Permit CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98- 10O8
DATE ISSUED: 08/18/98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S125CD-O4OOO
SITE ADDRESS...: LANDAU ST -
SUBDIVISION.... :BOULEVARD HEIGHTS ZONING :. R 4.5
BLOCK........... LOT.... ....... JURISDICTION: TIG
Pro.j ect De scr• i pt i on : Changing meter base
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 - 200 amp - 0 PL1MP /IRRIGATION - 0
EACH ADD' L 5O0SF...: 0 261 - 400 amp.......: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY - 0 401 - 6OO 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 on 1 y.....: 0 SVC /FDR ) = 225 AMPS..: CLASS AREA /SPEC OCC.
Owner: - -•- - FEES
PETER KUSYK type amount by date recpt
BEACON HOMES PRMT 60.00 B 08/18/98 98- 308326
9500 SW 125TH AVE 5PCT $ 3.00 B 08/18/98 98- 308326
BEAVERTON OR 97008
Phone #:
Contractor:
BEAR ELECTRIC $ 63.00 TOTAL
PO BOX 389
28085 BUTTEVILLE RD NE REQUIRED INSPECTIONS
DONALD OR 97020 Rough -in Elect'1 Final
Phone #: 678 -1355 Elect' 1 Service
Reg #..: 000209
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
days of issuance, or if work is suspended for mare 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 OUNC by calling (58.3)246-J987.
Permittee Signature: � Il �At Issued' By: rJ
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 --
S IGNATURE OF SUPR. ELE:C' N : MA, �l . (07\ DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. C G1
Tigard, OR 97223 Permit # LL IOO
/ � a�d,�l��ll" I � RECEIVED Date Issued q6- t1-`1b
,� I I Phone (503) 639 -4171
FAX (503) 684 -7297 iwG
CITY OF TIGARD TDD No. (503) 684 -2772 1 1998
Inspection (503) 6390Mipny nrIILOP p 1:2r
1. Job Address: ��'i 4. Comple Fee Schedule Below:
Name of Development 7 4 '7 ! Number of Inspections per permit allowed
Address 76 Stet/ L4/1/04u ST: Service included: Items Cost(ea) Sum
City /State /Zip / /6"//t 0, O/c. 'f72. 2- 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) igedLON g0/1f1CS Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ❑ Residential ' Q Limited Energy $25.00
C1iANGf /YMElEL. 11156 Each Maned Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor lk9/t- ELEGfit,Ec- � 2/vG• 200 amps or less / $60.00 ‘6.2.- 00 2
Address P 0. $oX 3$ 9 201 amps to 400 amps $80.00 2
City mNA d State O ZI J'7 7 401 amps to 600 amps $120.00 2
y p 601 amps to 1000 amps $180.00 2
Phone No. 6If /3.53 Over 1000 amps or volts $340.00 2
Job NO. /t//, Reconnect only $50.00 2
contractor's license NO. Z51 -/o 7c- - 10-1-9/S 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 209 <9 '7.---20-2000 Installation, alteration, or relocation
Signature of Supr. Elec'nX (�,--. £ ie..,P 200 amps or less 2
License No. 3/6 2 S Phone No. b70-135:r 201 amps to 400 amps $50.00 2
401 amps to 600 $75.00
10 - 1 - $
Over amps to 1 1000 volts $1
OI $100.00
. 2b. For owner installations: see "b" above. "
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First additional n a l circuit $35.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ Apo. 0
NOTICE 5% Surcharge (.05 X total fees) $ 3. co
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ (r3. dO
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ K
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ ( f, 07
COMMENCED. wormcandeNeiec- ❑ Trust Account # X
prmapp
Balance Due $ 6 3,0,,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 .
BUP
Date Requested S'Z5 AM PM BLD
Location '7 c 2 ) (And AA- Suite MEC
Contact Person r Ph (79 -/ 3 S PLM
Contractor Ph SWR
BUILDING: . ! Tenant/Owner ELC 9
D
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab I Drain Inspection Notes: Y, /N� "
SIT
Post & Beam ,, II -1
Ext Sheath /Shear VV �/V I. (\ 57iz ) - Ke wf I t "
Int Sheath /Shear t / r f -
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler . ef.--P.,
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING. `:::j
Post & Beam
Under Slab
•
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL ;x
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CELECT ,:- :
<Servibip
Rough I
UG /Slab
Low Voltage
Fire Alarm
Fin. ,
i PART FAIL
•
'is
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 - !4 �f9 Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.