Permit CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2000 -00335
�l DEVELOPMENT SERVICES DATE ISSUED: 06/16/2000
I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 AD -10000
SITE ADDRESS: 08710 SW REILING ST
SUBDIVISION: SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK: LOT : 059 JURISDICTION: TIG
Project Description: Install 2 branch circuits in single family 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: 1 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:
WILLIAMSON, LARRY C AND ECONO ELECTRIC
SANDRA L 5420 N MICHIGAN AVE
8710 SW REILING PORTLAND, OR 97217
TIGARD,. OR 97224
Phone: Phone: 735 -4705
Reg #: LIC 00067212
ELE 34 -195C
SUP 2146S
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT KJP 06/16/200C $42.85 0003057 Elect'I Final
5PCT KJP 06/16/200C $3.43 0003057
Total $46.28 ORGNP\
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 ordirect questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE W ISSUED BY: i .
f /0°17
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: C30-7-t.J DATE: G
LICENSE NO: , p7
/c/ s
Call 639 -4175 by 7:00pm for an inspection the next business day
...1 1 r yr I ILarr,IMv Electrical Permit Application Plan Check #
43125 SW HALL BLVD. Rec'd By
•
TIGARD OR 97223 Date Rec'd
Phone (503) 639 -4171, x304 Date to P.E.
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # E' - 'aasif 60335 -
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
•
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ( �I f / / / C t
p vr) S'p Number of inspections per permit allowed
Name (or name of business) ALL I t,7 Arc HAN1lii -tom Service included: Items Cost Sum 4
t� f
Address 10 C j ().) i2E 1 1,l NC7 _ 4a. Residential - per unit
Cit '147 44t V 1 ('J Y - C -7 2 Z -( 1000 sq. 11. or less $ 117.75 4
Each additional 500 sq. ft. or
c�'� portion thereof $ 26.75 1
Commercial Residential IaJ • Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 •
(Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders
Information for COT data se). Installation, alteration, or relocation
Electrical Contractor Co N No . CT ('acv . 200 amps or less $ 64.25 2
Addre s 5L/ 2c ,V, Nj , c c..,. , c , e l. N V G 201 amps to 400 amps $ 85.50 2
City �nir State yZ _Zip of '7 '� 401 amps to 600 amps $ 128.50 2
Phon No. - '7 �� - 4 - 7c , C 801 amps to 1000 amps $ 192.50 2
Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
____
Elec. Cont. Lice. No. -- r 4 ),5 - C. Exp.Date 0 / 4c. Temporary Services or Feeders
OR State CCB Reg. No. tl'7 Si 2 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. _ Exp.Date - 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n �,r,�,,,r,�� 401 amps to 600 amps $ 100.00 2
/ Over 600 amps to 1000 volts,
•
License No. Z IL/ Co S Exp.Date /0 / /! / b / see "b" above.
Phone No. '7'5' L/ '71,(i- 4d. Branch Circuits
-
New, alteration or extension per panel
a) The fee 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 ( $ 37.50 /
Each additional branch circuit i $ 5.35 I
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuits) or a limited energy
panel, 3. Plan Review section (if required):* Minor Labels (1 0 ) n or extension $ 100.00
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
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
descnbed in N.E.C. Chapter 5 5. Fees: 4217*-re g5-
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 8 % Surcharge X (.08 X total fees) g
Not required for temporary construction services. Subtotal $
NOTICE 5b. Enter 25% of line 5a for
Plan Review If required (Sec. 3) $ •
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ (0 "2'S
IS NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account* g AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ Lf (O Z i
•
i : \dsts \forms \electric.doc
CITY.OF-TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
7 BUP
�
Date Requested / cc AM PM BLD
c ,
Location Suite MEC
te
Contact Person Ph r n �T -6�( )PLM
Contractor Ph (0 2l) 9 7 ! , S(t1)sWR
BUILDING Tenant/Owner ELC Dt — eiv)di
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: r
Slab SIT
Post & Beam n n ,o _
Ext Sheath /Shear l o � / . V' �!
Ina Sheath /Shear �� k ✓vim /
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ^ /
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 FAIL
:earn : =ea / ' 2LJVYt
Rouugh In
Gas Line
Smoke Dampers 1
Fib -
` g. FAIL
ECTRICA
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
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
Other Date 74S � Inspector /L•tc� r� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.