Permit /�, CITY OF T1GARD ELECTRICAL PERMIT
mkroi DEVELOPMENT SERVICES PERMIT #: ELC98 -0719
!+L I! 13125 S W Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12 / 08 / 98
PARCEL: 1S135BD -01200
SITE ADDRESS...:09804 SW SHADY LN
SUBDIVISION - ZONING:C —G
BLOCK LOT JURISDICTION: TIG
Project Description : Nentel paging reconnect mechanical
- -- 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/0 SRVC OR FDR.: 1 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
NW COMMUNICATIONS type amount by date recpt
9804 SW SHADY LN PRMT $ 35.00 JSD 12/08/98 98- 311367
TIGARD OR 97223 SPCT $ 1.75 JSD 12/08/98 98- 311367
Phone #:
Contractor:
ROBBEN & SONS HEATING $ 36.75 TOTAL
2214 SE 8TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'1 Service
Phone #: 233 -5841 Wall Cover Elect'1 Final
Reg #..: 1884
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 or ,'re than W :• . ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. ose r •s a 'rth in OAR 952- 001 -0010 through OAR 952-00 - . You may obta• •
of these rules or direct questions to I b I• ' �> i -1987. r . Permittee Signature: ' Issued B �I /�
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 :: /�''
Date Rec'd 1;
_
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # F - C- p7-/ y
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
r i. a . -
Name (or name of business) / - , 7 .�((.f Service included: Items Cost Sum
I
Address 9I" e V," , - 4a. Residential - per unit
, /1 1000 sq. ft. or less $110.00 4
City /State/Zip _r i . f� r� Each additional 500 sq. ft. or
Commercial.KI ' Resident portion thereof $25.00
t 1
L imited Energy $25.00
-
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor insta ti ' n only' /
(Attach copy of al .ar icenses) iZ�`"''� 4b. Services or Feeders
Electrical Co actor y Installation, alteration, or relocation
Address 2/ • 7., ` 200 amps or less - $60.00 2
201 amps to 400 amps $80.00 2 -
City J tate Zip � d /Y 401 amps to 600 amps $120.00 2
-
Phone No. 2.3.3. , li / 601 amps to 1000 amps - $180.00 2
Job No. Over 1000 amps or volts - $340.00 2
�.� ..5 Exp.Date/D-9 � Reconnect onl $50.00 2
Elec. Cont. Lice. No. kk
OR State CCB Reg. No. / Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 0 9 Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
-
Signature of Supr. Elec' � 201 amps to 400 amps $ 100.0 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date 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
A , �� / purchase of service or
Print Owner's . - e /V' IL- / /&-- feeder fee.
Address B m I „ , 7 Each branch circuit $5.00 2
b) The fee for branch circuits
City State Z p 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. S. Fees: • t,-----
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ /r
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 #
Total balance Due $ •
•
1:\DSTS \ELC96.APP Rev 9/96
c-5 / y f 9 - Te' S %4 Jy 4 i
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
�[ /, p
13 `Tate Requested l �- 14- - / AM PM X BLD
Location ,/ Suite MEC s WA A
Contact Perso • ' / k_.„/ Ph PLM
Contractor A d L44 6 I Ph - 3 &S'7" SWR
BUILDING Tenant/Owner AJGN TE1, 4•5 q7, - 07
Retaining Wall ELR 7
Footing Access' t ,
Foundation �L4 FPS
Ftg Drain SGN
Crawl Drain L rain Inspection Notes: VVV
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall �
Fire Sprinkler / / JQ ! / T /9/7 ry iVE -
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
PA AIL
EC ICAL
Pos
Ro gh In
Gas Line
",•• - Sam ers
P
Fi ��
• ! • Z FAIL
TRICAL
Service
Rough In
UG /Slab
Low Voltage
larm
P 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 / (� / Oth /Sidewalk Date / Z »1 D I 2 `/ (/� )1' ) E x t
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 / 2 9 9 AM PM BLD
Location 90 G 0 SiJ S 4? y *,/ Suite MEC
Contact Person Ph PLM
Contractor 466EA1 F S&,•rr Ph Z33 -3-F41/ SWR
BUILDING Tenant/Owner 4101 9 / - 07 / /
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 e.-EQ
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling C i
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
PASO PART FAIL
ECTRICAL
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
ASS PART FAIL
SITE
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 Date
Other /` I Inspector Ext
nsp ecor
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.