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Permit
CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00354 � T A, DEVELOPMENT SERVICES DATE ISSUED: 7/5/01 13125 SW Hall B Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133DC-08900 SITE ADDRESS: 13225 SW SHORE DR SUBDIVISION: WINTER LAKE ZONING: R -7 BLOCK: LOT : 019 JURISDICTION: TIG Protect Description: Installation of main area lighting, outlets and switches. (3) branch circuits. Job #66629 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): SERVICEIFEEDER 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: 2 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: BRANDENBURGER, KAREN J TUALATIN ELECTRIC 13225 SW SHORE DR PO BOX 655 TIGARD, OR 97223 WILSONVILLE, OR 97070 Phone: Phone: 682 -2955 Reg #: LIC 00065650 SUP 3483S ELE 3 -268C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 7/5/01 $60.15 2720010000( Elect'I Final 5PCT CTR 7/5/01 $4.81 2720010000( Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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. .TTENTIO : Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0 ►10 re •g r OAR *52- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1-800- 332 -2344. Permit Signature: x Issued By: A, / / % �j � 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: 071 (2./p4) °LOA- T I (fl DATE: LICENSE NO: r 6V3 Call 639 -4175 by 7:00pm for an inspection the next business day At. Electrical Permit Application Date received: Z 5/0' Permit no.: OI[ ) O -3 5 L Averfp I _11- 4.:4i1 i City of Tigard ei& Project/appl.no.: Expire date: • City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By:fj6 I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family • 0 Tenant improvement 0 New construction 0 Addition/alteration/replacement O Other: 0 Partial • JOB SITE INFORMATION Job address: \ 3 'Z�5 ''J 0 ..Dr Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Bloc : Subdivision: 1 v . 413 Project name: -a y , I Description and location of work on premises: 1`1y; Qom, 1t3 r1 r o- .�e Estimated date of completion/inspection: Sw,A CONTRACTOR APPLICATION FEE SCHEDULE Job no: i („cpt Fee Max 1 Description Qty. (ea.) Total no.lnsp Business name: - 'v.ale\1l-N j c L A-,-; L. Address: (c.5. New residential - single or multi - family per © dwelling unit Includes attached garage. City: 1 1, 1\ 1 1 ,„, 1 1 State: I ZIP: 91�o 0 Service included: Phone: Cam , ,- ... 0 1S5 - YFax: 6$a -1' 5 I E -mail: 1000 sq. ft. or less 4 • CCB no.: t -- 6 - 4 I Elec. bus. lic. no: •� (��L Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro li Limited energy, non- residential 2 '1.—F).0) Each manufactured home or modular dwelling Signal e o upervi • • g electrician (required) Date Service and/or feeder 2 Sup. elect. name (p) t): rt, eh ,..C,.... k License no: 3 �}8-_S Services orfeeders - installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): co . br°p Ln L t� 201 amps to 400 amps ; 2 Mailing address: °J S .) r 401 amps to 600 amps 2 1�- 601 amps to 1000 amps 2 City: \ G- I State: t 'ZIP: q1 3 Over 1000 amps or volts 2 Phone: 5c BS (z I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - . which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 • ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: • I ZIP: B. Fee for branch circuits without purchase 1 of service or feeder fee, first branch circuit: 1166 y(,,9 S 2 Phone: Fax: E -mail: Each additional branch circuit: Q 6.65 13,3. PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan 0 Other. Per inspection I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ bb . O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ y - a 1 Expires accepted as complete. TOTAL $ l��t .1 Name of cardholder as shown on credit card • $ Cardholder signature Amount • 440-4615 (6/00/COM) • • Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY (� Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener' Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems* 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps . , , $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 . Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 • - 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ■ see "b" above. n Audio and Stereo Systems Branch Circuits ❑ Boiler Controls • New, alteration or extension per panel a) The fee for branch circuits with purchase of service or ❑ Clock Systems II feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit • $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous - n; Instrumentation (Service or feeder not included) - Each pump or irrigation circle ' $53.40 ❑ Intercom and Paging Systems ` Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels (10) $125.00' ❑ Medical Each additional inspection over the allowable in any of the above El Nurse Calls Per inspection $62.50 Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees: . ❑ Protective Signaling • Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees • $ • ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ • i:\dsts \forms \elc- fees.doc 10/09/00 � CITY OF TIGARD BUILDING INSPECTION DIVISION • MST 24 -Hour Inspectiop Line: 639 -4175 Business Line: 639 -4171 BUP • Date Requested 7 - 3 I AM PM BLD Location ) 3 2- s f Suite MEC Contact Person k // c J Ph �fU - O 7 7 PLM Contractor �Va `g dY /� �= l� /4.mA_, L e Ph SWR BUILDING Tenant/Owner 6 c 630 ELCo?ej6l 80-3S Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes n /1"- SGN Slab �-�l/� l . Pi/�- . 'at SIT Post & Beam Ext Sheath /Shear a p Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler / o ! j� � Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING y� / 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 co= PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm PASS 'ART 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 Approach /Sidewalk Date 7 _3 / ( Inspector n /J Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. U / • C! OF TIGARD BUILDING INSPECTION DIVISION - MST_ , - 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP Date Requested 7 -11— AM PM BLD Location / 3 Z t SG✓ 546 Y-e Or Suite MEC Contact Person / Ph 6 rZ Z � J J S PLM Contractor /L ( C 4 I, e r/ c Ph 04 / SWR BUILDING Tenant/Owner /c` r4 14 ,b u)-S .Qr — karev J, ELC 20/ 35 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Li 9 I/ _ S e c ef► Int Sheath /Shear Framing Insulation a Drywall Nailing � �/d L -- Firewall Fire Sprinkler /,, / / / c514..1 L /` G-► b O �Z� °L C.C1 t ��1 / //I /� O r Fire Alarm r / Susp'd Ceiling FI n / z' 1- ( )c / I Roof Misc: Final PASS PART FAIL Kt=:' ry ` ©)-4 j am ? c 6 1 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 SS PART FAIL Service c - 'cti Rough In UG /Slab Low Voltage Fire rm F P - ASS •RT 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 Approach /Sidewalk Other Date 7 - 1 Inspector � Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . Cry OF TIGARD BUILDING INSPECTION DIVISION MSt - • 24 -Hour Inspection,Line: 639 -4175 Business Line: 639 -4171 7 BUP Date Requested - - r AM PM BLD Location 6 3 Z-2 5 � - Suite MEC Contact Person / Ph PLM Contractor £ Ph 6 SWR BUILDING Tenant/Owner X j ELC A) a 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 Firewall -- Fire Sprinkler / Y /) DPI C �)/9t c0 / Fire Alarm Susp'd Ceiling Roof /4 Q Pi S !� P7 Misc: ! Y � 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 ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm PASS PAR FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ) Reinspection fee of $ required before n-xt inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [please call for reinspection RE: [ nable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Other Date (7") Inspecto / /�� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00354 � T A, DEVELOPMENT SERVICES DATE ISSUED: 7/5/01 13125 SW Hall B Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133DC-08900 SITE ADDRESS: 13225 SW SHORE DR SUBDIVISION: WINTER LAKE ZONING: R -7 BLOCK: LOT : 019 JURISDICTION: TIG Protect Description: Installation of main area lighting, outlets and switches. (3) branch circuits. Job #66629 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): SERVICEIFEEDER 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: 2 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: BRANDENBURGER, KAREN J TUALATIN ELECTRIC 13225 SW SHORE DR PO BOX 655 TIGARD, OR 97223 WILSONVILLE, OR 97070 Phone: Phone: 682 -2955 Reg #: LIC 00065650 SUP 3483S ELE 3 -268C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 7/5/01 $60.15 2720010000( Elect'I Final 5PCT CTR 7/5/01 $4.81 2720010000( Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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. .TTENTIO : Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0 ►10 re •g r OAR *52- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1-800- 332 -2344. Permit Signature: x Issued By: A, / / % �j � 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: 071 (2./p4) °LOA- T I (fl DATE: LICENSE NO: r 6V3 Call 639 -4175 by 7:00pm for an inspection the next business day