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Permit CITY OF TIGARD ELECTRICAL PERMIT c : PERMIT #: ELC1999 -00644 I DEVELOPMENT SERVICES DATE ISSUED: 10/28/1999 All 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134CD -06300 • SITE ADDRESS: 11690 SW SUMMER CREST DR SUBDIVISION: BURLWOOD NO.3 ZONING: R -4.5 BLOCK: LOT : 023 JURISDICTION: TIG Project Description: Electrical permit to replace expired WaCo permit #5- 465 -87. 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: PER HOUR: 2 401 - 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: Phone: Phone: ORIGINAL • . Reg #: • FEES Required Inspections Type By Date • Amount Receipt Elect'l Final PRMT GEO 10/28/199£ $100.00 99- 319406 Total $100.00 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 acoordance 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 (` % 1 / ISSUED BY: OWNER INSTALLATION ONLY The installation is being.made on pro erty I own •ch i of intended for sale, lease, or rent. OWNER'S SIGNATURE: x 7// i DATE:_ A6/ 7.l CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: 7 /e. DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day . CITY OF TIGARD Electrical Permit Application Plan Check # : :13125 SW HALL BLVD. Rec'd By COLA TIGARD OR 97223 Date Rec'd /o/2_ rQ Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # EL& if ff - 004 , Y y 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) :re a¢ 1i +e._ Service included: Items Cost Sum 4 Address MO 4k ‘vipplz('reSi Of' 4a. Residential - per unit City/State /Zip Tr, I of 1 7ZZJ • Eachad additional 500 $ 117.75 4 Each additionnal 500 sq. ft. or portion thereof $ 26.75 1 Commercial ❑ Residential ® 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 base). Installation, alteration, or relocation Electrical Contractor 200 amps or less $ 64.25 2 Address 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 City State Zip 601 amps to 1000 amps $ 192.50 2 Phone No. Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders OR State CCB Reg. No. Exp.Date Installation, alteration, or relocation COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, • see "b" above. License No. Exp.Date Phone No. 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or • /� JJ feeder fee. Print Owner's Name 74- C.F f''^. r i-04. Each branch circuit $ 5.35 2 Address /G 0 441/ um r ri d"- or b) The fee for branch circuits f' r r �l without purchase of service � 1.9 City A, State O/ Zip 072 Z 3 or feeder fee. Phone ho. 4, 5 y First branch circuit $ 37.50 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 3. Plan Revie section (if required):* panL alteration or extension $ 60.00 Minor Labels (10) $ 100.00 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 . 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 $ * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 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 # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ /00 i:\dsts\forms\electric.doc 1/21/00 Activities for Case #: ELC1999 -00644 3:54:23 PM Assigned - Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 10/28/99 KJP RECD No Hold GEO 10/28/99 ELCA003 Permit created 10/28/99 KJP DONE No Hold GEO 10/28/99 Per Hap email 10/19/99 charge only a two hour fee of $50.00 per hour on final inspection ELCA799 Elect'I Final 10/28/99 10/28/99 1/3/00 BRP PASS No Hold AKJ 1/3/00 ELCA500 (F) Issue permit 10/28/99 KJP DONE No Hold GEO 10/28/99 ELCA800 Case finaled 1/3/00 AKJ DONE No Hold AKJ 1/3/00 • • • • • Page oft • UILDING INSPECTION DIVISION MST ection Line: 639 -4175 Business Line: 639 -4171 II BUP Date Requested `" b 3 — D 0 AM PM BLD Location Jl i 9 2) Sv 110 n1 Lo,X CYcrS° / ,Op , Suite MEC J Contact Person P a /S 1e4 c ^ Ph 4Y6 -A 4 f PLM Contractor Ph SWR BUILDING Tenant/Owner ELC !7= q ' 00 61 L Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath/Shear „(� / l Framing / lh c s f4 / /2 / / G „ap tv r S ?J Insulation (� / Drywall Nailing 7Q ga Y / /Cr /e caz c/ / r- 4) /Y0 f p S Firewall �(/ Fire Sprinkler Fire Alarm / J”— 4 .S Susp'd Ceiling � / g 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 joecc ART FAIL - ELECTRICA Service Rough In UG /Slab Low Voltage Fire Alarm SS PART FAIL Sift 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 / 0 3 --e9c Inspector Other P Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION citio 00 3 (Lot, 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP % Date Requested V 3/6 d AM PM BLD . I . Location k 1 L 0 sAAnn C,✓ T \ • Su MEC W Contact Person Ph PLM Contractor Ph SWR UI _ Tenant/Owner ELC 0 0 t° 44 Retaining Wall ELR A Footing Access: I%ipr Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear EV � .4� — 0 „ �, i L d V,' 06 6-p.) Framing V `Y"j �" 4- 1 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: PART FAIL • II ' BING 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 Final PASS 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 c II for reinspection RE: [ ] Unable to inspect - no access ADA \ Approach /Sidewalk G Other Date Inspector Ext --. Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.