Permit A. CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00204
,,^ DEVELOPMENT SERVICES DATE ISSUED: 4/8/99
„� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S104BA -15500
SITE ADDRESS: 13550 SW LIDEN DR
SUBDIVISION: CASTLE HILL NO. 3 ZONING: R -12
BLOCK: LOT : 185 JURISDICTION: TIG
Project Description: Installation of 1 branch circuit.
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:---, E -r��
GRANT, PAT & JUDI
13550 SW LIDEN DR P r ' - (oa$
TIGARD, OR 97223 1�1Lx�t��LL -� 12 - 47070
Phone: Phone: (12,2,-. 49 34
Reg #: g$4 sa
FEES Required Inspections
Type By Date Amount Receipt Rough - in
Elect'l Service
PRMT DRA 4/8/99 $35.00 99- 314346 Elect'l Final
5PCT DRA 4/8/99 $1.75 99- 314346
Total $36.75
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 copie es- les or direct questions to OUNC at (503)
246 -1987.
Permit Signature: � v� Issu d By: A i1, , : 41 /L I L L ...,
OWNER INSTALLATION 0
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: . Q9__ 0 Ai DATE:
LICENSE NO:
17 05
CaIII 639 -4175 by 7:00pm for an inspection the next business day
•
CITY OF TIGARD RECEIVED Electrical Permit Application Plan Ch
13125 SW HALL BLVD. Recd
TIGARD OR 97223 APR 0 8 1999 Date Recd 4/ -8-97
Phone (503) 639-4171. Date to P.E.
Inspection (503) 639-4 "UNITY DEVELOPMENT Print or Type Date to DST
Incomplete or illegible will not be accepted Permit atctg 99-ooao�
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) PAT & JUDI GRANT Service included: Items Cost Sum
1.
•
Address 13 5 50 SW L I D EN DR . 4a. Residential - per unit
City /State /Zip TIGARD, OREGON 9722? 1000 sq. It. or less $110.00 4
Each additional 500 sq. It or
Commercial El Residential ® Portion thereof $25.00 1
Limited Energy $25.00
Each Manufd 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 BOO N E S FERRY. EL ELECT R I C Installation, alteration, or relocation
Address P 0 Box 628 200 amps or less $60.00 2
201 amps to 400 amps $8000 2
City Wi lsonvi 1leState OR Zip 97070 401 amps to 600 amps $120.00
Phone No. 6 8 2 - 4 9 3 6 601 amps to 1000 amps $180 2 - Job No. to 4 'VI I Over 1000 amps or volts $34000 2
2
Reconnect only
Elec. Cont. Lice. No. 3 - 2 2 3 C Exp.Date -3 y $50.00 2
OR State CCB Reg. No. 8 8 4 8 2 Exp.Date 717 1199. 4c. Temporary Services or Feeders
COT Business Tax or Me o No 2 8 51 Exp.Date 8/1/99 Installation, alteration, or relocation
•
200 amps or less $50.00 2
Signature of Supr. Elec' 201 amps to 400 amps $75.00 2
401 see amp"b" s to 600 above. amps $100.00 2
License No 3170 Exp.Date 10/1/01 1 /0 1
S Over 600 amps to 1000 volts. --
Phone Nr 6 8 2-49 3 3 6
f 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations:
a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
City State Zjp b) The fee for branch circuits
Phone No. without purchase of
service or feeder fee.
First branch circuit 1 $35.00 ? 5 n n 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
• intended for sale, lease or rent.
4e. Miscellaneous
Owners Signature (Service or feeder not included) •
Each pump or irrigation circle $40.00 . 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required): * Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10)
Please appropriate item and enter fee in section 58. $1 00.0•3
• 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. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above lees $ 3 5 . n n
5% Surcharge (.05 X total fees) $ 1 _ 75
•
NOTICE Subtotal $ 36.75
5b. Enter 25% of line 5a for . - -
I PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, 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 it
Total balance Due s 36.
r.
v,afry 1OSTS'ELC96.APP Rev 996
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
q
Date Requested AM PM BLD
Location I 'S9") L.4rcL ,r) Df! Suite MEC
Contact Person V L- Ph 60gZ - W 3e PLM
Contractor Ph SWR ,,,.,� /
BUILDING Tenant/Owner ELC I 93 0 021
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing �t X - - 4- D C1/48
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final �� / — �•Z S S
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
tp
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
gtEG b
Service
Rough In K V
UG /Slab
Low Voltage vvv
Fire Alarm
410
PART FAIL
E
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 / 9 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.