Permit ELECTRICAL PERMIT
CRY OF TIGARD PERMIT #: E
'COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/02/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S104BA -08900
SITE ADDRESS...: 13863 SW LIDEN DR
SUBDIVISION • CASTLE HILL #2 ZONING:R -25 PD
BLOCK LOT •124
Project Description: Installing one branch circuit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 •- 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 - 400 amp 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 - 600 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 • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 1 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 only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC °
Owner: FEES
DANNY LEUNG type amount by date recpt
13863 SW LIDEN DR PRMT $ 35.00 CJS 08/02/96 96- 282450
• 5PCT $ 1.75 CJS 08/02/96 96- 282450
TIGARD OR 97223
Phone #:
Contract or:
GRF ELECTRIC $ 36.75 TOTAL
15460 SE PARADISE LN
REQUIRED INSPECTIONS
MULINO OR 97042 Wall Cover Elect'1 Final
Phone #: 503 -829 -4146 Elect' 1 Service
Reg #..: 101543
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 cl es . - .),rll c `—
than 180 days. Issued By
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: erY1etl led DATE: $- oZ - 95
LICENSE NO:
Call for inspection - 639- -4175
I 1
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # 1 LCC -n SV)
AlPil � .Date Issued �- a- 46
ov ly, Phone (503) 639 -4171
„,41, FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of- Develepntent D jr I) I L.. p (A)") �A Number of Inspections per permit allowed
Address 1 3 0 Lt L/ aril br, Service included: Items Cost(ea) Sum
_ S
City /State /Zip
"'-._
l 1 tit r( IC C' 7 2 2 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ❑ Residential X Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
FF 4b. Services or Feeders
Electrical Contractor G K r 0 l ~� Installation, alteration, or relocation
200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
Address -- )1-1., (9 g 1' I-4 D(.t.c 401 amps to 600 amps $120.00 2
City M t4 I 1. n State �� Zip 4/ y._ Z 601 amps to 1000 amps $180.00 2
Phone No. C{)-9 - y t y -(,, Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$ 50. 00 2
contractor's license NO. a (P k') C- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. ff9 / 0/ 4-4-3 Installation, alteration, or relocation 2
Signature of Supr. Elec'n � /l 200 amps or less 2
License No. 1 a3 - S hone N T1 OS ,;( `y-! 201 amps to 400 amps $30.00 2
�/�p 401 amps to 600 amps $75.00
-
Over 600 amps to 1000 volts $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
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without 0"---
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit / $35.00
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: 7
5a. Enter total of above fees $ J
NOTICE 5% Surcharge (.05 X total fees) $ 1. 7
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. worecomdMe&eo- ❑ Trust Account #
prm.app $ '
Balance Due $ S
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
99:%?/ ` / Date Requested / /�/ y�, AM >X PM BLD
Location /, g 6 , SG() L/led2 J Suite CLLZW 9
Contact Person L 11/2.0 Lear" Ph -5 3 PLM
Contractor J Ph SWR
BUILDING Tenant/Owner ! D 0-576
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab G Weintozu SIT
Post & Beam �� ��ll �,
Ext Sheath /Shear ref 1L ! G� - /n,[XC/7 - d ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final J .11
PASS PART FAIL PLUMBING / Z , 4t-
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECI NICA9
Post & eam
Rough In
Gas Line
Smoke Dampers
C Final
S PART FAIL
�ECTRICAt
Service
Rough In
UG /Slab
Low Voltage
arm
S 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 / g
Approach /Sidewalk Date `" Z - Z G 7 Inspector
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•