Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00278
liA DEVELOPMENT SERVICES DATE ISSUED: 5/30/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111AD -05400
SITE ADDRESS: 08770 SW PINEBROOK ST
SUBDIVISION: PINEBROOK TERRACE ZONING: R -4.5
BLOCK: LOT : 077 JURISDICTION: TIG
Project Description: Install one branch circuit in SF dwelling
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
• 601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BRIAN STRAHAN WEST SIDE ELECTRIC CO INC
8770 SW PINEBROOK ST 1834 SE 8TH AVE •
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
231 -1548 ORIGINAL
Reg #: LIC 13306
SUP 1556s
ELE 26 -135c
•
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT SS 5/30/00 $37.50 0002511 Elect'l Final
- 5PCT SS 5/30/00 $3.00 0002511
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ck k le 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: (g►u a p c o.+' 1& DATE:
LICENSE NO: /.675
S
Call 639 -4175 by 7:00pm for an inspection the next business day
05 -26 - 00 .11:09AM FROM WEST SIDE ELECTRIC P02
RECEIVED
CITY OF TIGARD Electrical Permit Application Reid Check #
13126 SW HALL BLVD. MAY 2 6 2000 bate Rec'd Ms? zt,, ,o0 0
TIGARD OR 97223. Date to P.E.
Phone (503) 839-4111,. x304 COMMUNITY DEVELOPMENT Date to DST
Inspection (503) 839 -4175 Print of Type Permit 5 SIC 70e0 -00 2.7P
• Fax (503) 598 -1980 Incomplete or Illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:'
Name of Development Number of Ins ctions per perm all owed
Name (or name of business) • Service Included: Items Cost Sum
Address 1' t'1 () � fn, e_ S4" 4a. Residential - per unit
� .. "M d n^ , r _ 1000 a or less S 117.76 4
City/State/Zip . 1 ( rs -1 .,,toff -t Each addit ddlllonal 600 eq. R. or portion thereof $ 28.25 1
Commercial CI Residential a. United Energy $ moo
Each Manufd Home or Modular
2e. Contractor Installation only: Dwelling Service or Feeder S 72.76 2
(Prior to permit Issuance, applicants must provide contractor license db. Services or Feeders
Information for COT data base). � 1 � Installation, alteration, or relocation
Electrical Contractor i e-.
/ e" 54' `/r/ L 200 amps or less $ 64.25 2
Addre c/L L-<' 201 amps to 400 amps 5 85.50 2
401 amps to 600 amps S 128,50 2
City r Gr► / State Zip �l��. y / 801 amps to 1000 amps $ 1 92.60 2
Ph No. 23/ - / S z �� Over 1000 amps or volts $ 363.75 2
Job No. -- r t) VI ti/) Reconnect only $ 63.60 2
Elec. Cont. Lice. No. ,7[ / ��6
, Exp.Date /0 / /(20 4c. Temporary Services or Feeders
OR State CCB Reg. No. 1330 Exp,Date Si, WO' Instailetion, alteration, or relocation
s or less 5 63.60 2
COT Business Tax or Metro No. .2 7 Exp.Date ///0/ / 200 amps
201 amps to 400 amps $ 80.25 2
• Signature of Supr. Eleen 401 amps to 600 amps • $ 107.00 2
9 Over 800 amps to 1000 volts,
/ �S Exp.Date /U // /0 / see "b" above.
License No. p - dd. Branch Circuits
Phone N0. 3/- s Y.)? New, alteration or extension per panel
a) The tee for branch circuits
2b. For owner Installations: with purchase of service or
feeder fee,
Print Owners Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit i $ 37.50 7 ,
Each additional branch circuit $ 6.36
The Installation is being made on property I own which is not 40, Miscellaneous
intended for sale, lease or rent. (Service or feeder not Included)
Each pump or Irrigation circle S 42.75
Owner's Signature Each sign or outline lighting S 42,75
Signal circult(e) or a limited energy
(if required):*
panel, a Labels (10) or extension 5 60.00
3. Plan Review section
( Minor labels (10) $ 107.00
Please check appropriate Item and enter fee In section 8B. 4f. Each additional Inspection over
4 or more residential units In one structure the allowable In any of the above
Service and feeder 225 amps or more Per Inspection - $ 60.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described In N.E.C. Chapter 5 5. Fees-
6e. Enter total of above fees S
* Submit 2 sets of plans with application where arty of the above apply. h4..Surcharge Ulu total tees) (' S S. l
Not required for temporary construction cervices. Subtotal S
• 6p. Enter 25% of line 6a for
NOTICE Plan Review If required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR . � � 3
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 150 DAYS Trust Account 4 j "5,
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due .. (.� $ _W
I: \dsts \forms \e lectric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 6394171
`30 BUP
Date Requested (- 1 0 Q AM iSM BLD
p �
Location I3 0 )Q / ✓lrQJYDD I I � ,, Suite ME S
.0 Yom
Contact Person ? 2 Ph cP S'l— / / / / PL
Contractor Ph SWR
BUILDING Tenant/Owner ELC W00
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 —7
Insulation ' '
Drywall Nailing C.
Firewall
Fire Sprinkler L A E
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam r- � z
Under Slab L,�)
Top Out r� �t I�—
Water Service 1 4-c 6.! l Afs i/ °���
Sanitary Sewer / /"
Rain Drains ` ( D S- e
- S PART FAIL
NfiC
Po & eam
Rough In
Gas Line
Smoke Dampers
•S PART FAIL
eECTRICy1?
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
i 4 11 10
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
A
DA
Approach /Sidewalk
Other Date !/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.