Permit CITY O F T I GA R D ELECTRICAL PERMIT
P ERMIT #: ELC1999 -00498
;�y DEVELOPMENT SERVICES DATE ISSUED: 8/12/99
- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 AD -03300
SITE ADDRESS: 08975 SW PINEBROOK CT
SUBDIVISION: PINEBROOK TERRACE ZONING: R -4.5
BLOCK: LOT : 030 JURISDICTION: TIG
Project Description: Service or feeder to 200 amps and 3 branch circuits
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: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FOR: 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:
HAGELBERGER, VERNON E OREGON ELECTRIC CONST /GROUP
SHERON L 1010 SE 11TH AVE
659 SW VIEW CREST DR - PORTLAND, OR 97214
DUNDEE, OR 97115
Phone: Phone: 234 -9900
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections •
Type By Date Amount Receipt Elect'I Service
PRMT BON 8/12/99 $80.30 99- 317611 Elect'I Final
5PCT BON 8/12/99 $5.63 99- 317611
Total $85.93
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 This will expire 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.
Permit Signature: Ste- (ess Issued By: 6
/ GZ(,•�V�OW
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: ®?� (lC44«y, DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
.CITgr.ol= TIf;ARD Electrical Permit Application Rya Check 19,_ i
13125 SW HALL BLVD. Date Recd `b 'l2 -D (�1
TIGARD OR 97223 Dab to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit ofie t) - 004
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
P
1. Job.Address:
4. Complete e Fee Schedule Below: .
Number of Inspections per permit allowed
Name of Development
Name (or name of business) Hag1 1 hprg r Service included: Items Cost Sum y
Address i&975 cW p i nehrnnk f nu r f- 4a. Residential -per unl
• 1000 sq. It. or less • $ 117.75 4
City/State/Tp T i g rA Each additiona 500 sq. R or .
portion thereof $ 26.25 1
Commercial ❑ Residential ® Umned Energy t eo.00
Each Manufd Home or Modular
2a. Contractor installation only: - D wean g mice or Feeder $ 72.75 2
' (Prior to permit issuance, applicants must provide cmn'.reeto; license . , 4b. Services or Feeders -
information for COT data base). Installation, alteration. or relocation
Electrical'Contrador Oregon Electric Group . 200 amps ot less - 1 $ 64.25 64.25 2
1 01 0 SE 11th 1 th Ave 201 amp` to 400 amp` 85.50 2
Address 401 amps to 600 amps 5 128.50 2
City P n r 1•• 1 anti State op Zip 97214 601 amps to 1000. amps S 192.50 2
Phone No. 214-99 nn Over 1000 amps or volts $ 363.75 2
Job No. R 1 9 S 1 Reconnect only 3 as.so 2
Elea Cont Lice. No. 76- da 5C Exp.Date • . 4e:. Temporary Services or Feeders -
OR State CCB Reg. No. 203 Exp.Date Installation. alteration. or relocation 2
COT Business Tax or Metro NOExp.Date 200 amps or less S 53.50 201 amps to 400 amps s 80.25 2
//�' /}� 401 amps to 600 $ 107.00 2
•
Signature of Supr. Elec.'n �5��" ° Over 600 amps to 1000 volts.
see "b" above.
License No. 2841 S , -- Exp.Date
4d. Branch Circuits
Phone No. 714-49111) New, atteration.or extension per panel •
a) The tee for branch dnuits -
2b. For owner installations: with p urchase of ierice or
feeder fee.
Each branch draril 3 $ 535 16.05 2
Print Owner's Name b) The fee for branch circuits •
Address without purchase of service
City State Zip or feeder fee. • Phone No. First branch drwit • $ 37.50
. Each additional branch drw8 ^ -- $ 5.35
The Installation is being made on property I own which is not 4e. tieiscelhursous
intended for sale, lease or rent. • (Service or feeder not Included) .
Each pimp or &teJen circle • _ $ - 42.76
. E at+ sign o o utline lighting $ 42.75 •
Owner's Signature _ " _ -._ •--- - -- - - - - -- Signal mss) or a limited ener9y --
panel, situation or extension - -- -$ - - 60.00 - -- - - --
3. Plan •Review section (if required): • - Minor Labels (10) $ 107.00
• Please check appropriate item and enter fee In section 5B. 4f. Each additional Inspection over
4 or more residential units in one structure the allowable In any of the above
Per inspedlah 5 50.00 --
Service and feeder 225 amps or mcce • per hour _ s 50.00
System over 600 volts nominal . In Plant s woo
Classified area or structure containing special occupancy as Fees:
described in N.E.C. Chapter 5 5 . $ 80.30
fig. Enter total of above fees • i 5. 6 3
!' Submit 2 sob of plans with application where any of the above apply. 5% Surcharge (. X total fees)
Not required for temporary construction services. Subtotal 5 8 5. 9 3 .
60. Enter 2596 of line Sa for S
t4OTICE Plan Review d required (Sec. 3)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal 5
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account 8 . $ 8 ®
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due
g000 (MOLL d0 JLLIO 098T 962 COS YVd 6T OT I)H.L 86 /LT /90
8/23/99 Activities for Case #: ELC1999 -00498
1:15:32 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 8/12/99 BON DONE No Hold BON 8/12/99
ELCA003 Permit created 8/12/99 BON DONE No Hold BON 8/12/99
ELCA730 Elect, Service 8/12/99 8/12/99 No Hold BON 8/12/99
ELCA799 Elect'l Final 8/12/99 8/12/99 8/13/99 BRP PASS No Hold AKJ 8/15/99
ELCA500 (F) Issue permit 8/12/99 BON DONE No Hold BON 8/12/99 According to Albert's message
okay to issue without double
fees.
ELCA800 Case finaled 8/15/99 AKJ DONE No Hold AKJ 8/15/99
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
Date Requested I,, ,4 �- ! ( AM �C PM BLD
p�Q
Location D -! ?S P V L9JOiennk L. Suite MEC
Contact Person 6. G U Ph S3S-267 PLM
Contractor Ph SWR Q I � Q
BUILDING Tenant/Owner ELC 1 / q � 7 ' ' ( l rg
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 / M
Drywall Nailing / I w 0 v (J lei Y 1'Y1 I / Cho ii/ Jj e
Firewall
Fire Sprinkler vI'
h c o o '—
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
PASS PART FAIL
ry
CTRIL
Rough In
UG /Slab
Low Voltage
Fire Alarm
, i;78
ASS PART FAIL
�ITt
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 �.. / 3 — 9
Other Date ! ` Inspector di Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.