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Permit
CITY OF T ELECTRICAL PERMIT �� „��,�:� DEVELOPMENT SERVICES DATE ISSUED: ELC98-0729 /1 /98 PARCEL: 25102BC -05700 SITE ADDRESS...:12615 SW PATHFINDER CT SUBDIVISION -YOLO ESTATES ZONING:R -4.5 BLOCK • LOT •006 JURISDICTION: TIG Project Description: Add a first 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/0 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 CHRIS YURJEVICH type amount by date recpt 123615 SW PATHFINDER PRMT $ 35.00 GEO 12/11/98 98- 311483 TIGARD OR 97223 5PCT $ 1.75 GEO 12/11/98 98- 311483 Phone #: 620 -5247 Contractor: S Sa YURJ EVICH C EXPIRED HI YURJEVICH $ 36.75 TOTAL 12615 SW PATHFINDER REQUIRED INSPECTIONS TIGARD OR 97223 Elect'1 Service Phone #: Elect'1 Final Reg #.. . This persit 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 sore than 1:'s days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth ' OAR 952- 001-0010 through OAR 952 -001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503 )246- / / Permittee Signature: By: - 9 ' / Issued P Y OWNER INSTALLATION a LY The installation is being made on property I ,/wn which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: jilillar■ DATE: lo �`1 95? CO Q '•CTa4 NSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Recd Date to P.E. Phone (503) 639 -4171, x304 Print or Type Date to DST Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # EG C°9S -0 a `/ 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) C1 g iS `/u i2 Y) C (-1 Service included: Items Cost Sum Address 124; i S SW PATH i N c 6 2 C . 1 . 4a. Residential - per unit P 1 R ( 0 / ( 222 1000 sq. ft. or less $110.00 4 City/State/Zip G Each additional 500 sq. ft. or portion thereof $25.00 1 Commercial ❑ Residential El Li mited Energy $25.00 Each Manuf'd 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 Installation, alteration, or relocation 200 amps or less . $60.00 2 Address 201 amps to 400 amps $80.00 2 City State Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Exp.Date OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 - Signature of Supr. Elec'n 201 amps to 400 am $75.00 2 - 401 amps to 600 amps $100.00 2 - Over 600 amps to 1000 volts, License No. Ex. - i4.1.4 M '1 .. ‘ ' :A. see "b" above. Phone No. " ' ' t• - f:,s 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 CiU/ /S Ui 1G/d feeder fee. Address tQ /5 SW / 1-- E it/r1F�L G7- • Each branch circuit $5.00 2 "t A -- St ate ©r- Zip 7 7 '7 23 b) The fee for branch as crcuits City � Q P without purchase of Phone No. 503 - 1:2,4_19 -Sa 5/, service or feeder fee. First branch circuit ) $35.00 2 The installation is being made on property I own which is Each additional branch circuit $5.00 2 intended for sale, lease or rent. r 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 sec on (if quired): * 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. 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 fees $ - 5% Surcharge (.05 X total fees) $ NOTICE • Subtotal $ / r -7 5b. Enter 25% of line 5a for 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 3 TIME AFTER WORK IS COMMENCED. ❑ Trust Account # -� 7 Total balance Due $ I:\DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST -,24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested Z Z AM PM BLD Location / 265 t , /5 3') ir✓D &sL ct Suite MEC Contact Person C !'i S yci_1(.11 G Ph PLM Contractor Ph SWR G� BUILDING Tenant/Owner a 92 - C Retaining Wall ELR Footing Access: Foundation , /1 / Nut D _ 6 S e, p p FPS Ftg Drain �t/ / SGN • Crawl Drain Inspection Notes: /A-e,� Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation i • Drywall Nailing �_< <_,�_ I) Firewall / Fire Sprinkler 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 ART IL LECT L Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART jF L SITE Backfill /Grading Sanitary Sewer Storm Drain [ J Reinspection fee of $ required before next inspection. Pa at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: nable to inspect - no access ADA Approach/Sidewalk Other Date /. 9, Inspector J .J Ext Final PASS PART FAIL D • NOT REMOVE this inspection record from the job site.