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Permit „ ____,_ CITY O TIGARD ELECTRICL r PERMIT ( A DEVELOPMENT SERVICES PERMIT #: ELC98 -061 .i i 13125SW Hall Blvd ., Tigard, OR97223(503)639.4171 DATE ISSUED: 10/16/98 PARCEL: 2S102CB -00500 SITE ADDRESS...:10250 SW SCHOOL ST SUBDIVISION °NORTH TIGARDVILLE ADDITION ZONING:R -4.5 BLOCK LOT •034 JURISDICTION: TIG Pro-j ect Description : SF electrical addition - -- 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 • 1 W /SERVICE OR FEEDER: 1 PER INSPECTION : 0 201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 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 RITA PHILLIPS type amount by date recpt 10250 SW SCHOOL ST PRMT $ 60.00 B 10/08/98 98- 309817 TIGARD OR 97223 SPCT $ 3.00 B 10/08/98 98- 309817 PRMT $ 5.00 JSD 10/16/98 98- 310058 Phone #: 5PCT $ 0.25 JSD 10/16/98 98- 310058 Contractor: APOLLO ELECTRIC $ 68.25 TOTAL 1102 SW STEPHENSON REG!U I RED INSPECTIONS PORTLAND OR 97219 Rough -in Elect'1 Final Phone #: 244 -4410 Elect'1 Service Reg #..: 001022 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 t e rules adopted by the Oregon Utility Notification Center. Those rules - • set forth in OAR 952- 001-0010 through OAR 952 ".” ' You ma - -' of these rules or direct questions to OUNC by (503 -1987. '. , � T_ Permittee Signature: / �. ,� 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 : DATE: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 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 I0 -6 -1 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print or Type Permit # Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 10 - 1 1. Job Address: /0250 5W SChae)) St 4. Complete Fee Schedule Below: Name of Development f,, / Number of Inspections per permit allowed Name (or name of business) / // k f 2 / / /�p� Service included: Items Cost Sum I Address /6266 SLt) 509 66 1 SF 4a. Residential - per unit 773,C118) ^ „ or less $110.00 4 City /StCity/State/Zip ( //'G' E ach additional additit ional 500 sq. ft. or portion thereof $25.00 1 Commercial ❑ Residential Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of rrent icons 4b. Services or Feeders Electrical Contractor -rr... lb Ng ' / 1C Installation, alteration, or relocation � 200 amps or less $60.00 Cam 2 Address //OZ, SGu 5 'ice .-.,in '5611 201 amps to 400 amps $80.00 - City �� State Zip y/ 401 amps to 600 amps $120.00 2 - Phone No. Zyy y6/ft7 601 amps to 1000 amps $180.00 2 Job No. !G /R' C, Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. y Exp.Date lb Reconnect only $50.00 2 OR State CCB Reg. No. bZZq i 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 Sur. Elec'�� ' 201 amps to 400 amps $75.00 2 - g p n 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, � /2 License No. ., Exp.Date /b - 0/ see "b" above. Phone No. Z J- e/e // 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 feeder fee. Address Each branch circuit $5.00 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (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 required):* 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. 5. Fees: g5.co Not required for temporary construction services. 5a. Enter total of above fees $ CO 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 # (--1,-.66 Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / g _ BUP 0 Date Requested 19- 2P AM A. PM BLD Location /025D ( Sk.) ' � / Suite!/ // MEC Contact Person / \ C C/ Ph oP- ` '' / V/0 PLM Contractor .�,!`�� : �/ Ph gel "'07. SWR ie, BUILDING Tenan Owner ��i� -i-e_ ELC • / % a Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes Slab Post &Beam C JL� 611M-6 SIT Int Sheath /Shear .r4 Int Sheath /Shear Framing Drywall Nailing Insulation Pa Drywal L �/ /jllcr - eQiL_, 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 1 PART FAIL LECTRICAL Service Rough In UG /Slab Low Voltage F' _ - rm QV PART FAIL S 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 D ate Other /U �y /ff Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.