Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00634
' _ 1 6 DEVE PMENT r S o ERV 2CES 639 -4171 DATE ISSUED: 10/25/1999
13125 PARCEL: 1S125CD-07900
SITE ADDRESS: 09909 SW LANDAU PL
SUBDIVISION: TIGARD WOODS ZONING: R -4.5
BLOCK: LOT : 005 JURISDICTION: TIG
Project Description: Install 1 branch circuit in single family residence.
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:
BEACON HOMES INC BEAR ELECTRIC
7125 SW HAMPTON P O BOX 389
PORTLAND, OR 97223 DONALD, OR 97020
Phone: Phone: 503 - 678 -1355
Reg #: LIC 20919 ORIGINAL
ELE 24 -107C
SUP 3162 -S
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT KJP 10/25/199 $37.50 99- 319312 Elect'I Service
5PCT KJP 10/25/199 $3.00 99- 319312 Elect'I Final
Total $40.50
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. _
PERMITTEE'S SIGNATURE ISSUED BY: X Pf...e./L-
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: /0/
LICENSE NO: 3 f ( /2
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD l Plan Check #
-13125 SW HALL BLVD. R c �4+ectrical Permit Application Recd By
Date Recd
TIGARD OR 97223 OCT 2 5 199C: .7 Date to P.E.
Phone (503) 639 -4171, x304 1
Date to DST
Inspection (503) 639 -4175 COMMUNITY u,., _ -v, Print of Type Permit # E Lc. 19Qq- hpr'o3'�
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development r 1 . rd w az aL 5 Number of Inspections per permit allowed
Name (or name of business) B re c n /-� a /Me- c Service included: Items Cost Sum 1' Address 9 90 9 5' L) L an cl, c. c.. pt. 4a. Residential - per unit
City /State /Zip ` a 1000 sq. ft. or less $ 117.75 4
t' Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial ❑ Residential G Cs Limited Energy $ 60.00
o f 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 base). Installation, alteration, or relocation
Electrical Contractor gj .g= err 5 /e- c/ L I n . 200 amps or less $ 64.25 2
Address P® a a x 3 5 ? 201 amps to 400 amps $ 85.50 2
City D64. %v4 State Or . Zip G ? (S 2a 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. l 7 (6 - / 3 S'..r Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2 cy " /4)7 Exp.Date (01) I Ob 4c. Temporary Services or Feeders
OR State CCB Reg. No. 20 r!!? Exp.Date 1-l10I Gel Installation, alteration, or relocation
COT Business Tax or Metro No.3v 577 Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 6 2 (<_ e,izx,---r,0 401 amps to 600 amps $ 1 07.00 2
Over 600 amps to 1000 volts,
`6 2 , Ex p.Date l 011101 see "b" above.
License No. 4d. Branch Circuits
Phone No. 6-2 g- 1 3 .SS
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 ( $ 37.50 3 2. S O
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
• 3. Plan Review section (if required):* panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 107.00
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
Service and feeder 225 amps or more Per inspection $ 50.00
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 $ 37. $ b
* Submit 2 sets of plans with application where any of the above apply. e% Surcharge (.65X total fees) $ 3 , Q
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR 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 #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 90.0
i : \fists \forms \e lectri c. doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ld / AM PM BLD
Location T / Z 7 ASn._61 ��� Suite MEC /
Contact Person Ph 2- PLM
Contractor / Ph SWR
BUILD ELC 1 006 3 if
INGS�`�„ a � � �`�' Tenant/ wn r�
Retaining Wall ELR
Footing CCeSSJ
Foundation FPS
Ftg Drain
Crawl Drain In .. Notes: , 77 M • SGN
Slab. ! era-Ac 1 O ' 7� "49-, / / / SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING`
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P T FAIL
CHANIC
Beam
Rough In ‘C/.
Gas Line
Smoke Dampers ,)
•! ART FAIL l/
ECTRIC
Sery ce
Rough In
UG /Slab I
Low Voltage
Fire Iarm
_ ®_ 'PART FAIL
SITE
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 /0 � Inspector 0 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.