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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00187 — DEVELOPMENT SERVICES DATE ISSUED: 04/19/2000 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DB-08300 SITE ADDRESS: 07230 SW SHADY CT SUBDIVISION: SHADY DELL NO.2 ZONING: R -4.5 BLOCK: LOT : 056 JURISDICTION: TIG Project Description: Install two (2) branch circuits to an existing dwelling. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps •1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DAN BURLEIGH WEST SIDE ELECTRIC CO INC 7230 SW SHADY CT 1834 SE 8TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: Phone: 231 -1548 Reg #: LIC 13306 SUP 1556s ELE 26 -135c FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT GEO 04/19/200C $42.85 0001527 Elect'l Final 5PCT GEO 04/19/200C $3.43 0001527 Total $46.28 ORG1NA This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE / 9 ISSUED BY: / 1, OWNER INSTALLATION ON Y 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: 4 DATE: LICENSE NO: c� l/ �� S Call 639 -4175 by 7:00pm for an inspection the next business day APR - 18 - 00 06:27 PM WEST SIDE ELECTRIC 503 736 0677 P.01 1 I i . I CI Y Clif TIGARD i Plan Check S Electrical Permit Application 1' Reed By Date By 25 SW HALL BLVD. d TI ARD OR 97223 I Date to P.E. Ph- ne (503) 639 -4171, x304 °� jl Date to DST ' �. Ins .ection (503) 839 -4175 Print of Type Y Permit /fff /Sf- Fa (503) 598 -1960 1 Incomplete or Illegible will not be accepted Called I 1. Job Address: 4. Complete Fee Schedule Below: Na : of Development Number of inspections per permit allowed Na , (or name of business) I . On i0 - re . . Service Included: Items Cost Sum y Add =se 72J ShJ ' �a da. Residential - per unit City - tate/Zip T ro G 4 q7 e? 2 3 1000 sq. li. or less $ 117.76 4 r Each additional 500 sq. n. or portion thereof S 20.25 1 Co ercial ❑ Residential Limited Energy $ 60.00 Each Manurd Home or Modular Dwelling Service or Feeder S 72.75 2 2a. Contractor installation only: (Pd • to permit Issuance, apptIOnts must provide contractor license db. Services or Feeders In • Won for COT data bass).,J1 Installation, alteration, or relocation El - cal Contractor .5 / i e C • 7 c,. 200 amps or less 8 64,25 2 Add . s - i ' c !Z; " .G.-e 201 amps to 400 amps $ 85.50 2 CI � 7 / c 401 amps to 600 amps i 128,50 2 ly � fat = , Zip I c e01 amps to 1000 amps S 192.60 2 Pho a No. - 3/- / C . Over 1000 amps or volts $ 363,75 2 Job o. 2 Reconnect only , $ 53.50 2 • I Ele- Cont, Lice. No. Exp.Date 4c. Temporary Services or Feeders I OR tate CCt3 Reg. No. . .) Exp.Date Installation, alteration, or relocation CO Business Tax or Metro o. Exp.Date 200 amps or less $ 63.50 2 I 201 amps to 400 amps $ 80,25 2 401 amps l0 600 amps 5 107.00 2 Sig :lure of Supr, Elec I Over 800 amps t 1 000 vo i , / cc "b" above, Lice se No. .3 Exp.Date I Pho e No, 3/- /.S ci+`. 4d. Branch Circuits • New, alteration or extension per panel I I a) The fee for branch circuits 1 2b. For owner installations: with purchase of service or Neely fee. Prin Owners Name Each branch circuit S 5.35 2 Add ss • b) The fee for branch circuits without purchase of service City !State Zip or feeder S Pho a No. First branch circuit _ ' $ 37,50 3 Each a branch circull / S 5.35 '��- r The nstallatlon is being madq on property I own which is not se. Miscellaneous inte ded for sale, lease or rent. • (Service or feeder not Included) Each pump or Irrigation circle 5 42.75 Ow rs Signature Each sign or outline lighting 42.75 Signal cIrcuit(s) or a limited energy 3. Plan Review section (if required):' panel, alteration or extension $ 80.00 Minor Labels (10) S 107,00 P :ase check appropriate Iem and enter fee In section 58. 4f. Each additional Inspection over . 1 4 or more residential un i s in one structure the allowable In any of the above Service and feeder 225 (amps or more Per inspection S 60.00 Per hour S 50.00 System over 600 volts 1ominal In Plant _ $ 69.00 Classified area or structure containing special occupancy as I described in N.E.C. Chapter 5 5. Fees: �� Si. Enter total of above fees $ /. 2 1 • S . mit 2 seta of plans with sliplication where any of the above apply, 5% Surcharge (.05 x total fees) $ i N required for temporary c4istruction services. Subtotal S i db. Enter 25% of line 6a for 'IOTICF Plan Review if required (Sec. 3) S PE' ITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal 5 IS . T COMMENCED WITHIN 1 0 DAYS, OR IF CONSTRUCTION OR WO K IS SUSPENDED OR ABA DONED FOR A PERIOD OF 180 DAYS Trust Account 1t / 3 AT • : Y TIME AFTER WORK IS OMMENCED. Total balance Due $ Li L Zg i ' , I 'I .nn I' Iii ,so, CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171. _ MST BUP Date Requested SI /D/ ©0 AM PM BLD Location — 71; 0 514 .01Cbi bet-. Suite MEC Contact Person DaA _. 114PM Ph 73 ) - r' C, 9 f PLM Contractor G � Ph "? (0 d ' 9&,b SWR BUILDING Tenant/Owner ELC cO —O Q 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 1 I r `1 _ Fire wall fr/C Fire S rinkler Fire Alarm Susp'd Ceiling Roof Misc: G�✓ Final - -PASS PART FAIL PLUMBING Post & Beam �J 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 10ECT Service oug UG /Slab Low Voltage Fire Alarm I r-I t 413 S S RT FAIL SIT ackfill /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 -1 Inspector ` /(iC�_, Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.