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Permit CITY OF TIGARD ft / DEVELOPMENT SERVICES ELECTRICAL PERMIT PERMIT #: ELC96 -0629 l J.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/07/96 PARCEL: IS136AD- 02900 SITE ADDRESS...: 06909 SW PINE ST SUBDIVISION • VILLA RIDGE ZONING:R -4.5 BLOCK • LOT °6 Project Description: Rewiring - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS 1 0 — 200 amp 0 PUMP /IRRIGATION • 0 EACH ADD'L 500SF...: 1 201 — 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.: 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 DCC.: Owner: FEES KEVIN BLECHMAN type amount by date recpt 6909 SW PINE ST PRMT $ 135.00 JDA 10/04/96 96- 284796 5PCT $ 6.75 JDA 10/04/96 96- 284796 TIGARD OR 97223 Phone #: Contractor: OWNER $ 141.75 TOTAL REQUIRED INSPECTIONS Ceiling Cover Elect'l Service Phone #: SEE ABOVE Wall Cover Elect'l Final Reg #..: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Signature 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. Issued By 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 for inspection — 639 -4175 • - 1 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Tigard, OR a 97223 Permit # �=L cq (- 00 - 41,00, Date Issued 1 b I y ( q4& 1 � Phone (503) 639 -4171 FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Address 6 9 09 S u,1 P, / V.Q. Service included: Items Cost(ea) Sum City /State /Zip - PG FWD Oa- S 7 Z Z L 4a. Residential - per unit 1000 sq. ft. or less 1 $110.00 I I 0 4 Name (or name of business) Each additional 500 sq. ft. or • Z �} portion thereof $25.00 1 Commercial 111 Residential ISI Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Installation, alteration, or relocation 2 Electrical Contractor 200 amps or less $60.00 Address 201 amps to 400 amps $80.00 2 City State Zip 401 amps to 600 amps $120.00 2 601 amps to 1000 amps $180.00 2 Phone No. Over 1000 amps or volts $340.00 2 Job NO. Reconnect only $50.00 2 contractor's license NO. 4c. Temporary Services or Feeders Contractor's Board Reg. No. Installation, alteration, or relocation 2 Signature of Supr. Elec'n 200 amps or less 2 License No. Phone No. 201 amps to 400 am $50.00 2 401 amps to 600 amps $75.00 Over 600 amps to 1000 volts $100.00 . 2b. For owner installations: see "b" above. /� '/_ ^ a �� 4d. Branch Circuits Print Owner's Name KgV l n gcr.cie AAA New, alteration or extension per pane Address 690/ S,.J lei nPv a) The fee for branch circuits with 2 purchase of service or feeder fee. City T( f� -p State (p2 Zip 97 Z 23 Each branch circuit $5.00 Phone No. b) The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 not intended for sale, lease or rent. First branch circuit $ $5 . 00 Each additional branch circuit $5.00 Owner's Signature �i�o� 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review s (on (if required): Each pump or irrigation circle $40.00 2 e Each sign or outline lighting $40.00 - Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00 4 or more residential units in one structure Minor Labels (10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per inspection $35.00 Per hour $55.00 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: ����„„ 5a. Enter total of above fees $ �Ll "R-1 ►T I NOTICE 5% Surcharge (.OS X total fees) * / J ?Ai PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal ' $ / AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b . Enter v i of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. woracomdevldeo- ❑ Trust Account # $ prm.app Balance Due • ••• / ' ) . 7 5 —C■e-42—et.‹..,_.■eLV CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. Plbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: 5 — I Date: /2/3 J9 A. . P.M. Entry: Address: c0 9 0 9 r— -- rt Q. S* Tenant: Ste: MST: `� BUP: Con /ev : K,e.4J z r /Z EtJ MEC: (9 7 7 — 30 ©' T3 ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: g' - 7 U - -2 -1 (r2 6 Go) _.Z..47..-v ( C c---ear --ce, c— art: _ _ • f ,, i - • ! S e1c70 / t v1 c -e G g /'cP ¢ `.'Q . • 1..2 s ector: 4 Dat A PPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO V