Permit CITY OF TIGARD ELECTRICAL PERMIT
��"�; DEVELOPMENT SERVICES PERMIT #: ELC98 -0441
'I
A .
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 07/31/98
PARCEL: 1S133DB -03500
SITE ADDRESS...:11567 SW SHEFFIELD CIR
SUBDIVISION :BRITTANY SQUARE NO. 2 ZONING:R -12
BLOCK LOT •059 JURISDICTION: TIG
Project Description : Installation of 10 branch circuits.
- -- 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: 9 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
MARC ALBERT type amount by date recpt
11567 SW SHEFFIELD CIRCLE PRMT $ 80.00 DEB 07/31/98 98- 307892
TIGARD OR 97223 5PCT $ 4.00 DEB 07/31/98 98- 307892
Phone #: 524 -4642
Contractor:
MARC ALBERT $ 84.00 TOTAL
11567 SW SHEFFIELD CIRCLE
REQUIRED INSPECTIONS
TIGARD OR 97223 Rough —in Elect'1 Final
Phone #: Elect' 1 Service
Reg #.. .
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 for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rule are .e• orth n OAR 952 -001 0 throu OAR 952 -' 1 -1987. You may obtain a copy
of these rules or direct questions to .L by cal IT .' g ', 119,' / .
g
Permittee Signature: •i jMJj Issue : ,2- 2 -�-f�C y
OWNE'r ST' IT IN 0 Y
The installation is bhp„ made o. drip , I ow/ which is not intended for
sale, lease, or rent. L 2,
OWNER'S SIGNATURE : _ �I .4 i -= . L . . "-L' :li DATE: ?-di --Fe
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 Ch= '
13125 SW HALL BLVD. Recd I:y ini do
TIGARD OR 97223 Date Recd 7 -0
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # � C - C 9 - 7 : - . 7 - q 1
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: Q 4. Complete Fee Schedule Below:
Name of Development R . ') / I n � Ur 1, 't- Number of Inspections per permit allowed
.,
Name (or name of business) Service included: Items Cost Sum
I
Address I I 5(O 7 � 5 � A . S� "E ' ' £ CC (�' 4a. Residential - per unit
ty p
CI /State/Zi ' 1 UNT1b/ q 72.W J 1000 sq. ft. or less
Each additional 500 sq. ft. or $110.00 4
Commercial ❑ Residential portion thereof $25.00 1 -
Li mited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Installation, alteration, or relocation
200 amps or less $60.00 2 -
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No Exp.Date see "b" above.
Phone Nr
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's N ame V" 1 N cSEP, -- feeder fee.
Address I c J' / S i SkLE FI ELL ci (2_ . Each branch circuit $5.00 2
ZI
i City State O I 72. b) The fee for branch as cr f
circuits
tY T St Zip 6 without purchase o
Phone No. SO3 - S 2 K - rI G q a service or feeder fee.
First branch circuit $35.00 3 S ' ��
I 2
The installation is being made on pr. .. rty I own w ' his nut Each additional branch circuit $5.00 2
intended for sale, lea rent. / / 4e. Miscellaneous
V/ (Service or feeder not included)
Owner's Signature 1 �1r. 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. 5. Fees: 80.00
Not required for temporary construction services. 5a. Enter total of above fees $ , L
5% Surcharge (.05 X total fees) $ 7 , Ov
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 # f ci ,
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
a1^ f #I4 'IX C r. OPP t3t1' 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
I p� BUP
Date Requested 8l l I 1 0 AM PM BLD
Location //5e d
Q 0 e , Suite MEC
f klb-2
Contact Person 11t Ph 5{- ¥ PLM
Contractor Ph SWR �!
BUILDING Tenant/Owner ELC / T
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 /Vt 7C , ' Open wJ/ r/ h � qt P f'yI ✓) \ ?Q y I// C e_
Firewall
Fire Sprinkler S C� P D Yc7C' k 9`// 0 6 P_ R c Ji ,
Fire Alarm
Susp'd Ceiling
Roof gne_ /Q1 / _
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
FAIL
ELE TRICAL
rvice
Rough In
UG /Slab
Low Voltage
Fire Alarm
F 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 Q / G�
Other oach /Sidewalk Date U '1� i l Inspector /dot .�?4-eil Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL PERMIT
��"�; DEVELOPMENT SERVICES PERMIT #: ELC98 -0441
'I
A .
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 07/31/98
PARCEL: 1S133DB -03500
SITE ADDRESS...:11567 SW SHEFFIELD CIR
SUBDIVISION :BRITTANY SQUARE NO. 2 ZONING:R -12
BLOCK LOT •059 JURISDICTION: TIG
Project Description : Installation of 10 branch circuits.
- -- 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: 9 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
MARC ALBERT type amount by date recpt
11567 SW SHEFFIELD CIRCLE PRMT $ 80.00 DEB 07/31/98 98- 307892
TIGARD OR 97223 5PCT $ 4.00 DEB 07/31/98 98- 307892
Phone #: 524 -4642
Contractor:
MARC ALBERT $ 84.00 TOTAL
11567 SW SHEFFIELD CIRCLE
REQUIRED INSPECTIONS
TIGARD OR 97223 Rough —in Elect'1 Final
Phone #: Elect' 1 Service
Reg #.. .
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 for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rule are .e• orth n OAR 952 -001 0 throu OAR 952 -' 1 -1987. You may obtain a copy
of these rules or direct questions to .L by cal IT .' g ', 119,' / .
g
Permittee Signature: •i jMJj Issue : ,2- 2 -�-f�C y
OWNE'r ST' IT IN 0 Y
The installation is bhp„ made o. drip , I ow/ which is not intended for
sale, lease, or rent. L 2,
OWNER'S SIGNATURE : _ �I .4 i -= . L . . "-L' :li DATE: ?-di --Fe
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
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++