Permit CITY OF TIGARD
ELECTRICAL PERMIT
% ��i DEVELOPMEN SERVI PERMIIS*: ELC9B- 007008
PARCEL: 15135CD -01300
SITE ADDRESS. ..: q Q
SUBDIVISION •GREENBU � F `` e76-' BLOCK LOT •005 JURISDICTION: TIG
Project Description : Install a 200 AMP service for a single family dwelling.
- -- 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 • 1 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp • 0 1st W/O 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
J.BRADLEY PIHAS type amount by date recpt
18025 SW SARAH HILL LANE PRMT $ 60.00 GEO 02/13/98 98- 303268
LAKE OSWEGO OR 97035 5PCT $ 3.00 GEO 02/13/98 98- 303268
Phone #:
Contractor:
ADAMS ELECTRIC CO INC $ 63.00 TOTAL
2340 SE CLATSOP
REQUIRED INSPECTIONS
PORTLAND OR 97202 Underground Cove Elect'1 Final
Phone #: 234 -9651 Elect'1 Service
Reg #.. 000005
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- 001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling ( )246 -1987.
Permittee Si /�/ /
Signature: Issued B : 4
9 Y
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 : �'� c - DATE: A
LICENSE NO: & G --5
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
rd
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
Date Rec'd
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # L'. Is- -00 .76
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) BRA b • I Service included: Items Cost Sum
Address / / 70 5 5, ta, ?crr1/2 4a. Residential - per unit
City /State /Zip rJ ' Each additional it or less 5 s $110.00 4
TI � If �� � �- 7� 2 3 Each additional 500 sq. ft. or
/
portion thereof $25.00 1
Commercial ❑ Residential
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 19 /171 �G7ie /c_, Installation, alteration, or relocation
Addre 39D S. . ( L. #7 TS I� to 5 7 201 amps to 400 amps $80.00 2
", 200 amps or less / $60.00 � - �� 2
i'
City , i_'TL. JM/b State OR , Zip q'7.. 0.2. 401 amps to 600 amps $120.00 2
Phone No. ,, ..3q -- __/ S/ 601 amps to 1000 amps $180.00 2
Job No. 3 OS /7�
Over 1000 amps or volts $340.00 2
� Reconnect only $50.00 2
Elec. Cont. Lice. No. �?L - 5 Exp.Date l0 -/-- �/
OR State CCB Reg. No. .S"9‘> Exp.Date o? -1 7- r � / .. 4c. Temporary Services or Feeders
COT Business Tax or Metro No. /0 74n Exp.Date 7-1 -9, r Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00
Signature of Supr. Elec - 401 amps to 600 amps $100.00 2
p /0 - / -- 9, ----
0-/ �/ Over 600 amps to 1000 volts,
License No. ,..?1 5'6 -:S Exp.Date jf see "b" above.
Phone No._ ..,3V-/-, rS /
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
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 circ $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.
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: s , tr"V
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE 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 # -
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
RECEIVED
FEB 0 1998
COMMUNITY DLVELOPU..:::r.,
( I 3 i •
0° CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested:
/ A.M. P.M. MST:
Location: 1 170 S ad C8 f'n Q,I J ,e, U r 7 q Q/ P/ >IRs cT BUP:
Tenant: Suite: Bldg: �� o/ 10 MEC: ,
Contractor: C �,�P� Phone: / Q � 3 `T / �/ PLM: p p� -7r71
Owner Phone: ELC: '7O -00 / 0
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL �LEC CAI) SITE
Site Post/Beam Post/Beam Post/Beam Cove Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceilin: Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approv Approved
Appr /Sdwlk Not Approved Not Approved Not Approved a.:. „. ed Not Approved
FINAL FINAL FINAL °' :T FINAL
l_
_ v
n c5),
CI Call for reinspection O lion fee of $ z required before next inspection O Unable to inspect
Inspector: Date: 0 4 ? aage of
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�f BUP
Date Requested 9/3 /J�7r AM PM BLD
l
Location q 99/ Sul /9/ e C4 Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC - 470070
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation Q Ve/79?
Drywall Nailing //✓i¢ �� /� !J �/n "
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
410
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
((LECTRICAL ,)
k 'Sefiri
Rough In
UG /Slab
Low Voltage
c ilWarm .�"-
gr 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 D ate ' / ' D //' 9 7 � Inspector Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.