlON: Oregon law requires you to follow . e rules adopted by
the Oregon Utility Notification Center. Those,rul»s o OAR 952-001-0010 through OAR 952-001 ^8 obtain a copy
i of the roles or direct que�tioo� �o b/ ' l�n' ( 4: .
��' 'Al . .
Permittee Signat `- : �m� _, Issued By __ *tatia _ ___ ___
OWNER INSTALLATION ONLY — ' —
The installation is being made on propert'y I own which is not intended for
sale, lease, or rent. . ,
OWNER'S SIGNATURE: . DATE: ___
CONTRACTOR INSTALLATION ONLY ---- —
SIGNATURE OF SUPR. ELEC'N: ___ � . DATE:
LICENSE NO: _ ___ ___
-- - -- --_'
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
� S•
CITY OF TIGARD Electrical Permit Appilrea Iforrip Planc,Clittrda
13125 SW HALL BLVD. Rec'd By il�PS
TIGARD OR 97223
JUN 2 _; 1998 Date Reed ' ff
Date to P.E.
Phone (503) 639 -4171, x304 'IMUNITY DEVELOPMENT Date to DST
Inspection (503) 639 -4175 Print or T 'e Permit # GL - : ;j o3
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
-
Name (or name of business) Rill_ ST LA. i U1 Service included: Items Cost Sum
Address 9 Bci 0 SW 1a.NYl L-y Ott. • 4a. Residential - per unit v
,� 1000 sq. ft. or less $110.00 4
City /State /Zip - IC r� L1 , (•)R.. 9 Each additional 500 sq. ft. or
Commercial ❑ Residential1' portion thereof $25.00 1
Limited 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 1/4.kp T .A CXYLT-C Installation, alteration, or relocation
Address 1$3'4 52 41'"'` 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City State 00.. Zip M14 401 amps to 600 amps $120.00 2
Phone No. 23t - tS 601 amps to 1000 amps $180.00 2
Job No. 1706-010 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 26 -1o5C Exp.Date
OR State CCB Reg. No. 1 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 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. j J J'e 5 Exp.Date see "b" above.
Phone No. 2
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
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 1 $35.00 35-. CO 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:
35,o I
Not required for temporary construction services. 5a. Enter total of above fees $
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'DAYS7 - IF - CONSTRUCTION - OR - WORK Subtotal - $ - IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 3b `7S
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
1/7/2005
Case Activity Listing 1:44:36PM
TIDEMARK Case #: ELC98 -00344
COMPUTER SYSTEMS, INC.
:B t
u,,,
ss a ane � r a e
r ate %'
, . ,.. ... .., ate Da te 2 � - ate 3; ��,< >. Hold_. ,. Pis ft To: " \ 'B. ote
Descry ton .... D ''
Acttv�t _ ;e � .., ..... s
�..... �>.. ... , . _ ... ..,..... ..ter ....... p „, .. ,..,�,�_ aw.w� ,Y” ,........,'.F BY:;: ....��..�. >... $�3;r „�; . .�:... _.
N
ELCA001 Application received 6/25/1998 None USPS JSD 6/25/1998
JSD
ELCA003 Permit created 6/25/1998 None PASS JSD 6/25/1998
JSD
ELCA700 Rough -in 7/15/1998 None PASS TLP 7/16/1998
TLP
ELCA730 Elect'! Service 7/15/1998 None PASS TLP 7/16/1998
TLP
ELCA799 Elect'! Final 7/16/1998 None PASS TLP 7/16/1998
J *H
ELCA500 (F) Issue permit 6/25/1998 None PASS JSD 6/25/1998
JSD
ELCA800 Case finaled 7/16/1998 None PASS TLP 7/16/1998
J *H
i
Page 1 of 1 CaseActivity..rpt
• CITY OF TIGARD BUILDING INSPEj CAN DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
t ( SDI Date Requested ' 1 S S 41:1 X PM BLD
Location C; 1S9O S W ZA. Suite 4.130 C ?-Q LL/(- f
Contact Person "_ J' adWY ,' Ph (9z (4- z7oi- PLM
s �,
Contractor C ereAt/V1W■ Ickta Ph SWR
BUILDING Tenant/Owner Phi 1 1 Vv (C,h & .a.o - 65 2_6 9R 3V
Retaining Wall ELR
Footing 1 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 6 , Q 6Q ` 2
Susp'd Ceiling _
Roof
Misc:
Final
PASS PART FAIL
PLUMBING 6»5 - 1jj9C . 57a,ece
Post & Beam
Under Slab O ff/ r ic;Q 7c vSce,
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
• = ' FAIL,
-0u.. I t/100)1/ •sLi• ampers
/7'' - • FAIL
eivrce
ough I
Low Voltage
Fire Alarm
Fina
la) 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 —
D ate / 7/17 1 Inspector " II LC . O / 6 Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.