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Permit _, A CITY OF T ELECTRICAL PERMIT ���i� ;� DEVELOPMENT SERVICES DAE PERMIT ISSUED: LC�9;OO�99 PARCEL: 2S111AD -11400 SITE ADDRESS...:O884O SW REILING ST SUBDIVISION •SCHECKLA PARK ESTATES ZONING:R -4.5 BLOCK LOT -045 JURISDICTION: TIG Project Description: Add two (2) branch circuits. -- -- RESIDENTIAL UNIT - - - -- - -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS • 1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 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-- - 0 - 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: 1 IN PLANT - 0 6O1 - 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 - JULIA ISLITZER type amount by date recpt 8840 SW REILING AVE PRMT $ 40.00 GEO 01/25/99 99- 312391 TIGARD OR 972240 aPCT $ 2.00 GEO 01/25/99 99- 312391 Phone #: 620 -7647 Contractor: --- - - - -- JULIA ISLITZER $ 42.00 TOTAL 8840 SW REILING REQUIRED INSPECTIONS --- TIGARD OR 97224 Elect'1 Service _ Phone #: Elect'1 Final Reg #.. . This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -vil0 through OAR 952 -001 -1987. You lay obtain a copy : f th rules or direct questions to QUNC by calling (503)246 -1987. Issued B ttee Signature: ...41 1 _ , ,, �� ,. ,1� y: • OWNER INSTALLATION ONLY - The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S 5I GNATURE : DATE: _ /- 9 --- - - - - -- CONTRACT INSTALLATION ONLY --------- ._ - - -_ SIGNATURE OF SUPR. ELEC' N : DATE: LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + +++ + + + + + + + + + + +-1- ++ + ++ ++ Call. 639 --4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + ++ CITY - OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd Date to P.E. Phone (503) 639 -4171, x304 Date to DST Print or Type Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # �R% Do �/ Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: / Name of Development Number of inspections per permit allowed Name (or name of business) �l n `t F . �S ZC r Service included: Items Cost Sum .Address C n AO `F,,,) �' i 1 1 Yl o 4a. Residential - per unit \ 1000 sq. ft. or less $110.00 4 ( City /State/Zip l 1 C�CI r , O �1 a Each additional 500 sq. ft. or Commercial ❑ 1 Residential portion thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor Installation, alteration, or relocation Address 200 amps or less $60.00 2 201 amps to 400 amps $80.00 2 City State Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Exp.Date OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. Exp.Date see "b" above. Phone No. 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name cccc 3\u \i Ts\ . Z.Cr ' feeder fee. �������� o Each branch circuit $5.00 2 Address y�� r' 1 \ b) The fee for branch circuits City 1 ‘c.-4‘c.-4 - State OT . Zip Tir`�r` Ll without purchase of Phone Nd. (-AD 14nc -1 service or feeder fee. - First branch circuit ' $35.00 3r ----- 2 The installation is being made on property I own which is not Each additional branch circuit 7 - $5.00 2 intended for sale, le e or rent. 4e. Miscellaneous r (Service or feeder not included) Owner's Signature ��. � Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if re ed): * Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. S. Fees: 4.10 Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ ,• NOTICE Subtotal $ 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # q02 Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WILLAMETTE ELECTRIC INC PO BOX 230547 TIGARD OR 97281 Electrical Signature Form Permit # • ELC99 - 0049 Date Issued.: 02/08/99 Parcel • 2S111AD -11400 Site Address: 08840 SW REILING ST Subdivision.: SCHECKLA PARK ESTATES Block Lot: 045 Jurisdiction: TIG Zoning R -4.5 Remarks: Add two (2) branch circuits. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received. AN INK SIGNATURE IS REQUIRED ON THIS FORM OWNER: ELECTRICAL CONTRACTOR: JULIA ISLITZER WILLAMETTE ELECTRIC INC 8840 SW REILING AVE PO BOX 230547 TIGARD OR 972240 TIGARD OR 97281 Phone #: 620 -7647 Phone #: 624 -2938 FAX Reg #..: 000750 X A 1 1 Signature of Sup g Electrician If you have any questions, please call 639 -4171, ext. #310 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP /: 'Yid Date Requ sted :::1;7f5 AM PM BLD Location af Suite MEC Contact Person Ph PLM Contractor Ph ga3/ SWR BUILDING Tenant/Owner ELC 99-M0 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 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 PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL CTR C Service Rough In UG /Slab Low Voltage Fire Alarm PART FAIL SITE 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 �. c 4l,J7 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested .4/;- AM PM BLD Location ?slit) Suite MEC Contact Person Ph / a.-- PLM Contractor _ Q/kit Ph SWR /�. BUILDING Tenant/Owner ELC 9 / ,e)o 49 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 Drywall Nailing � � 4 e_ ,�4 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 PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Se ug UG Slab Low Voltage Fire Al- 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 D �Z�� 1 Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.