Permit ELECTRICAL PERMIT /
C OF T DATE I ISSUED: 05 /01/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 2S1 14BB -16000
SITE ADDRESS...: 10241 SW PICK'S CT
SUBDIVISION • RIVERVIEW ESTATES ZONING:R -7 PD
BLOCK • LOT •6
Project Description: Installing one branch circuit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 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-- -
O — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp ° 0 1st W/O 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
SKYLIGHT HOME BUILDERS CO type amount by date recpt
P 0 BOX 2315 PRMT $ 35.00 CJS 05/01/96 96- 278815
5PCT $ 1.75 CJS 05/01/96 96- 278815
LAKE OSWEGO OR 97035
Phone #: 636 -2994.
Contractor: - - --
WESTSIDE ELECTRIC $ 36.75 TOTAL
7518 SW MACADAM AVE
REQUIRED INSPECTIONS
PORTLAND OR 97219 Wall Cover Elect'1 Final
Phone #: 503 - 245 -3385 Elect'1 Service
Reg #... 13306
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee 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 ( A4 9li�a�u
t 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: on cippllr�fi n DATE: 5- I - 96
LICENSE NO: //
Call for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
• 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 96- a7S6
3 li
1 ' ; ) I �, ; , Permit # fl C_ 9. 6- n7:7 0
P hone (503) 639 -4171 Date Issued 5- /- 96
FAX (503) 684 -7297 '
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by CA a.1� SGh.v, 1lI-
Inspection (503) 639 -4175
! 1. Job Address: 4. Complete Fee Schedule Below:
Name of Development y / Number of Inspections per permit allowed
Address /02-W , S /CL C7 Service included: Items Cost(ea) Sum
■
City/State/Zip 7 /3a 4a. Residential - per unit 4
�f 1 000 sq. ft. or less $11 0.00
Name (or name of business) . _i/ -, /116 J Each additional 500 sq. ft. or
/ portion thereof $25.00 1
Commercial 0 Residential t 3 (,/ - OOS Limited Energy $25.00 - Each Manufd Home or Modular 2
Dwelling Service or Feeder $88.00
2a. Contractor installation o ly:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor - el i e' / ., 200 amps or less $60.00 2
Address : G/r /74 7 ■/11 jLj ",, 201 amps to 400 amps $80.00 2 - - j
/ 401 amps to 600 amps $120.00 2 -
City . / ( Q/L _ G State �f Zip / 601 amps to 1000 amps $180.00 2 - Phone No. - �{ Over 1000 amps or volts $340.00 2
-
Contractor's License No. Reconned only $50.00
Contractor's Board Reg. No. () 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n __ / 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
License No. 'hone No. fiT 401 amps to soo amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b• above.
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2 2
not intended for sale, lease or rent. First branch circuit 1 $35.00 3 2
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) • 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - 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 M inor 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 P er 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:
NOTICE 5a. Enter total of above fees $ _3J''
5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review 'f required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtot $
COMMENCED. Trust Account # $
/ /
�
Balance Due $ 6
ra0bandwAeloCym.arp
6 /1 /99 • Activities for Case #: ELC96 -00270
2:39:09 PM
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 5/1/96 CJS RECD CJS 5/1/96
ELCA003 Permit created 5/1/96 CJS PEND CJS 5/1/96
ELCA720 Wall Cover 5/1/96 CJS 5/1/96
ELCA730 Elect'I Service 5/1/96 CJS 5/1/96
ELCA799 Elect'I Final 5/1/96 5/4/99 VLN VLN 5/4/99 Request for research to Chuck
D. 5/4/99.
ELCA500 (F) Issue permit 5/1/96 CJS PASS CJS 5/1/96
ELCA799 Elect Final 5/18/99 5/18/99 5/18/99 TLP PASS No Hold AKJ 5/18/99
ELCA800 Case finaled 5/18/99 AKJ DONE No Hold AKJ 5/18/99
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 p C Business Line: 639 -4171
Q n este d 5 r l / o 1 1 BUP
Date Requested AM PM BLD
Location /0, 40 ( Suite MEC q6-0611 �o
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 96-0 O - 7C)
Retaining Wall ELR
Footing Access:
Foundation /000 FPS
Ftg Drain SGN
Crawl Drain Inspection No s:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation J
Drywall Nailing '�. y./ 1 ' L 1.Ii
Firewall ..� /
Fire Sprinkler `� 1L �� !� .�J I I_ ✓L /_
Fire Alarm / r/
Susp'd Ceiling - -A �4a.41 04-1 I�1 1 ° 1 — = 02 !LL
Roof • t / // / i /
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer 5 E C q
Rain Drains Cq
Final
PAS _ FAIL
Po
Pos : :earn
Rough in e'
Gas Line
S Dampers
�'" • �.. - • RT FAIL
e'
Rough In
UG /Slab
Low Voltage '
c
Fire Alarm
t 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: _ Ida. AP ] Unable to inspect - no access
ADA / VIP Otheoach /Sidewalk Date r p / Inspector � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.