Permit CITY OF TIGARD
rP. DEVELOPMENT SERVICES ELECTRICAL PERMIT
iu,:�'NKr
PERMIT #: ELC97 -0023
L. 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 01/17/97
PARCEL: 2S111CA -02500
SITE ADDRESS...: 15433 SW SUMMERFIELD LN
SUBDIVISION....: SUMMERFIELD NO.7 ZONING:R -7
BLOCK LOT • 328
Project Description: INSTL 1 BRANCH CIRCUIT
1/17/97 -added 1 branch circuit to this permit perm
- -- 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.: 2 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
VIRGIL BROWN type amount by date recpt
15433 SW SUMMERFIELD LN PRMT $ 35.00 TAT 01/15/97 97- 288918
SPCT $ 1.75 TAT 01/15/97 97- 288918
TIGARG OR 97224 PRMT $ 35.00 TAT 01/17/97 97- 289083
Phone #: SPCT $ 1.75 TAT 01/17/97 97- 289083
Contractor:
WESTSIDE ELECTRIC $ 73.50 TOTAL
7518 SW MACADAM AVE
REG!U I RED INSPECTIONS
PORTLAND OR 97219 Ceiling Cover Underground Cove
Phone #: 503- 245 -3385 Wall Cover Elect' 1 Service
Reg #..: 000133
This persit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This persit will expire if work is not started
within 180 days of issuance, or if work is suspended for sore
than 180 days. Issued By
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: DATE:
LICENSE NO:
Call for inspection,- 639 -4175
01 -17 -97 11:39AM FROM WEST SIDE ELECTRIC P02
I '� .
r / 4 / /
Community Development ELECTRICAL PERMIT APPLICATION
A 13125 SW Hall Blvd.
^
Tigard, OR 97223 Perm, # C -( CQ 7 .. , ,
Date' Issued //
t ii Phone (503) 639 -4171
CITY P TIOORD -_ • .. .. FAX (503) 694-7297'
IDs:) No. (503).13914 - 2772. * .
Inspection (503) 839-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development J�/ Number Of Inspections per permit allowed
Address ice/...r.3 S/rl .,fuo n .o/ ERY l ..t.. service Included; Items Cost(aa) Sum
CitylStatelZlp Ti Dte.1 _0/ 972 / 4a. Residential - per unit
/1 / j / � 1000 sq. ft. or bee 1110.00 4
Name (or name of business) __My ► U (#4 al 600 aq• R• or
r-,_� portion thereof • $26.00 1
Commercial ❑ • Residential '2" .....-
Limited Energy - .. •
Each Manure Here or Mo
Dwelling Sauce or feeder 1168.00 2
2a. Contractor installation only:
4b. ServIces of Feeders
installation,.I(eredoe. orrebe.tlon
Electrical Contract - r �� era. $ 80 . 00 2
Address ' • 1 J / f / u 201 amp' to 400 amps seam City i -' � State #Y Zip 1 7k 401 singe to 600 amps 5180.00 2
601 amps to 1000 amps
Phone No. % • over loco amps ervolta Odom 2
Job NO. /13- ! ?/Z Reconnect only 650'00 2
contractor's license NO. 7 4- / 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 6 Installation, alteration, or relocation
Signature of Supr. Eisen 200 amps wen 2
Li No._ /.i' f 5 hone No._ P' /l -fr 201 amps to400ems , 660.00 2. .
401 amp' to 600 amps $75.00
_ �j r /��/��� }� /�� /� Over 600 amps to 1000 volts $100.00
.y -2b
. . o eetner..l r �l1a t Qns:.. .... .. _..... . y .- 7 ...,4...4....... .._. ._ . _..__....•.. . . _ ...._ . f. .. ...
Print Owner's Name
4d. Drench i nanition or extension per pane
Address e) The fee for branch circuits waft
City ( State Zip E within h circuit m at feeder M. $6.00 2
Phone No. b) The tee for branch ctm & orfroolt
The Installation is being made on property I own which Is pureness of service or feeder fee. 3
Fist branch circuit ;36.00 3 s 3
not Intended for sale, lease or rent. UM additional branch ciroult 35.00
Owner's Signature 4e. Mleeellaneous
(Service or feeder not Included) 2
3. Plan Review section (if required): Earth Pump or irrigation carob i40.00 2
Each sign or outliner Oghling y40.00 3
Signal olrcua(s) er a pinked energy
• Please check appropriate Item and enter fee in section 68. panel, alteration or extension $40.00
4 or more residential units In one structure Mena labels (10) *loom
Service and feeder 225 amps or more .. . • t' ' • ' • • ' Si'vttem Dver'600 volts nominal ' N. Each'etjtl(tidnal' Inspleetlofr ;tor •
Classified area or structure containing special occupancy the allowable In any of the above
as described in N.E.C. Chapter 5 Per Inspection • ' � • Per hour 666.00
• In plena 666.00
Submit 2 Sets of Dian with applieadon where any of the above
apply. Net required for temporary construction services. 5. Fees:
6a. Enter total of above fees $ 3 S. y
N OTICE . .. . . .•∎ - . . • -- •• - 6% Surcharge (.05 X•tote• fees) - • '"--- • 16 ....• f• . .'
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Suer $
AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS, OR IF lib. Enter 2 5l Re vi Ilne A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Revi view If required (Sec.3)
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subfo $
COMMENCED. dW+� Trust Account S 5 11
• 3 • .r. .. ..
• Balance Due - • • $
I . • • .. • • ••• . . . . . •
CITY OF TIGARD
.,i DEVELOPMENT SERVICES ELECTRICAL PERMIT
'� 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT #: E LC97 -0023
DATE ISSUED: 01/15/97
PARCEL: 2S111CA -02500
SITE ADDRESS...: 15433 SW SUMMERFIELD LN
SUBDIVISION • SUMMERFIELD NO.7 ZONING:R -7
BLOCK LOT •328
Project Description: INSTL 1 BRANCH CIRCUIT
--- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS....: 0 0 — 200 : 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/O SRVC OR FDR.: 1 PER HOUR......,....: 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
VIRGIL BROWN type amount by date recpt
15433 SW SUMMERFIELD LN PRMT $ 35.00 TAT 01/15/97 97- 288918
SPCT $ 1.75 TAT 01/15/97 97- 288918
TIGARG OR 97224
Phone #:
Contractor:
WESTSIDE ELECTRIC $ 36.75 TOTAL
7518 SW MACADAM AVE
REQUIRED INSPECTIONS
PORTLAND OR 97219 Ceiling Cover Underground Cove
Phone #: 503 -245 -3385 Wall Cover Elect '1 Service
Reg #..: 13306
This permit is issued subject to the regulations contained in the LYinrA1.P d,
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm • e Si gnat _r
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 ___ . U ,i t .. .
than 180 days. Issued By .
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 : DATE:
LICENSE NO:
Call for inspection.— 639 -4175,
w /I ,
. 4.
r Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. ,
Tigard, OR 97223 Permit # E�/7 7 Z?j
,, l , , Date Issued / �j� y7
./ � I Phone (503) 639 -4171 / /II
_14 FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development / ' Number of Inspections per permit allowed
Address /SY j yt/ J f C/f�l /hQ"- lie /eL od.,_ Service included: Items Cost(ea) Sum
City /State /Zip / / 9Ct,� c2 97 y 4a. Residential - per unit 4
i / , 1000 sq. ft. or less $110.00
Name (or name of business) Ud/y / 41 /1 K:// Each additional 500 sq. ft. or
portion thereof $25.00
• Commercial ❑ Residential Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
� 4b. Services or Feeders
Electrical Contractor P / CJt � / Installation, alteration, or relocation $60.00 2
� 200 amps or less
Address : V#QC ',, A 201 amps to 400 amps $80.00 2
401 am to 600 amps $120.00 2
City 1i,� State Itlf Zip C/72�1' $180.00 2
601 amps to 1000 amps
Phone No. Z yr- Jr! Over 1000 amps or volts $340.00 2
Job N O . / / 3- (9/ 2 Reconnect only $50.00 2
contractor's license NO. 2 6 - % 4c. Temporary Services or Feeders
Contractor's Board Reg. No. t �(^, Installation, alteration, or relocation
Signature of Supr. Elec'n 200 amps or less 2
License No. /1 one No. Z yi --4 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane .
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
E
not intended for sale, lease or rent.
First
c h a additionaal l bddch nbrr I $$5.00 3
Each circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
-
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $38.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $,:
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subto $
COMMENCED. wordlc °maMNeo- Trust Account # 3_12_-----
prm.epp
Balance Due $
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
OP
Date Requested: I 4 A.M. P.M. MST:
Location: / S 4" 33 : ,Q. L ( ) r7 , BUP:
Tenant: . i��Z2u
errant: Smte: Bldg: MEC:
Contractor: /,f) P.(J ,4,.../ �LJ Phone: c: .. ; — iS PLM: -2 - ac^a..1r.4. e-,
Owner: Phone: ELC:r7 O 0 Z,
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling _ Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect t
Bsmt Damp Drywall Storm Furnace Temp S C.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved „. 14* A roved Not Approved
FINAL FINAL FINAL FINAL
A Am-e... e...._ ■ Y Af,
ea.
O Call for rein • - ' • ii e 0 Reinspection f -: of $ required before next inspection O Unable to inspect
Inspector: _ A Date: (o — 3 - 7 g Page of
j