Permit A CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC95 -00046
� DEVELOPMENT SERVICES DATE ISSUED: 11/8/95
-" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 BC -03300
SITE ADDRESS: 12419 SW KNOLL DR
SUBDIVISION: PP1994 -025 ZONING: R -4.5
BLOCK: LOT : 002 JURISDICTION: TIG
Proiect Description:
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 48 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 (10): 0
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 0 W /SERVICE OR FEEDER: PER INSPECTION: 0
201 - 400 amp: 0 1st W/O SRVC OR FDR: 0 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
OMNI ELECTRIC OF OREGON
A.K.A OREGON ELECTRICAL CONSTR
1010 SE 11TH
PORTLAND, OR 97214
Phone: Phone:
234 -9900
Reg #:
FEES Required Inspections
Type By • Date Amount Receipt
Electrial Final
PRMT TMP 11/8/95 $50.00 95- 266672
5PCT TMP 11/8/95 $2.50 95- 266672
Total $52.50
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. / pg
PERMITTEE'S SIGNATURE //1/,7'25 SUED BY:
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
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SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
TIGARD
iiiii WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land U - : Transportation
' .fiV Electrical I F ssects • - ection APPLICATION
155 North Firs • venue, #350 -12
Hillsboro, • egon 97124
Information: (50 . = • .3470 Fax: (503) 693 -4412
PLEASE PRINT Permit /)3 / 9,r - Please complete all sections, 1 through 5 Number irk CAS - q � Date !
1. Location of installation 4. Complete Fee Schedule below
Address 12419 SW Knoll Number of inspections per permit allowed
Building
City Tigard Suite No. Service included: Items Cost(ea.) Sum
Tenant Name A. Residential - per unit
(if commercial)
1000 sq. ft. or less $110.00 4
Ma No. Tax Lot Each additional 500 sq. ft •
p or portion thereof $25.00
Book: Page: 655 Section: F -4 Limited Energy $25.00 1
Thomas Map 9 Each Manuf'd Home or Modular
Directions House is behind "12435" Dwelling Service or Feeder $68.00 2
Commercial n Residential Ix B. Services or Feeders
Installation, alterations or relocation
200 amps or less $60.00 2
2a. Contractor installation only: • 201 amps to 400 amps $80.00 2
Electrical Contractor Omni Electric Contractors
401 amps to 1000 amps $120.00 2
Address PO Box 1788 Over amps to amps amps $40.00 2
Over 1000 amps or volts $340.00 2
City Lake Oswego State OR ZIP 97035 • Reconnect only -L $50.00 00.00 2
Date 6/7/95 Job Number 16074
Property Owner K I SH , R . J . C. Temporary Services or Feeders
Contractor's License No. 1 8 2 C Installation, alteration or relocation
Contractor's Board Reg. N.. amps or less $50.00 2
� • 200 am p
201 amps to 400 amps $75.00 2
Signature of Supr. Elec ' 401 amps to 600 amps $100.00 2
License No. 2345S Phone 635-4306 Over 600 amps to 1000 volts see "B" above
D. Branch Circuits
2b. For owner installations: New, alteration or extension per panel
a) The fee for branch circuits with
Print Owner's Name Phone No. purchase of service or feeder fee.
Each branch circuit $5.00 2
Address • b) The fee for branch circuits without
purchase of service or feeder fee.
City State Zip First branch circuit $35.00 2
Each add'nl branch circuit $5.00 2
The installation is being made on property I own E. Miscellaneous (Service or Feeder not included)
which is not intended for sale, lease or rent. Each pump or irrigation circle $40.00 2
• Each sign or outline lighting $40.00 2
Owner's Signature Signal circuit(s) or a limited
energy panel, alteration
3. Plan Review section (if required) or extension $40.00 2
Please check appropriate item and enter fee in section 5B. F. Each additional inspection over the allowable
4 or more residential units in one structure in any of the above
- amps or more Per inspection $35.00
Service and feeder, 800 am
P Per hour $55.00
System over 600 volts nominal In Plant $55.00
Classified area or structure containing special •
occupancy as described in N.E.C. Chapter 5 5. Fees •
Submit 2 sets of plans with application where any of the A. Enter total of above fees $ 50 .00
above apply. Not required for temporary construction 5% Surcharge (.05 X total fees) $ a.SO
services. Subtotal $
This permit becomes null and void if the work authorized by the permit is B. Enter 25% of line A for
not commenced within 180 days from date of issuance of such permit or Plan Review if required (Section 3) $
if work authorizedis suspended or abandoned at any time after work Subtotal $
is commenced for a period of 180 days. Electrical Permits are non- $
❑
refundable and non - transferable. J Trust Account
J i .i For inspections call (03T Lip Balance Due $ 5a.5o
'.r( /s 8
24 -hour recorder, one working day in advance of need
BL28 • 3/95
5/9/00. Activities for Case #: ELC95 -00046
4:1907 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 6/13/95 JDA RECD TMP 11/8/95
ELCA003 permit created 6/13/95 JDA RECD TMP 11/8/95
ELCA799 Electrial Final 6/13/95 6/23/95 MJR PASS JF 9/6/96
ELCA500 (F) Issue permit 6/13/95 JDA PASS CTR 1/12/96
ELCA800 Case finaled 9/6/96 JF 9/6/96
ELCA510 (F) Reprint permit 5/9/00 SLT DONE No Hold ST 5/9/00 Unable to locate original
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: r
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line • -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech. -
Underflr. Insul. Shear Wall Gyp. Bd. 44.11:210
Date Requested: 2 / --3 )95 Time: AM PM
Address: l 4 \ A/
Builder: Co 3,- -4 - 1 4 , 0G Z2-Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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•
Inspector: 6' / ` j�� Date :� V
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APPROVED DISAPPROVED _ _ ___ _APPROVED _SUBJEC_T_T_O_ABOVE __
_Call For Reinsp. 4 A47