Permit 4 11 , '
CITY OF TIGARD ELECTRICAL PERMIT
l'� DEVELOPMENT SERVICES DATE IS UED: 6/22/99 9 -00370
1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S114BB -00500
SITE ADDRESS: 10065 SW SERENA WAY
SUBDIVISION: PICKS LANDING NO.1 ZONING: R -4.5
BLOCK: LOT : 004 JURISDICTION: TIG
• Project Description: Installation of one branch circuit.
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: 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:
LUKENS, JOHN P /HELEN DIAN • SHARPE ELECTRIC INC
10065 SW SERENA WAY 22605 SW RIGGS
TIGARD, OR 97224 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date. Amount Receipt Elect'I Service
5PCT DEB 6/22/99 . $1.87 99- 316316 Elect'I Final
PRMT DEB 6/22/99 $37.50 99- 316316
Total $39.37
•
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.
Permit Signature: A � / � _ � Issued By: T -
. OWNER INSTALLATION ONLY '
The installation is being made on property y I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: /e/14G� � -Cl2 ® DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
ELECTRICAL PERMIT
`� PERMIT #: ELC1999 -00370
; . iIi& DEVELOPMENT SERVICES = „„ DATE ISSUED: 6/22/99
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 p RCEL: 2S1146B -00500
SITE ADDRESS: 10065 SW SERENA WAY SUBDIV ISION: PICKS LANDING NO.1 ING: R -4.5
BLOCK: LOT : 0 prostNA
JURISDICTION: TIG
Project Description: Installation of one branch circuit. --s; 4,4- 9, t s g 99 .
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: 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:
LUKENS, JOHN P /HELEN DIAN SHARPE ELECTRIC INC
10065 SW SERENA WAY 22605 SW RIGGS •
TIGARD, OR 97224 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
5PCT DEB 6/22/99 $1.87 99- 316316 Elect'I Final '
PRMT DEB 6/22/99 $37.50 99- 316316
Total $39.37
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 rule • _ - - - - • the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtai' copies of these r -s or direct questions to OUNC at (503)
246 -1987.
Permit Signature: � Is . ued By: , 1 • • P Oko/K-4_k,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: . - - I A I` ` t 0._ DATE: 6 - ate^
LICENSE NO: 354
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Plan Check
4131' SW HALL BLVD. Electrical Permit Application Recd By
TIGARD OR 97223 Date Recd 1,-.2-p-
Date to P.E. -----
Phone (503) 639 -4171, x304
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # c-C- e -igg -0
Fax (503) 598 - 1960 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) T /) M L u K e Ns Service included: Items Cost Sum 4'
Address _/004.5 S L(/ S'+l1OeHA I✓Ati( 4a. Residential - per unit
City/State /Zip -1 l c r Q o 4e 9 7 Z �{ 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof • $ 26.25 1
Commercial ❑ Residentiall Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data basq) Installation, alteration, or relocation
Electrical Contractor S /) Q /'� t / P_L ° l C hG 200 amps or less $ 64.25 2
Address ZZC. OS .S 1 9 yS 201 amps to 400 amps $ 85.50 2
n 401 amps to 600 amps $ 128.50 2
City _J)Pd,(/?.trtt8'I - State e: Zip q 7ov 7 601 amps to 1000 amps $ 192.50 2
Phone No._(G Y - -Z-- .i 1 3 7 Over 1000 amps or volts $ 363.75 2
Job N ,e / S ref? ? Reconnect only $ 53.50 2
Elec. Cont. Lice. No 3 -A 17 C. Exp.Date /d!/J p 4c. Temporary Services or Feeders'
OR State CCB Reg. No. /S/ V Exp.Date S G`Ol Installation, alteration, or relocation
COT Business Tax or Metro No. %.53 / Exp.Date a / / 200 amps or less $ 53.50 2
n 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. 3 3 4 Cf.5 /6 / /iff see "b" above.
Exp.Date
Phone No. L Y2 - 7Q37 4d. Branch Circuits
New, alteration.or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee. i{ . 57) Phone No. First branch circuit 1 $ 37.50 0' 7 '
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy .
• (if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: b
5a. Enter total of above fees $ -. 7.5-
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $, ',sr-7
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # �{ Q
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ✓ / ,
is \fists \forms \electri c.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
.4 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested - 7 -R - c N AM Y PM BLD
Location 16060 S (Jal Suite MEC I ( I g'Cr7/20
Contact Person - 11' I WY) Q Ph (0 Za p1 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC / 99q-co370
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
Inulati
D on „� / ? 9 ? z7 0
Drywall Nailing r,�
Firewall
Fire Sprinkler 4.M Z-<22
Fire Alarm /999 a O O 3Q
Susp'd Ceiling
Roof
rj
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab ,
Top Out
Water Service ..41144
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHANti a
Post & Beam
Rough In
Gas Line
Smoke Dampers
CialP
PASS ART FAIL
<tLEQJR4.
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: [ ] Unable to inspect - no access
ADA p
Other oach /Sidewalk Date 7 d 9 Inspector - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.