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Permit • CITY OF TIGARD PERMIT PERMIT #: ELC2000 -00269 ���, DEVELOPMENT SERVICES DATE ISSUED: 05/22/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1 14 B B -03000 SITE ADDRESS: 10065 SW KENT PL SUBDIVISION: PICKS LANDING NO.1 ZONING: R -4.5 - BLOCK: LOT : 044 JURISDICTION: TIG Project Description: Install a first 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: 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: MCMAHON, MARGARET A + SHARPE ELECTRIC INC • MOORE, JEFFREY D 22605 SW RIGGS 10065 KENT PL BEAVERTON, OR 97007 TIGARD, OR 97224 Phone: Phone: 642 -7937 Reg #: LIC 000815 SUP 3344S ELE 34 -217C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT GEO 05/22/200C $37.50 0002346 Elect'I Final 5PCT GEO 05/22/200C $3.00 0002346 Total $40.50 GI NA 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: ,dig ‹,1101 011 1, OWNER INSTALLATION ONLY - 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 SUPR. ELEC'N: DATE: —2 .0 7- 0( 7 LICENSE NO: 3 3 �S�S Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Check # 13125 S V HALL BLVD. Rec'd By TIGARD OR 97223 Date Recd Date to P.E. Phone (503) 639 -4171, x304 ''V(' Date to DST Inspection (503) 639 -4175 Print of Type Permit #Fle e )040 - Fax (503) 598 -1960 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) / ' Wj'4"ti Service included: Items Cost Sum l' Address C COf' 5 5 ' PL-a ci - 4a. Residential - per unit City/State /Zip 1 3 4' « , q "7 / 1000 sq. ft. or less $ 117.75 4 ` Each additional 500 sq. ft. or portion thereof $ 26.75 1 Commercial ❑ Residential J 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 bas ). _ /� Installation, alteration, or relocation Electrical Contractor , ' /) L L.- L L' 7 /c_ 200 amps or less $ 64.25 2 /!,7 201 amps to 400 amps $ 85.50 . 2 Address S Li) ) �s c -t 401 amps to 600 amps $ 128.50 2 City 14-e."4-6/2-r State O Zip ! ?co 7 601 amps to 1000 amps $ 192.50 2 Phone No. (30. /‘, .ii' - 7r/. 3 7 Over 1000 amps or volts $ 363.75 2 Job No. /e I on Reconnect only $ 53.50 2 Elec. Cont. Lice. No. .3 ` .- /7G Exp.Date ICS /D /`QQ 4c. Temporary Services or Feeders OR State CCB Reg. No. /$ V Exp.Date 5 G /O / Installation, alteration, or relocation COT Business Tax or Metro No. ,751/4.? 1 Exp.Date 200 amps or less $ 53.50 2 l 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n . • Q 1 / a'/ 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, I ,�° • see "b" above. 3 `/ License No. 3 Exp.Date /b/0/ Al / 4d. Branch Circuits Phone No. SG l �� 79 3 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 Q $ 37.50 Each additional branch circuit $ 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 * panel, alteration or extension $ 60.00 3. Plan Review section (if required): Minor Labels (10) $ 100.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Per inspection $ 50.00 Service and feeder 225 amps or more 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 $ * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ ? -C Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME IFWORICOR 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 # i f y � AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ �I I i:Afists \formsAcicctric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 6394171 BUP Date Requested qzLl/O� AM PM BLD Location / U 5 p` - P - Suite MEC 2f "3l c e Contact Person j , 4J Ph tP W " VO PLM Contractor Ph SWR BUILDING. `% Tenant/Owner ELC '2 D - 00 2Cr l Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear , S ,� — 6r-e -- :mil/! 4wa'- Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ® t- C � �G�c rO 0 (q / / - 7 Fire Alarm / �(4-6 Susp'd Ceiling Q— Z49-2:113 – V 0 is j Roof Misc: Final PASS PART FAIL PLUMBING C - Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MANIC Post & Beam - Rough In Gas Line Smoke Dampers PAS PART FAIL RIC7�C� . Service Rough In UG /Slab Low Voltage Fir- Alarm anal 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 • A Other Date rm. I nspector / � i Ext Final PASS PART FAIL DO OT - MOVE this inspection record from the job site.