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Permit CITY OF TIGARD ., „ ; i ,� DEVELOPMENT SERVICES ELECTRICAL PERMIT "'� �� 13125 SW HaII Blvd., Ti ard, OR 97223 503 639 -4171 PERMIT #: ELC96 - 0807 DATE ISSUED: 12/23/96 PARCEL: 25112AD -00900 SITE ADDRESS...: 14800 SW SEQUOIA PKWY SUBDIVISION • ZONING:I -P BLOCK • LOT • Project Description: Installing first branch circuit and two add'l 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/0 SRVC OR FDR.: 1 PER HOUR • 0 401 - 600 amp : 0 EA ADD'L BRNCH CIRC: 2 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 $ 45.00 B 12/23/96 96- 288063 SPCT $ 2.25 B 12/23/96 96- 288063 TIGARD OR 97224 Phone #: Contract or: CHRISTENSON ELECTRIC INC $ 47.25 TOTAL_ 111 SW COLUMBIA SUITE 480 REQUIRED INSPECTIONS PORTLAND OR 97201 Elect'1 Service Phone #: 503- 241 -4812 Elect'1 Final Reg #..: 000004 I w This permit is issued subject to the regulations contained in the V ” \ 1 Tigard Municipal Cade, State of Ore. Specialty Codes and all other �P m i t t e e Signature applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started P��w within 180 days of issuance, or if work is suspended for more than 180 days. 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: CONTR CTOR .A INSTA AT -ION ONLY - SIGNATURE OF SUPR. ELEC' N:7 I/\ ` ^ DATE: LICENSE NO: Call for inspection - 639 -4175 L. -t, Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. / Tigard, OR 97223 Permit # E 'i - OW) , �+ruii� rI Date Issued lZ - ii, '. I 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 a C A-9 P 460 Number of Inspections per permit allowed Address 1480 6-W ` r I a " ^' n P' Service included: Items Cost(ea) Sum City /State /Zip 1 ©R- q 4a. Residential - per unit �A , , t 1000 sq. ft. or less $110.00 4 Name (or name of business) A- ^W P A$dJrz Each additional 500 sq. ft. or portion thereof $25.00 • Commercial I Residential ❑ Limited Energy $ 25 . 00 1 Each Manufd Home or Modular . Dwelling Service or Feeder $68.00 2 - 2a. Contractor installation only: 4b. Services or Feeders CHRISTENSON ELECTRIC, INC Installation, alteration, or relocation 2 Electrical Contractor 200 amps or less $60.00 Address 111 SW COLUMBIA SUITE 480 201 amps to 400 amps $80.00 2 City PORTLAND State OR Zip 97201-5885 401 amps to 600 amps $120.00 2 `7 601 amps to 1000 amps Phone No. 503 241 -4812 Over 1000 amps or volts $340.00 2 Job NO. 221 6cIct3 Reconnect only $50.00 2 contractor's license NO. 26 - 34C 4c. Temporary Services or Feeders Contractor's Board = ....._ _ 00 58 Installation, alteration, or relocation 2 Signature of Sup . '- � 1_ �� 2> 200 amps or less � � 201 amps to 400 amps $50.00 2 License No. 873S Phone No. 241 -48 2 401 amps to 600 amps $75.00 2 12-17-96 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 2 City State Zip purchase of service or feeder fee. •r Each branch circuit $5.00 Phone No. b) The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. a 2 First branch circuit $35. 35 - 2 not intended for sale, lease or rent. Each additional branch circuit $5.00 / 0 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or Irrigation circle $4o.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 w 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) $ 225 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 41�'J_ 5b. Enter 25% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF - 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. worthcomdevlelet, ❑ Trust Account # $ pm .app Balance Due $ 47, 47.25 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -H ur Inspection Line: 639 -4175 Business Line: 639 -4171 q � � BUP 0-5 t!!� Date Requested 10 � C U AM PM BLD Location / `ROV SW - P e ' / / P 4t k Suite _ MEG r 7 Contact Person 41114 / J ;/ � ; _1, !_ Ph S-d O' / 3 PLM Contractor Ph SWR BUILDING Tenant/Owner 4 CaP M) V C 616 ^ ()eJ 7' Retaining Wall ELR Footing Access: Foundation S7G FPS Ftg Drain SGN Crawl Drain Inspection Notes: � I , i% Slab [[�i(( JJ / SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing . Insulation r Drywall Nailing ,i4 .etZ � Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof . Misc: C 4:1217 " ) ) 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 PAS RT FAIL Q! ECTRICA�L Service Rough In UG /Slab Low Voltage - . ` _ •ART FAIL 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 Other Date /V j'P Inspector ________________________ Ext Final .PASS PART FAIL DO NOT REMOVE this inspection record from the job site. L