Permit •
CITY OFTIGARD
r,1 DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC98 -0280
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 05/27/98
PARCEL: 1S135BD -01100
SITE ADDRESS...:O978O SW SHADY LN #200
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Project Description : Tenant iuproveient - electrical
- -- 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 1 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
GLORIA LEWIS type amount by date recpt
7720 SW WESTGATE WAY PRMT $ 40.00 B 05/27/98 98- 306053
PORTLAND OR 97225 SPCT $ 2.00 B 05/27/98 98- 306053
Phone #:
Contractor:
EVANS ELECTRIC INC $ 42.00 TOTAL
11867 SW WILTON AVE
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Elect'l Service
Phone #: 639 -5572 Wall Cover Elect'l Final
Reg #..: 104896
This peroit 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 peruit will expire if work is not started within 180
days of issuance, or if work is suspended for 'lore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-10 through OAR 952- 'A1 -1987. You may obtain a copy
of these rules or direct questions to 44 /111, b callli (503)246 -1987.
Permittee Signature: , l/�i�i�,� ;� Issued By: ' 0.441
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
r .
SIGNATURE OF SUPR. ELEC' N : (�1 4 l I1 it A DATE :
i
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 - 4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
, Y i :t Permit # �LGCjg - bzw
Vii' " " ; � � .I Phone (503) 639-4171 Date Issued, S - 27 - 155
° '` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued bya
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
•
Name of Development Number of Inspections per permit allowed
Address t(OSI,LJ ,5h/0y LivNe 5Te- ,?-00 Service included: Items Cost(ea) Sum
City /State/Zip I l 74.rJ 02 9'7?-k3 4a. Residential - per unit 4
S � , 1000 sq. ft. or less $11000
-
Name (or name of business) •`l .w- ^ \ 1 1Nr „ ,VL.0 additional 500 sq. ft. or 1
portion thereof $25.00
-
Commercial ❑ Residential ❑ Limited Energy $25.00
- Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor tv4 Flv{ rt'c.-- TnL 200 amps or less $60.00 2
A � 201 amps to 400 amps $80.00 2
Address , /7/1 -f� 5L4./ 4/, �w/S .44.,c, 3 401 amps to 600 amps $120.00 2
City 17,7 te State Ott? Zip 601 amps to 1000 amps $180.00 2
Phone No. (,,,� 9 L - ,5 Over 1000 amps or volts $340.00 2
Contractor's License No. ,1,./-057-C-- Reconnect only $50.00
Contractor's Board Reg. No. /0 t9 fa 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n /� � a>rj� 200 amps or less $50.00 2 -
License No. y ,)-)... S =S Phone No. 6 a 7-5-5-7,) 201 amps to 400 amps $7s.00 100 2 -
401 amps to 600 amps $.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder 1'6e. 2
Each branch circuit $5.00
Phone No. b) The lee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit r $35.00 5" 2
Each additional branch circuit T $5.00 5
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 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 where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ = /p "`
5% Surcharge (.05 X total fees) $ a..
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
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. ❑ Trust Account # $
Balance Due $ 1 / - C)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p / BUP
��/Q /6 Date Requested A AM PM BLD
Location .997e0 0 ! Suite MEC
Contact Person i Ph 5-13"f oa,�
�V PLM
Contractor Ph SWR rs1
BUILDING Tenant/Owner ,A! 4 ��y I/D/. i i ?Ci?'ZItY'
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab G, $ � plc a �C SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Nailing .!/Y7 c
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
PASS PART FAIL
LECIB1CAL
Service
Rough /
UG /Slab
Low Voltage
Fir- Iarm
tar: 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
Other Date Inspector Ext
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.