Permit •
:4. ' ;
PERMIT #: ELC2000 -00260
,i'l4, DEVELOPMENT SERVICES DATE ISSUED: 5/19/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
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PARCEL: 1S136AA-07100
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SITE ADDRESS: 07081 SW LOCUST ST
SUBDIVISION: AUM DOWNS ZONING: R -4.5
BLOCK: LOT : 005 JURISDICTION: TIG
Project Description: Installation of one branch circuit for new a/c unit. Job No. J01603.
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:
TANZ, GUY H AND WEST SIDE ELECTRIC CO INC
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BADZIK, KATHLEEN M E 1834 SE 8TH AVE
7081 SW LOCUST PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone: ORIGIN
231 -1548
Reg #: LIC 13306
• SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 5/19/00 $37.50 0002297 Elect'I Final
5PCT DEB 5/19/00 $3.00 0002297
Total $40.50
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 of thes ules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE , � — /, - ISSUED B C�GfDif
• 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 IN TALLATION ONLY
A
SIGNATURE OF SUPR. ELEC'N: . >® 0 D o' ; ! !� 1�i1 DATE:
LICENSE NO: i' SS7a S
Call 639 -4175 by 7:00pm for an inspection the next business day
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MAY -16 -00 06:03 PM WEST SIDE ELECTRIC 503 736 0677 P.01
^ I OF TIGARD Electrical Permit Application Plan C = - ;,._ , :ra. 1
31 s SW HALL BLVD. pP Reed = �iZfl11� '
Tl�i . RD OR 972 t3 RECEIVED Date Recd 5'17 ■ • •
. . Dale to P.E. -----'
I . ph ' • (503) 839 -4171, x304 MAY 17 2000 Date to DST �'
Ins ction (503) 8y9 -4175 , Print of Type Permit I ft.G2 `C C
. FaX 03) 598 -1960 IMMUNITY DEKkinaglete or Illegible will not be accepted Called
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1. • b Address: 4. Complete Fee Schedule Below: •
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Mamje • • Developmen. 1 Number of Ins lions per permit allowed
Name or name of business) 40 Z /SU��� Service Included: Items Cost Sum
Addf .: 7Q r / Siti OC cars 4a. Residential •per unit
Cityl5 additional to /Zip / 7 Q0- a 9 7213 1000 sq. It. or labs f 117.75 4
Eac aonal 500 sq. ft. or
I: i I portion thereof $ 28.25 1
Co j =rdal El Residential U Limited Energy S 50.00
I : I • Each Manufd Home or Modular
i 2 ontractor installal Ion only: Dwelling Service or Feeder $ 72.75 2
OA •. permit Issuance, appiican`s must provide contractor license 4b. services or Feeders
r
I o on for COT data bass). • Installation, alteration, or relocation •
I l al Contractor i� r � N � /� �4 % C 200 amps or less 19 64.25 2
dcki - 4 iO % � /Y G. ' 201 amps 10 400 amps $ 85.50
2
•i ' I T 4• /i C' late ? ': Zip e/7 y 401 amps to 600 amps $ 122.50 2
p 601 amps to 1000 amps $ 192.50 2
Phon = No. 2.3/ / S 1 1 e Over 1000 amps or volts S 383.75 2
Job k . .I 0/AD 3 Reconnect only S 63.50 2
Ele ' ont. Lice. No. ' / - C Exp.Date /r t ') 4c, Temporary Services or Feeders -
!OR
to CCB Reg. No. / • U Exp.Date l / `/ c} Installation, alteration, or relocation
, CO ! : usiness Tax or Metro Pk. 2 g 7 Exp.Date 2/ __ Zoo amps or less $ 53.50 2
• I 201 amps to 400 amps $ 80.25 2
I Sig re of Supr. Elec'n _...---- • 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
I LIce No. IS "..r .3 Exp.Date /t)// /C / see "b" above.
I Phon: No. 3/- /.S y 7 4d. Branch Circuits
New, alteration or extension per panel
i. ' I a) The fee for branch circuits
4b.! or owner Installat ►ons: with purchase of service or •
1. feeder fee.
Pint « «wner's Name Each branch circuit a 6,35 2
ddd[ = 6 b) The fee for branch circuits
J without purchase of service
4ity! State Zip or feeder fee, S
Ohoh N0. First branch circuit / 6 37,50 7
1. i � Each additional branch circuit $ 5.35
't ~he ' I tallation is bei 1g made 4 n property I own which is not 4e. Miscellaneous
I • d for sale, lease or rent.' (Service or feeder not Included)
__ i Each pump or Irrigation circle S 42.75
a1SIA: ` Signature Each sign or outline lighting S 42,75
? I Signal circull(s) or a limited energy
3, i lan Review sectici If required) : e Minor Labels (10) S 107.00
1 PIp u se check appr Dprlate Kok and enter fee in section 511 41. Each additional Inspection over
4 or more real iential units :in one structure the allowable in any of the above •
' I Service and feeder 225 a ps or more Per inspection S 50.00
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Per hour S 50.00
System over 600 volts no Inal in Plant s 59.00
Classified area or structur containing special occupancy as
: t described in N.E.C. Cha O ter.5 5. Fees: 3
i 1 6a. Enter total of above fees S
` . • Sy' It 2 sets of plan a with application where any of the above apply. 5% Surcharge (.05 X total fees) $ 3 es
Not squired for temi ovary con truction services. Subtotal $
Sb. Enter 25% of line 6a for
N TICE Plan Review If required (Sec. 3) S
E' S BECOME VO D IF WOR OR CONSTRUCTION AUTHORIZED Subtotal $
P
IS Np COMMENCED WITHIN 18 DAYS, OR IF CONSTRUCTION OR
• WO IS SUSPENDED OR ABAN ZONED FOR A PERIOD OF 180 DAYS Trust account d / ` v / r L
AT • TIME AFTER VI ORK IS COMMENCED, Total balance Duey 3, $ /Q -S-C)
I: \dsjs ,nips \cicclric.dnc a 6 0 ad-?
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• CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested VS/0 A PM BLD
Location [ Dg Suite MEC 2. - oO1 q 3
Contact Person 6 LAit U I 1 Ph 53 - $ 307 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 2-000 O2L0
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab kin SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall (2 /��
Fire Sprinkler L�
Fire Alarm
Susp'd Ceiling
Roof �4 7 — 41 _
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ANICAI
Rough In
Gas Line
S l i k e Dampers
Fine.
PART FAIL
a'TRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
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 Inspector Ext
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.