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Permit C CITY ELECTRICAL PERMIT O F TIGARD G A R D PERMIT #: ELC2000 -00581 �r DEVELOPMENT SERVICES DATE ISSUED: 10/6/00 r�l I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AD-04400 SITE ADDRESS: 08516 SW LUCILLE CT SUBDIVISION: LUCILLE ESTATES ZONING: R -12 BLOCK: LOT : 006 JURISDICTION: TIG Project Description: Installation of 7 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: 6 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: NATHAN, ERWIN J VANDER STOEP ELECTRIC 8516 SW LUCILLE CT 23765 THIRD ST NE TIGARD, OR 97223 AURORA, OR 97002 Phone: Phone: Reg #: LIC 89417 SUP 4360S ELE 24 -304C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 10/6/00 $86.75 2720000000( Wall Cover 5PCT CTR 10/6/00 $6.94 2720000000( Elect'l Final Total $93.69 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 SIGNATUR % / �+1 /r+: 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: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day r . ,. Electrical Permit Application A. Date received: /(j /eVer Permit no.: 6GC ego oO -DO / -•11, ;•f i City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT i 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement 0 New construction O Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: S576. S, (J 1,1 ).4....e. C7' Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: • I Block: I Subdivision: Project name: 17(f . frkc'{.4 )'J I Description and location of work on premises: 8 R 7:)a/446I= "* •1 Estimated date of completion/inspection: I — 0 CONTRACTOR APPLICATION FEE SCIIEDU.E Job no: Fee Max Business name: ['h./pg./Q._ SEEP &1.-.EC - Description Qty. (ea.) Total no. insp � 1^ New residential - single or multi - family per Address: Z37�� / /�(RD ��- • G dwelling unit Includes attached garage. City: 1) I Stater ZIP: €772,c.2"7.._-- Service included: • Phone: 'e57 j !1 I Fax:�'Z$- 17 (` 'E -mail: }�t/�,11D siv� t• or less 4 CCB no.: : I Elec. bus. lic. no: 21.-30 2 / Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 Cit I Limited energy, non- residential 2 / __ �„„+ %1/ 1O _e.i... DU Each manufactured home or modular dwelling ignature of supervising el- . ician (required) Date Service and/or feeder 2 Sup. elect. name (print):•L bE12 .S a-0� License no: 43 C OS Services or feeders installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps • 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am . s 2 ENGINEER 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 2 City: I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail: of service or feeder fee, first branch circuit: (� 2 2 Each additional branch circuit: O PLAN REVIEW' (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps - rating of 1 &2 0 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, O System over 600 volts nominal more residential units in one structure alteration, or extensions` _ 2 O Building over three stories Cl Feeders, 400 amps or more *Description: O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan 0 Other: Per inspection I I I I 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 Penult fee $ k - 7 j O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ 4=agb Credit card number: / / within 180 days after it has been State surcharge (8 %) $ G .9Y. Expires accepted as complete. TOTAL $ _ ?'.3 . eo 9 Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00/COM) • •r • • Electrical Permit Fees: Limited Energy Permit Fees: Number of Inspections per permit allowed TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Service included: • Items Cost Total 4a. Residential - per unit Restricted Energy Fee $75.00 1000 sq. ft. or less $147.15 4 (FOR ALL SYSTEMS) • Each additional 500 sq. ft. or portion thereof $33.40 1 Check Type of Work Involved: Umited Energy $75.00 • Each Manufd Home or Modular - ❑ Audio and Stereo Systems Dwelling Service or Feeder $90.90 2 Burglar Alarm 4b. Services or Feeders • Installation, alteration, or relocation Garage Door Opener' 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 0 Heating, Ventilation and Air Conditioning System' 601 amps to 1000 amps $240.60 2 Over 1000 amps or volts $454.65 2 ❑ Vacuum Systems' Reconnect only $66.85 2 4c. Temporary Services or Feeders ❑ Other Installation, alteration, or relocation 200 amps or less .$66.85 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY 201 amps to 400 amps r $100.30 2 401 amps to 600 amps . $133.75 2 Fee for each system $75.00 Over 600 amps to 1000 volts.. (SEE OAR 918 - 260 -260) see "b" above. 4d. Branch Circuits Check Type of Work Involved: New alteration or extension per. panel Audio and Stereo Systems a) The fee for branch circuits with purchase of service or ❑ feeder fee. Boiler Controls • Each branch circuit $6.65 2 b) The fee for branch circuits ❑ Clock Systems without purchase of service . , or feeder fee. Data Telecommunication Installation First branch circuit $46.85 �� • 3 Each additional branch circuit co $6.65 ,, .g n Fire Alarm Installation 4e. Miscellaneous (Service or feeder not Included) ❑ HVAC Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Instrumentation Signal circuit(s) or a limited energy . panel, alteration or extension $75.00 _ ❑ Intercom and Paging Systems Minor Labels (10) $125.00 4f. Each additional Inspection over : ❑ Landscape Irrigation Control' the allowable In any of the above Per Inspection $62.50 ❑ Medical Per hour $ 62.50 • In Plant - $73.75 _ ❑ Nurse Calls • 5. Fees: LC. , 75 El Outdoor Landscape Lighting' 6a. Enter total of above fees $ o 8% Surcharge (.08 X total fees) $ O Subtotal Protective Signaling 6b. Enter 25% of line 6a for ❑ Plan Review if required (Sec. 3) $ Other Subtotal $ Number of Systems ❑ Trust Account a / 9 • No licenses are required. Licenses are required for all other installations Tota! balance Due $ J rG • FEES: ENTER FEES $ • • 8% SURCHARGE (.08 X TOTAL ABOVE) $ • • TOTAL $ • • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ;• BUP Date Requested /1- Le/ AM PM BLD cv Location �i S ( Stv G i /Aa CA Suite MEC Contact Person Ph VlO 7 -57 / Z PLM - Contractor :ir cif-r- 6 • ; Ph SWR BUILDING Tenant/ wner ELC, vj/ -ric) 5 Retaining Wall Gr! f( VCI ,S 6.6 ELR Footing Access: 1 &9 f " Foundation OH f G _ v FPS Ftg Drain / / 0 SGN Crawl Drain Inspection Notes: Slab 7- c( R SIT Post & Beam Ext Sheath /Shear Uf L f S i fl (2- S cl (e, 4- rQ,_ ), r / 0 / iluip Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler "�/ tit 4.-4•4! 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 PASS PART FAIL Cf LEM:RIG Service Rough In UG /Slab Low Voltage Fire Alarm P T FAIL BackfillGrading 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 p D Inspector t Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.