Permit CITY OF T I G A R D I:::I...E::(;•TR I:(: :fll... l::'1:: :RiYll :1'
�N DEVELOPMENT SERVICES PERMIT 03 E :L..C. :9 c >rr >.:I.:I illy1 DATE ISSUED: 05/20/98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
/ ! PARCEL: 2531(•fl k1C•• -C) :1. 7C Cr)
s :1 : =: ADDI: ES3s.... : :I.c_'4';.i(i) SW KNOI...1... DR
Sat. JB DIVIS3IC)hl....... :'T :r.OARD] :A TERRACE :ZONING :l: _4..I:;
BLOCK.......... " — .. :: L.ar.............. ............ : :0102 JuRISI)]: :1: ON: T :I :(a
P ?1. Description:: Install a new 280 AI's' service /feeder for an existing single
family dwelling. UPDATE: PLEASE SEE ADDITIONAL FEES & LOGNOTE.
- •- •- •-RES3I I)ENT:I: AL. UI�11: T ---- -• -- TI:::tir sRVc /FEI :I)E :Firs._- :...__.. ._..._.._....__Ii:t: aC E:I...LANIE:Clus•-_--_..-
1.0
1000 SF OR L_ESS3......., : ('J C -- no amp..........: (%J pt.JMYll /IRRI(af-ITI( :)hl....... ( %)
EACH ADD " L. 500S3F......: 0 201 -• 400 amp.............: 0 SIGN/OUT i..INE: L..'T(3...: (%)
LIMITED ENERGY.......: (%) 401 --• C❖, { =Jt7 amp............: 1:1 fia: C; hl f••1L. /PANE :L...............: 0
IYIflNF•. I-Ill/ S3VC /FI)R...: (%? 60:1•4am ••1 (noo vol. ts..: Cf) NItioti i...f-EEL (1.0) : 0
• -S E :RVICE : /FI :EI)ER-- .._..._••- ----BRANCH CIRCUI'TS__.._._........ .._._.•- .ADD" L INSI :'C :CTIO1*I #:3•••••• -••••
C) • -• 200 amp........... : :I. W /531: : :1'•iV :t :ci: OR FEEDER: 1 PER I I Isr.:'E: :CT :r.ON.. „ ...:: 0
2Q31 -- 400 amp..........: C 1st W/O sRVC OR FDR..: 1 PER HOUR...........: ( %)
401 •••• 600 amp..........: C I: : :I:1 AI)I)" L. BRNCH CIRc: 0 IN I:'1_.(m ........ ... : 0
6 0 1 . - :1( ?)00 amp.......... : ( % ) _._......._.___...... ._......... ._............_._..r:'l RE V1Q13 SE :C'TIC)N __ ._.........._....._ ._ ..__ ........_
1.000+ amp /vot— .. . : fc) > : -:4 RE S UhiITE3„ ............: > 6(Q) VOLT 1 ::
Reconnect only.......: (%) SVC/FDR >:::: car:y,'.'i AMI : :'53.... :: CLASS AREA/SPEC OCC. :
Owner: - - _ __. _____..___. __ _____.._ _. __.... F E E S
CHARLES E DEFOE type amount by elate reecp
182 SW CORRAL CREEK RID I :'RM I' $ 60.00 I 0 04 /24 / 9F 98-305321
•- ;:3E?):'.'i::,. -'.:i.
SHERWOOD OR 97140 5l :'CT 4 3.. Q)QJ GEO 04/24/98 98-305321
I'RN"I' 4 40.00 DI H 05/20/98 91:s `:1C8•_.3( %);.','j I.(j
Phone t4: G,97•°•4280 SPCT . $ 2.. (70 DI...I -I Q /i?f) /':)!1 98-305910
OWME:R $ :1.05. ('J(') TOTAL.
------- RE: :(:1U :I :FEE: :I) INS 1 :'E :C:T :r. ()NS - ••__.._:. -....
Raugh -••in w.lec " :I. Final
Phone:? #: Elect" 1 Service
Reg #... : 000000 ..
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 be done in accordance with approved plans. This permit will expire if work is not started within 1:s
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to Ol1NC by callin: 503)246 -1987.
Per mi. ttcece ..._ ...,: i
Si. ,)7 11ttc�t nature - //f / /It _ :I :'.S'.ii lC�y:
OWNER :1: NSTALLAT I.ON ONLY----------------------------
The :Lt•t<.:st:a].1a. ;ison :i.s ICE? :1.rtci Made on l :r pert y I own which is rtcr(; :1rttend cecl •for
sale, l ease, or (' ?Ylt. .
OWNER" S SIGNATURE IDATE :
___..._......_ ..._....._ ........ _...._..... _....__ _ _- f'OI'ITRACTC)I INSTALLATION O N1 Y.._.._.._. ..........._......_._..._._..__ .................. ......w......................_.
S3IGN(1 T URE OF 9t. PR. EL 1 s � DATE: 1.-
LICENSE NO:
4.4-4-4-4-4-11.÷4-4-4.4-++++++++++++4-4-4-÷-1-4.- +4-4-4-1-4-4 4 •a-f -4--fr++ 4- 1 -i--4- t..e..e..4..4- -e- +•4+ ++++++++ +-t- 4--4 --e + - 4.4.4.
Call 639••••4 :1.75 by 7 ::00 p.m. for an inspection needed the next business day
4..4..:- 4..4.. 4..4..4 4- 4 -i -4- -4..4..4..4..4. .4..4..4..4..4..4..4.+.4..4..4. .4..4..4..4..4..4..x.4..4..4..4 ..4..4..4..4..4..4..4..4..4..4 - .4..4..4..4..1.. 4..4..4..4..4..4..4..4..4 .4..4 ..4..4_.4..4..4..4..4..4..4..4 +.4..4..4.
.„..,--
CITY OF T ELECTRICAL PERMIT
, DEVELOPMENT SERVICES PERMIT #: ELC98 -0211
2 �P'd6t DATE ISSUED° 04/24/98
_.. . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 2S1O1BC -01700
SITE ADDRESS... :12450 SW KNOLL DR
SUBDIVISION °TIGARDIA TERRACE ZONING :R -4.5
BLOCK LOT •002 JURISDICTION: TIG
Project Description : Install a new 200 AMP service /feeder for an existing single
family dwelling.
- -- RESIDENTIAL UNIT - - -- ----TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp . • 0 PUMP /IRRIGATION....: 0
EACH ADD'L 5O0SF...: 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 - 1 W /SERVICE OR FEEDER: 0 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..°..: 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES - ---
CHARLES E DEFOE type amount by date recpt
182 SW CORRAL CREEK RD PRMT $ 60.00 GEO 04/24/98 98- 305321
SHERWOOD OR 97140 SPCT $ 3.00 GEO 04/24/98 98- 305321
Phone #: 697 -4280 .
Contractor:
OWNER $ 63.00 TOTAL
REQUIRED INSPECTIONS
Elect' 1 Service
Phone #: Elect'l Final
Reg #.. .
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 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 lore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -rA-0010 through OAR 952 -001 -1 7. You nay obtain a copy
of these rules or direct questions to OUNC by calling (5' •• 987.
Permittee Signature: i , � � , . Issued By. l,� � —
O WNER INSTALLATION ONLY---- -
The installation is being made o- •perty I own which is not intended for
sale, lease, or rent.. / 4/"•27:- G
OWNER'S SIGNATURE: / .'_,;,�
DATE: l O
04NTR'TO
� R INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N: t/T DATE:
-- LICENSE - NO ;
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
f
x te
. r;.,_
CITY OF TIGARD Electrical P ermit 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 # -e-e' L!' $ -6) ,R /(
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedul Below:
Name of Development Number of Inspections per permit allowed
G
Name (or name of business) Che.G \ ,L �: °---- Service included: Items Cost Sum
Address /,Z � 4a. Residential - per unit v
� 7 ( - ' /
- "72 0 /� ( % •
9 7 2
/ GY` �! C , (��' / Each sq. ft. or less $110.00 4
City/State/Zip I' /J�1 tte�rr ( Each additional 500 sq. ft. or
Commercial ❑ Residential X. 3• 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 Installation, alteration, or relocatio
Address 200 amps or less X $60.00 6 C' 2
201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. 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
201 amps to 400 amps 75.00
Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No Exp.Date see "b" above.
Phone No.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
// �f .- purchase of service or
Print Owner's Name Ch a r if 5 !/ /Q C G 0 • feeder fee.
Address 12 yS "O A -sue // /S' Each branch circuit $5.00 2
State rLG Zip b) The fee for branch circuits
City ? �"-'f p without purchase of
Phone IA. #01 ;> ff ff / 697- �.� lf service or feeder fee. r
r / First branch circuit $35.00 2
The installation is being ma no pr 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 III - / Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section/' f re Q uire • :* 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. 55, Fees: �
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ -3 _ ..
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 OR IF CONSTRUCTION OR WORK - _ -- - Subtotal- _ - -- $ --
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
‘‘.2.---
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96 ,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 1 Business Line: 639 -4171
, ! �` ' �Q BUP
Date R equested 3 A M f U ' PM BLD
Location l 2- W / ,11e, f / Ac, Suit- MEC
Contact Person Lc /S DA-i7 0, i Ph PLM
Contractor Ph SWR.
BUILDING ° '' Tenant/Owner ELC it - c Zr-/ /
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab /' SIT •
Post & Beam (�l1 / 4 /L I S Ped J--,46)c CJV
Ext Sheath /Shear U t
Int Sheath /Shear •
Framing
Insulation
Drywall Nailing
Firewall j / kd Fire Sprinkler ri) `f Y e c.��1 nYl S pP Cgr ' U p cop-,
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING tj e,:: i _..d _
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL (y,
,MECHANIw.„; :. :;
Post & Beam
. .
Rough In
Gas Line , i
Smoke Dampers
Final
PASS P T FAIL
gW.CTRICAL;. ':
Service
Rough In �/ \ �A`� �
UG /Slab `� �` r
Low Voltage I
Fire Alarm/ Ck
PART FAIL
Backfill /Gradin
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 - Q Q -
Approach /Sidewalk Date "3 C J — ` Ins actor E xt
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.