Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00529
Vii& DEVELOPMENT r MENTS SERVICES 639 -4171 DATE ISSUED: 9/5/00
- 13125 SW Tigard, PARCEL: 2S109BA -06900
SITE ADDRESS:. 13874 SW LEAH TERR
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R -7
BLOCK: LOT : 055 JURISDICTION: TIG
Project Description: Installation of 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: 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: 1 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:
JOHN F NAEGELI OWNER
DIANNA M SCHUMACHER
13874 SW LEAH TERRACE
TIGARD, OR 97224
Phone: 590 -0396 Phone:
. Reg #:
FEES Required Inspections
Type By Date Amount Receipt
Ele Service
PRMT CTR 9/5/00 $53.50 2720000000( Elect'l Final
PRM2 CTR 9/5/00 $4.28 2720000000(
Total $57.78
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 se- - es or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE . -'-\./(..
cy ,.., , _. e . ,._..„ , _
ISSUE BY:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. ` /
c t OWNER'S SIGNATURE: �� DATE: l� 0,1'
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
CITY OF TIGARD Electrical Permit Application Recd B1��G�
1 Fe125 SW HALL BLVD.
TIGARD OR 97223 Date Reed 9
• P r int of Type
Date to P.E.
Phone (503) 639 -4171, x Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # CLC:.Bt 'c 5
Fax (503) 598 =1960 Called
1. Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per permit allowed
Name of Development Ft k L I- 514 t mil=
Name (or name of business) --o L. t•-)?:..?...e...-C,: Service included: Items Cost Total
Address 1 3 81'A 5 i`Q -rz_C- i" i2 4a. Residential - per unit
1000 sq. ft. or less $147.15 4
City/State /Zip ) ,c m- K' 0 re. Q'T'ZZ4-6 Each additional 500 sq. ft. or
portion thereof $33.40 1
Commercial ❑ Residentialin Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2
2a. Contractor installation only:
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
200 amps or less $80.30 2
Electrical Contractor 201 amps to 400 amps $106.85 2
Address 401 amps to 600 amps $160.60 2
City State Zip 601 amps to 1000 amps $240.60 2
Phone No. Over 1000 amps or volts $454.65 2
Job No. Reconnect only $66.85 2 •
Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders
OR State CCB Re . No.
Exp.Date Installation, alteration, or relocation
9 p 200 amps or less $66.85 2
COT Business Tax or Metro No. Exp.Date 201 amps to 400 amps $100.30 2
• 401 amps to 600 amps $133.75 2
Signature of Supr. Elec'n Over 600 amps to 1000 volts, .
see "b" above.
License No. Exp.Date 4d. Branch Circuits
Phone No. New, alteration or extension per panel
a) The fee for branch circuits
feeder purchase of service or
2b. For owner installations:
feeder fee.
Each branch circuit $6.65 2
Print Owner's Name ac, L_ N 1 " "i- 'ec. I. L b) The fee for branch circuits .
Address C5 8 7 ` ( S uo L m without purchase of service / _,
City -- v-,..,:r,....v -..Q._ State .0 /Z Zip q, 72.`11 or feeder fee. / ,/j . q5
Phone No. .._5-1 o ` p 5 942 First branch circuit $46.85 `/�(A
( Each additional branch circuit $6.65 _ (p r (pc i
The installation is being made on property I own which is not 4e. Miscellaneous
(Service or feeder not included) •
intended for sale, lease or rent.
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40
Owner's Signature := x _.,.._ Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
3. Plan Review section (if required). * Minor Labels (10) ' $125.00
4f. Each additional inspection over
Please check appropriate item and enter fee in section 5B. the allowable in any of the above
4 or more residential units in one structure Per inspection $62.50
Service and feeder 225 amps or more Per hour $62.50
System over 600 volts nominal In Plant $73.75 •
Classified area or structure containing special occupancy as 5. Fees:
described in N.E.C. Chapter 5 3 5 0
5a. Enter total of above. fees $ cc
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ y, a
Not required for temporary construction services. Subtotal
° $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
- IS - NOT - COMMENCED WITHIN - 180 DAYS, OR IF CONSTRUCTION OR ❑Trust Account #
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Total balance Due $ 5 - / ,71
AT ANY TIME AFTER WORK IS COMMENCED.
is \dsts \Corms \electric rev.doc - 8/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested — / � AM PM BLD
Location (3 t 7Y -5 4✓ L Suite MEC
Contact Person Je1/ 4 Ph sy o - G,� � PLM
Contractor L� (� t= Ph -SWR
BUILDING' . • Tenant/Owner ELC c›2001 5
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 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 _
PASS PART FAIL
MECHANICAL _
Post & Beam •
Rough In
Gas Line
Smoke Dampers
Final
RT FAIL
ELECTRICAO
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
dr 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
Approach /Sidewalk
Other Date 00 Inspector Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.