Permit CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00639
14. DEVELOPMENT SERVICES DATE ISSUED: 10/26/1999
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BD-03100
SITE ADDRESS: 12045 SW SPRINGWOOD DR
SUBDIVISION: ENGLEWOOD NO.2 ZONING: R -4.5
BLOCK: LOT : 119 JURISDICTION: TIG
Proiect Description: Install 1 branch circuit in single family dwelling.
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:
PARODI, WILLIS MARY LYNN ROSE HEATING
12045 SW SPRINGWOOD DR 9945 NE 6TH DR
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TIGARD, OR 97223 PORTLAND, OR 97211
Phone: Phone: 503 - 283 -5183 O R I G I N A L.
Reg #: LIC 2084
ELE 183LHR
SUP 852RET
FEES Required Inspections
Type By Date . Amount Receipt
Elect'I Service
PRMT KJP 10/26/199c. $37.50 99- 319354 Elect'I Final
5PCT KJP 10/26/199 $3.00 99- 319354
Total $40.50
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.
PERMITTEE'S SIGNATURE ISSUED BY: A
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: d'K- DATE: / o /2 7 / 9 9
LICENSE NO: Reg RE T
Call 639 -4175 by 7:00pm for an inspection the next business day
10/19/99 TUE 11: 2_6 FAX 503 598 1960 CITY OF TIGARD Q001
. . • •
-� C 1 14OF TIGARD Electrical Permit f E on Plan Check #
13125 SW HALL BLVD: Rec'd By
Date Rec'd •
TIGARD OR 97223 OCT 2 5 1999 Date to P.E.
Phone (503) 639 -4171, X304 Date to DST
Inspection (503) 639 -4175 Print q�NTI DEVELOPMENT Permit # L G 1999 - t 39
Fax (503) 598-1960 Incomplete or Illegible will not be accepted Called
1. Job Address:
� 4. Complete Fee Schedule Below:
Name of Development • N at DINS Pc t ` r Number of Inspections per permit allowed
Name (or name of business) Service Included: I ems Cost Sum
Address 4 ' Li
a r \i1�VJ eN� a 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City /State/Zip T ► q cA cA, Each additional 500 sq. ft. or
J portion thereof $ 2625 1
Commercial ❑ Residential ❑ Limited Energy $ 60.00 •
Each Maned Home or Modular
2a. Contractor installation only: D clling Scr.loo or Feodcr $ 72.75 2
(Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT da e). Installation, alteration, or relocation
Electrical Contractor KciSe., t4e..A 200 amps or less $ 64.25 2
Address � 4::= 1 .= t9 c r t �
l a Di'. 201 amps to 400 amps $ 85.50 2
�11 _ n 401 amps to 600 amps $ 128.50 2
Pp�
City C- AQt1C1 State o4Z Zip 9 �� 601 amps to 1000 amps $ 192.50 2
Phone No. `'''..c: Si €5 -7-- Over 1000 amps or volts $ 363.75 2
Job No. L7-5 .. Reconnect only $ 53.50 2
Elec. Cont. Lice.' No. l$'5- 04e. Exp.Date I c›-cal - °c:. . 4c. Temporary Services or Feeders
OR State CCB Reg. No. �{ Exp.Date 9 Installation, alteration, or relocation
COT Business Tax or Metro No. ` Exp.Date -01-,141 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
R 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n _ k Ai k Q n Over 600 amps to 1000 volts, .
w soo "b" a.,sve.
License No. $S�.Q'T Exp.Date ‘c.-•=3%- a 4d. Branch Circuits
Phone No. -- )4= 1 3- 14a;', New, alteration extension per panel
• a)'i tie 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
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 - 3 - 1 i n)
Each additional branch circuit $ 5.35
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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 l $ 42.75
Owner's Signature Each sign or outline lighting S 42.75
• Signal circuit(s) or a limited energy
(if required):* panel, alteration or extension $ 60.00
Review section
3. Plan ( Minor Labels (10) ------ $ *no
4f. Each additional inspection over 1
fod,
Please check appropriate item and enter fee in section 5B. the allowable In any of the above
4 or more residential units in one structure Per inspection $ 50.00
Service and feeder 225 amps or more .
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:
5a. Enter total of above fees $ -1 1. c"-:) * Submit 2 sets of plans with application where any of the above apply. r o.5�Surcharge (,06.X total fees) $ 3 , e-
Not required for temporary construction services. v Subtotal • el cr $ t.-10 ..
6b. Enter 25% of line 6a 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 #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
•
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST AK
24 - Hour Inspection Line: 639 - 4175 Business Line: 639 - 4171
BUP
Date Requested /d -(moo /, °.' AM ! PM BLD
Location (041`S"-- t w d A• Suite _ MEC / `t / Ua `ES i
Contact Person n ``I /Rose-- q Ph 2t 3 �� 8- _ PLM
•
Contractor 1/ Ph SWR
BUILDING Tenant/Owner j igg9- C&3 g
Retaining Wall ELR
Footing Access:
Foundation J _�1� Q
, / n hdY( n FPS
5
Ftg Drain IU (.(� 1 1. , - 1 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
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
PAS : • RT FAIL
Post & Beam
Rou. • In
Ga ine
S •, e . ampers
r ►
P_r. FAIL
roNklIP
Rough In
UG /Slab
Low Voltage
Fi - Alarm
eliMM 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 D 2 I - 2.0 ` Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.