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Permit CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: ELC96 -0804 DATE ISSUED: 12/19/96 PARCEL: 25112AD -00900 SITE ADDRESS...: 14800 SW SEQUOIA PKWY SUBDIVISION • ZONING:I -P BLOCK • LOT • Project Description: ADD 1 SERVICE FEEDER - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS-- -• -- 1000 SF OR LESS • 0 0 - 200 amp • 0 PUMF' /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 • 1 W /SERVICE OR FEEDER: 0 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 -- HOME DEPOT type amount by date recpt 14800 SW SEQUOIA PKWY PRMT $ 60.00 TAT 12/19/96 96- 288014 5PCT $ 3.00 TAT 12/19/96 96- 288014 TIGARD OR 97223 Phone #: Contractor: CRAWFORD ELECTRIC $ 63.00 TOTAL PO BOX 645 REQUIRED INSPECTIONS -- STAYTON OR 97383 Ceiling Cover Underground Cove Phone #: 503-743-2126 Wall Cover Elect'1 Service Reg #.. : 000040 This permit is issued subject to the regulations contained in the 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 approved plans. This permit will expire if work is not started ` ��� , within 180 days of issuance, or if work is suspended for more AdtjAef than 180 days. Issued B y 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 f \ C9TY of TIGARD Electrical Permit Application Plan Check # 3125 SW HALL BLVD. Rec'd By Date Rec'd TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to D T Print or Type , �� Inspection (503) 6394175 Permit • _� j������i Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _,, / /� Number of Inspections per permit allowed Name (or name of business) r�1e9'J7 ,lU Service included: Items Cost Sum I Address / 4 / cr CO o3 Mi .. �D L /.I , ,�i lyi�, 4a. Residential - per unit City /State /Zip ( n( 1000 sq. ft. or less $110.00 4 /i a4 A • Each additional 500 sq. ft. or Commercial 0 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 : current licenses _ 4b. Services or Feeders Installation, alteration, or relocation , • a & Electrical Contractor .1 .e._ . e./ . _i. - 200 amps or less Address 1�C� �o /� !S p $60.00 6 • 2 �P 201 amps to 400 amps $80.00 2 City State 44 . Zip 7T3�� 401 amps to 600 amps $120.00 2 Phone No. 7 V /ct (/, 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. c%2 /V7t: Exp.Date /O a -97 OR State CCB Reg. No. 5 Exp.Date 4 o1 f -97 4c. Temporary Services or Feeders COT Business Tax or Metro Nopoo ovo 45 Exp.Date // `/ - 9 2 Installation, alteration, or relocation W , l 200 amps or less $50.00 2 Signature of Supr. Elec w�� ..� 401 amps to 600 amps $ 2 O 600 amps to 1000 volts, License No. (.f 1 2,265 Exp.Date /6 97 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 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 circuit $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: Not required for temporary construction services. 5a. Enter total of above fees $ o 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. El Trust Account # / 3 o d $ Co 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 BUP Date Requested It //67/ qr AM PM BLD Location / `7 0 O �[ �-{ PA-4",, Suite MEC Contact Person Ph PLM Contractor Ph . 3 4 7 1 3 - c).6, SWR �/ BUILDING t/Owner �(l-yVL¢ _ D A-� ELC 7 ( ?' Retaining Wall ELR Footing Foundation Access: FPS Ftg Drain SGN Crawl Drain Inspection Notes: ) ° Slab l SIT Post & Beam / - Ext Sheath /Shear • Int Sheath /Shear Framing Insulation Drywall Nailing 14-11- pe eN I e r" /,lam ce I h e Lfit h ) Firewall � / Fire Sprinkler 7 Ct. p r D 1 D n S " Fire Alarm Susp'd Ceiling Roof Misc: - Final h0 SS 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 /'ASS 1 FAIL ELAGTRI \Service Rough In UG /Slab Low Voltage Fire Alarm 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: / 4 [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date /D ! 7 Inspector b avt Ext I /"A-5 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 /0 _ AM PM BLD Location 1M P J J P 2 Suite MEC Contact Person mgo tiA-t. Ph PLM Contractor Ph SWR BUILDING Tenant/Owner AM"' q6-cY76t Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain _ Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear IntSheath /Shear [[ / JJ Framing / L°— 2- - Y l YI , S' Ace //47 P / Q Insulation Drywall Nailing Firewall Fire Sprinkler /7 )) e � e r S gApP G r 1.0 rn to f Fire Alarm l Susp'd Ceiling � ° r )/ Q l' e Roof Misc: // � 12 J -- l Final UJi ,1 !P P4 ��Y lam //! Q ' �?�� � � �n e ell s P ASS PART FAIL J� / PLUMBING P(>r / — � 2 YG� / J1 S' Post & Beam Under Slab (/ Yq / Y /1 (Jld jam! ,e3 Top Out � Water Service D )4/1 E ,UP,O/0Z-- O 2Y.S� 1I D Q Z Ye Sanitary Sewer Rain Drains _ b O �h / s ms Cr //.9i / Q YJ , Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final T FAIL ELECTRICAL) - Rough In UG /Slab Low Voltage F' larm 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 Othe�ach /Sidewalk JD ^ Date ((( Inspector Ext Final PASS PART FAIL. DO NOT REMOVE this inspection record from the job site.