Permit CITY OFTIGARD
,,� ,, � i DEVELOPMENT SERVICES ELECTRICAL PERMIT
" ! . A
SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT #: ELC96 -0706
DATE ISSUED: 11/04/96
PARCEL: 2S111CA -11100
SITE ADDRESS...: 09564 SW SATTLER ST
SUBDIVISION • LAKESIDE PLACE ZONING:R -7 PD
BLOCK • LOT •2
Project Description: addint 2 branch circuits
- -- 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-- -
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
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
WINTERBLOOM type amount by date recpt
9564 SW SATTLER ST PRMT $ 40.00 TAT 11/04/96 96- 286064
5PCT $ 2.00 TAT 11/04/96 96- 286064
TIGARD OR 97223
Phone #:
Contractor:
TUALATIN ELECTRIC $ 42.00 TOTAL
PO BOX 655
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 Ceiling Cover Elect'1 Service
Phone #: 503 - 682 -2955 Wall Cover Elect'1 Final
Reg #..: 65650
This permit is issued subject to the regulations contained in the J
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t Signature
applicable laws. All work will be done in accordance with
/2
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more 4 t l i_, I�!a[/ i
than 180 days. I s s ed 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: DATE:
LICENSE NO:
Call for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
', 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # E LLq, -b7 40(e)
/��,i� �. Date Issued / 1/1/ 9k
,.� � ( Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ` Number of Inspections per permit allowed
1. L
Address - / f,A > � V c \ Q ` $r,1 Service included: Items Cost(ea) Sum
City /State /Zip - TIC( p -c) lam, q 4a. Residential - per unit
I i 1000 sq. ft. or less $110.00 4
Name (or name of business) 1 1.10 At 1(hI (s(1 n Each additional 500 sq. ft. or $25.00
portion thereof
Commercial ❑ Residential? Limited Energy $25.00 1
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
.....- Installation, alteration, or relocation
Electrical Contractor I t) Kk v"\ e � toc C . 200 amps or less $60.00 2
Address ? l' - P \li_. ( O., 201 amps to 400 amps $80.00 2 •
City , - ) t�S(�Y \) 1` `P S tate / o ZI '-] b 401 amps to 600 amps $120.00 2
`1 �/v l J ` p / Q 601 amps to 1000 amps $180.00 2
Phone No. (09 X55 Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $50.00 2
contractors licens 0. ... ♦ . •r 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 6. ♦ - '' Installation, alteration, or relocation
Signature of Supr. Elec'n `-' 200 amps or less 2
-
License No. . 2..._� Phone No. %s ,,P - "' S 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00 -
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
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
not intended for sale, lease or rent. First branch circuit I $ ';:j --- Each additional branch circuit _r $5.00 -s
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 Minor 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 Per 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:
5a. Enter total of above fees $
NOTICE 5% Surcharge (.05 X total fees) $
- g ---'
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ Lp -
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 if required (Sec.3) $
/
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wurd1wmderneleo- ❑ Trust Account #
pr ,.wp
Balance Due $ 1.4°,
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain app /Service FINAL:
Foundation Water Line -ding - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - ;ITTAJ
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: /ft Z ( l c A.M. P.M. Entry:
Address: ___-../ .' , :P��
Tenant: Ste: MST:
BUP:
Con /Own MEC:
PLM:
ELC:
THE F&. - -= CORK TIONSA R EQUIRED: LR:
% _ %, / : 6
uvire
-- ! 3 - w - —6 2 7 `c ±
8'L
'/ 7 ” — /2% 7
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�< i" I C ree( 4-1 /
e ._ ...) e, ) -e tr cy/ .
Inspector: r r e - c0 - C / lL.( l'lcf Date: // -2 4"/G j
X APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Co
Location 9S `7 c9,o -7 'ei � 74 Suite MEC
Contact Person Ph PLM
Contractor it14/4 -�j a J Ph (on - 2t S( SWR
BUILDING Tenant/Owner ELC — 070
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 7r.
Drywall Nailing �.0 o.L,
Firewall
Fire Sprinkler 6'Z1_972-PJ1 _• tAi e E is
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
P FAIL
ELECTRICAL
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk k — /j t
9t9 InS ecor Ext
62 E x
Other D Inspector
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.