Permit CITY OF TIGARD ELECTRICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: ELC98 -0740
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01 / 07 / 99
PARCEL: 2S102CB -01805
SITE ADDRESS. °.:10400 SW PARK ST
SUBDIVISION ZONING:R -3.5
BLOCK • LOT • JURISDICTION: TIG
Pro.j ect Description : Installation of electrical service.
- -- 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: 40 PER INSPECTION 0
1 201 — 400 amp • 1 1st W/0 SRVC OR FDR.: 0 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 -- JUMBO FERNANDO type amount by date recpt
Y 17549 SW OAK MEADOWS LN PRMT $ 280.00 GEO 12/17/98 98- 311625
LAKE OSWEGO OR 97034 SPCT $ 14.00 GEO 12/17/98 98- 311625
PLCK $ 70.00 GEO 12/17/98 98- 311625
Phone #:
Contractor:
BECK ELECTRIC INC $ 364.00 TOTAL
9318 SE CHURCH ST
REQUI RED INSPECTIONS
CLACKAMAS OR 97015 Ceiling Cover Elect'1 Service
Phone #: 656 -7396 Wall Cover Elect'1 Final
Reg #..: 000026
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 • es you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 '' through OA 2-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: .AMc J�te Issue • By: k ao,e2.4iA.4_4
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: 1• :.. ) . _ DATE: 1 "
LICENSE NO : 1 -G
tl
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + ++ + + + + + + + + ++ + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ 4- + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
i
CITY OF TIGARD Electrical Permit Application Rand Check #LA ,46 6
13125 SW HALL BLVD.
TIGARD OR 97223 Date Recd - -�rB"
Date to P.E. - /7 - P .l•
Phone (503) 639 -4171, x304 B -0/47 Print or Type Date to DST '- - a, .
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit ft c��9� D7'/d
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 Number of Inspections per permit allowed
Name (or name of business) k \ \ y (- a /� S
J\
x .L. Service included: Items Cost Sum
Address i ( -10 ) aiD PI kf" 1 4a. Residential - per unit
1 ((YIN 1000 sq. ft. or less $110.00 4
City /State/Zip ° X X8t "i vri N Each additional 500 sq. ft. or
Commercial Residential ❑ Limited Energy $25.00
Each Manuf d Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all rren licens 4b. Services or Feeders
Electrical Contractor p rck / i t ec / r, G Installation, alteration, or relocation
t7- - -v 200 amps or less $60.00 2
Address 731 D se- c avc 201 amps to 400 amps - r $80.00 VOCt 2
City /a a > - S � l tate Zip_ O /5 - 401 amps to 600 amps $120.00 2
Phone No. Q t 3 L ___
-2 601 amps to 1000 amps $180.00 2
Job No. ' _20 i! ID o, 99 ,� Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. - Exp.Dat- A ' -
OR State CCB Reg. No. • • Exp.Date - I - " ' 95-' • 4c. Temporary Services or Feeders
COT Business Tax or Metro No "` -... Exp.Date I - Installation, alteration, or relocation
��� 200 amps or less $50.00 2
Signature of Supr. Elec'n i g� • t -- 201 amps to 400 amps $75.00 2
YW .
401 amps to 600 amps $100.00 2
2lo Exp.Date ID / - / Over 600 amps to 1000 volts,
License No /32. 0 see "b" above.
Phone Nr 65 ' - 2 `� 6o
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. ' ` r
Address Each branch circuit "t d $5.00 2 CO ' 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui
$5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature 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) $100.00
Please check appropriate item and enter fee In section 5B.
1 4 or more residential units in one structure 4f. Each additional inspection over
X 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: 2 70 oa
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ � L
NOTICE • Subtotal $
5b. Enter 25% of line 5a for 70
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 # $ _3((,_ °
Total balance Due
1: \DSTS \ELC96.APP Rev 9/96
8 /8 /99 Activities for Case #: ELC98- 00740 .
3:18:55 PM
•
. Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 12/17/98 GEO RECD DLH 12/17/98
ELCC003 Permit created 12/17/98 DLH DONE DLH 12/17/98
ELCC102 Plans routed to Plans Examiner 12/17/98 DLH SENT DLH 12/17/98
ELCC700 Ceiling Cover 4/6/99 CD PASS CD 4/6/99 ceiling cover
ELCC720 Wall Cover 2/1/99 - BRP PASS • CD 2/2/99
•
ELCC730 Elect'l Service 2/18/99 BRP PASS VLN 2/23/99 Panel schedule to be
permanent ink or type; pencil
will fade. (Service pass).
ELCC799 Elect'l Final 4/2/99 CD FAIL AKJ 4/5/99 . Susp ceiling cover denied all
• drop in fixtures must have 2 •
• slack wires
ELCC920 Miscellaneous action 12/29/98 CD FAIL CD 12/29/98 need updated plans& approval
- before permit may be issued.
pool bonding denied, use
ground clamps listed for rebar
connection & burial in concrete.
ELCC920 Miscellaneous action 12/30/98 CD PASS CD 12/30/98 POOL BONDING ONLY
ELCC115 Approved plans routed to DSTs 1/6/99 CD PASS CD 1/6/99
ELCC400 (F)Ready to issue 1/7/99 DEB DONE DRA 1/7/99
' ELCC500 (F)Issue permit • 1/7/99 . DEB DONE DRA 1/7/99 Issued and mailed to contractor
per contractors request. •
•
ELCC920 Miscellaneous action 2/1/99 BRP PASS • CD 2/2/99 soffits •
ELCC799 Elect'l Final 5/6/99 5/6/99 5/6/99 BRP FAIL No Hold AKJ 5/6/99 Main panel not flush with
- finished wall
Switch plate not flat on wall
Fire alarm flex not secured
2 gan. receptacle in bookcase
needs liner extender, wall plate
- must not be cut
Receptacles marked GFCI are
• . not tripping
. Panel schedule words not
. - completed
Plates must cover wall opening •
Receptacles loose
Panel covers not secured
Inspection not completed, final
to be started from beginning
Flex on pool equip to be securec
Pool panel not flush
ELCC725 Underground Cover 5/9/99 5/9/99 5/7/99 BRP - PASS No Hold AKJ 5/9/99
ELCC799 Elect'l Final 5/16/99 5/16/99 5/14/99 BRP PASS No Hold AKJ 5/16/99
ELCC800 Case Finaled 5/16/99 AKJ - DONE No Hold AKJ 5/16/99
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�J BUP
Date Requested S -1 'I -q i AM PM BLD
Location L d tt bD ( Suite MEC
Contact Person ,1 ici.u."2 Ph (J.. Ar PLM
Contractor Ph 3.)q — W g q SWR / I
BUILDING Tenant/Owner ( C l` S l�(� ELC Q b -d7�/n
Retaining Wall ELR
Footing Access:
Foundation • -� A e 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: /-x T fl Ie - /r /C4 / ss
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
<ELECTRICAL.)
Service
Rough In
UG /Slab
Low Voltage
Fir- larm
- ASS 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
Approach/Sidewalk Date.:) 7 ' ` ,,frpffi Other Insp ectorl-i Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.