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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00576 • Lip l • DEVELOPMENT H PMENT Tigard, ) 639 -4171 DATE ISSUED: 10/3/00 PARCEL: 2S 104CA -02300 SITE ADDRESS: 13625 SW LAUREN LN SUBDIVISION: HILLSHIRE ZONING: R -7 BLOCK: LOT : 023 JURISDICTION: TIG Project Description: Installation of one 200 amp or less service /feeder and two 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: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: • • YARBROUGH, DAVID S + CAROLYN J OWNER 13625 SW LAUREN LANE TIGARD, OR 97223 Phone: Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT CTR 10/3/00 $93.60 2720000000( Elect'l Final 5PCT CTR 10/3/00 $7.49 2720000000( Total $101.09 • This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 throw h OAR 952 - 001 -0080. You 'may obtain copies of- these rulesotdirect questions to OUNC at (503) 246- 1987. \` I PERMITTEE'S SIGNATURE . e � ��� ISSUED Y: 1 �� / , s / � 0 NER INSTALLATION ONLY — The installation is being made on property I own which is not,intended for sale, lease, or rent. . OWNER'S SIGNATURE: J i _....AllaraW46Lt DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • l •• Electrical Permit Application Date received: /d 3 -op Permit no.: EL C - 005 ,,jyMi l City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction U Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 15 51.,0 i_tit .et, 1 - 4 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: • Project name: I Description and location of work on premises: kid p /UqS 1 1 , 4 f 74 Sha (-Obel Estimated date of completion/inspection: . CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: 0wo.e.(- Description Qty. (ea.) Total no. insp New residential - single or multi - family per Address: 13 4, LS su j c , t_ u. C V\ 1_41 dwelling unit. Includes attached garage. City: "1 "T a f -d I State: OIL I ZIP: g7x:2 3 Service included: • Phone: 4. I Fax: . I E -mail: 1000 sq. ft. or less 4 CCB no.: xI % I Elec. bus liC. no: Each additional 500 sq. ft. or portion thereof / �/� Limited energy, residential 2 City /metro lic. no.: V/4 Limited ener gy, non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect name (print): License no: Services or feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less I 2 Name (print): j ,1 • � ar D i b r Ott h 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 13 to 7, 5 $l.t) mu., ✓1 I -►" 601 amps to 1000 amps 2 City: Ti ar d I State:oe_ I ZIP: 972x3 Over 1000 amps or volts 2 Phone:603)42q_D3 /- I Fax: /,) i 1E-mail: j fif Reconnect only 1 Owner installation: The installation is being made on prop rty I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation ,alteration,orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 10 201 amps to 400 amps 2 Owner's signature: C . • Date: � 0 O 401 to 600 amps - 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit at .2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): • ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 . ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection I I I 1 Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: I I within 180 days after it has been State surcharge (8 %) .... $ • Expires ,accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6 /00 /COM) TYPE OF WORK INVOLVED - RESIDENTIAL ONC 4. Complete Fee Schedule Below: Number of Inspections per permit allowed Restricted Energy Fee $75.00 Service included: Items Cost Total 4. (FOR ALL SYSTEMS) 4a. Residential - per unit Check Type of Work Involved: • ' 1000 sq. ft. or less $147.15 4 Each additional 500 sq. ft. or n Audio and Stereo Systems portion thereof $33.40 1 Limited Energy $75.00 I-1 Each Manufd Home or Modular l 1 Burglar Alarm Dwelling Service or Feeder $90.90 2 • n • Garage Door Opener' 4b. Services or Feeders Installation, alteration, or relocation .` 0 n Heating, Ventilation and Air Conditioning System` 200 amps or less / $80.30 `6V 2 201 amps to 400 amps $106.85 2 n Vacuum Systems* 401 amps to 600 amps $160.60 . 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only • $66.85 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY 4c. Temporary Services or Feeders . Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 . 2 Check Type of Work Involved: Over 600 amps to 1000 volts, • . see "b" above. n Audio and Stereo Systems 4d. Branch Circuits New, alteration or extension per panel n Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. 2 Each branch circuit �/ ' $6.65 /5 ' 2 n b ) The fee for branch circuits Data Telecommunication Installation without purchase of service or feeder fee. .. n Fire Alarm Installation First branch circuit . $46.85 ' Each additional branch circuit $6.65 n HVAC 4e. Miscellaneous (Service or feeder not induded) n Instrumentatio Each pump or inigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal dreuit(s) or a limited energy . panel, alteration or extension $75.00 n Landscape Irrigation Control* Minor Labels (10) $125.00 • 4f. Each additional inspection over n . Medical the allowable in any of the above n Per inspection $62.50 Nurse Calls • Per hour $62.50 In Plant $73.75 n Outdoor Landscape Lighting' 5. Fees: .(c'0 I 1 Protective Signaling 5a. Enter total of above fees $ 8% Surcharge (.08 X total fees) $ 7• (pi n Other ' Subtotal $ 5b. Enter 25% of line 5a for Number of Systems Plan Review if required (Sec. 3) $ Subtotal $ * No licenses are required. Licenses are required for all other installations ❑ Trust Account # • / O FEES: W Total balance Due $ ENTER FEES $ 8% SURCHARGE (.08 X TOTAL ABOVE) $ TOTAL • $ • CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �i B Date Requested / Z / 0 AM PM BLD Location / 3 6 Z)J .->G✓ - / PLY LA Suite MEC Contact Person Ph 7c, PLM Contractor -.--' J _ Ph SWR BUILDING : 1. �'. �, Tenant/Owner ELC jw -vc- Retaining Wall ELR Footing Access: Foundation • Z A/ 4. _ FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab F�� 711 ° C r 2 . 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 L 0 ���� PLUMBING p " Post & Beam Under Slab • Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL; A Post & Beam Rough In Gas Line Smoke Dampers • Final RT FAIL ELECTRICAL x, fi • Service Rough In UG /Slab Low Voltage Fire Alarm Fi ASS 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 A roach /Sidewalk Other Date f2_ /I — O) Inspector x t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.