Permit f CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES
PERMIT S: D 6
DATE ISSUED: : 1 11 1/16/9/9
8
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1O3DA -04500
SITE ADDRESS...:1O6O0 SW PARK ST
SUBDIVISION -FANTASY HILL ZONING:R -3.5
BLOCK LOT °002 JURISDICTION: TIG
Project Description : Add first branch circuit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp 0 PUMP /IRRIGATION 0
EACH ADD'L 5O0SF...: 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
TERRY WEESE type amount by date recpt
10600 SW PARK STREET PRMT $ 35.00 GEO 11/16/98 98- 310819
TIGARD OR 97223 5PCT $ 1.75 GEO 11/16/98 98- 310819
Phone #:
Contractor:
JACOBS HEATING AND A/C $ 36.75 TOTAL
1421 SE HOLGATE
REQUIRED INSPECTIONS
PORTLAND OR 97202 Elect'1 Service
Phone #: 234 -7331 Elect'1 Final
Reg #..: 1441
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 law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- w41 -0010 through OAR 952 - 'i' 1 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5031246 -1987.
Permittee Signature: Issued By: e giadfia-------
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 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
07/31/98 FRI 14:14 FAX 503 598 1960 CITY OF TIGARD gi 002
i
CITY OF TIGARD RECEIVEElectrical Permit Application Plan Check ft
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 NOV 131998 Date Rec'd
• Phone (503) 639 -4171, x304
Date to P.E.
Inspection (503) 639- 417gOf "MUNITY DEVELOPMENT Print or Type Date to DST
Fax (503) 684 Incomplete or illegible will not be accept Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development - K , . I Number of Inspections per permit allowed '
Name (or name of business) 1r r� w2P.SQ. Service Included: Items Cost Sum
Address I Gp • c_ l.) PG( _ 4a. Residential - per unit ; i
Cify /StatelZi • _ _. � • r 1000 sq. ft. or less $110.00 4 1
Each additional 500 sq. It. or
Commercial ❑ Residential portion thereof $25.00 1
Limited Energy $25.00 i
Each Manufd Home or Modular
(Melling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current lice ties 4b. Services or Feeders
Electrical Contractor !1� Installation, alteration, or relocation
Address es - 14l 5l~ �1 i l .L� ;,v) 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City . -P -k-tC9 State 02 Zip cj* 401 amps to 600 amps $120.00 2
Phone No. : .-1,351 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts _ $340.00 2
Elec. Cont. Lice. No.2 . .-ii► .. -. Exp.Oate JY// ' i / Reconnect only $50.00 2
OR State CCB Reg. N'4 . l .Da ti ' .OD - 1 4e. Temporary Services or Feeders
COT Business Tax or ' . No. - LD , ..Date I • ' Installation, alteration, or relocation
200 amps or less $50.00 2
' `�� 201 amps to 400 amps $75.00
Signature of Supr. El = : >♦= � 2
�� _ ���- � - 401 amps to 600 amps $100.00 2
License No 1 aoZ L Exp.Datej0 "/" ` Q O s er ee "b "b a " abbos ove .1000 volts,
s.
Phone Nr
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.
Address Each branch circuit $5.00 2
City State Zip b) The too for branch circuits
Phone No. service service feeder fee.
First branch circuit $35.00 • C)O 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous •
(Service or feeder not included)
Owners 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.
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) $ �v..
NOTIE Subtotal $
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
�• TIME AFTER WORK IS COMMENCED. ❑ Trust Account ft (3b.-15
Total balance Due
IADSTSIELCBO.APP Rev 11188
81-1051
7/25/99 Activities for Case #: ELC98 -00687
6:24:08 PM
• Assigned • Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 11/13/98 GEO MAIL GEO 11/16/98
ELCA003 Permit created 11/16/98 GEO DONE GEO 11/16/98 •
ELCA730 Elect'I Service 12/4/98 TLP PASS TLP 12/7/98 •
ELCA799 Elect'I Final 12/4/98 TLP PASS TLP 12/7/98
ELCA500 (F) Issue permit 11/16/98 GEO PASS GEO 11/16/98
ELCA800 Case finaled 12/4/98 TLP PASS - J*H . 12/7/98
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST ■
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 410 .. 3 /537 Date Requested /2 AM
BLD wig-
Location /0600 ,c14/ PA K Si Suite 41 "— - = =_? '575
Contact Person Met,,J1E Ph PLM A 0 O3
Contractor 0A H7 Ph SWR / F
BUILDING Tenant/Owner 7 &1A- (,C✓_(� r�- 4--e_d ELC qI %4 — 7
Retaining Wall U ELR
Footing Access:
Foundation /`� 4� / AS R5 c J� / �"� FPS
Ftg Drain (� J / !�C/ SGN
Crawl Drain Inspection Notes: /
Slab , �j /J SIT
Post ost & Beam (�
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm `
Susp'd Ceil g
Roof
Misc:
Final -- ------, y
SASS-- -R,AI� FAIL �_
/ PLUMBING i
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
• brains
Fi 1 .
�� - = FAIL
-_► CAL
Post & Beam jam'
Ro / / 1 v �J
n�,
Smoke Dampers i �I
‹Final
FAIL
CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Final
1 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 M Otheoach /Sidewalk Date 1 � — y` — Inspector
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.