Permit CITY OF TIGARD ELECTRICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: ELC98 -0394
� I 13125 SW HaII Blvd., Tigard, OR 97223 503 639.4171 DATE ISSUED: 07 / 16 / 98
PARCEL: 1S133DA -01400
SITE ADDRESS...:11O95 SW SUMMER LAKE DR
SUBDIVISION •AMART SUMMERLAKE ZONING:R -7
BLOCK • LOT •036 JURISDICTION: TIG
Project Description: Installing two branch circuits. Job No. 85475.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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: 1 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
BOB MILLER type amount by date recpt
11095 SW SUMMER LAKE DR PRMT $ 40.00 DEB 07/16/98 98- 307396
TIGARD OR 97223 5PCT $ 2.00 DEB 07/16/98 98- 307396
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 42.00 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Rough —in Elect'1 Final
Phone #: 234 -9900 Elect'1 Service
Reg #..: 203
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 rules are set forth in OAR 952- %1401'. . OAR 952-1-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
•
Permittee Signature: t Issued B- #4 /
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 : • AOO i f P ' l atl 4-- v`•• DATE: 7- t 1 -QO
p
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
If, .
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. LC�g �D 29
Tigard, OR 972�paCE1VED Permit # C / J
, �. , + 1 . Date Issued ").-/&
eel � Phone (503) 639
h1 Phone 1 6 199E
CITY OF TIGARD FAX (503) 684 -797'
TDD No. (503) 684-2 pEVEIOPi
Inspection (503)C6
1. Job Address: Q ry�� 4. Complete Fee Schedule Below:
,
Name of Development LY �r�ILC('( � -i. ) Number of Inspections per permit allowed
Address /t / 15 l.J D d o/7.. -fce Service included: Items Cost(ea) Sum
City /State /Zip c)C � I , og, 77a 9,3 4a. Residential - per unit
/� 1000 sq. ft. or less $110.00 4
Name (or name of business) b14 *2( Each additional 500 sq. ft. or
((�� portion thereof $25.00
ICI
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
Installation, alteration, or relocation
Electrical Contractor eke .P_
1v C_/ te, 01. I 200 amps or less $60.00 2
Address 4 , S -, • ' 2
i 201 amps to 400 amps $80.00
Cit y ,041 JP. 2
4 01 amps to 600 amps $120.00
tate D� Zip 9 7/ a 3 601 amps to 1000 amps $180.00 2
Phone No.__ lt 4 t ? - 0 7g Over 1000 amps or volts $340.00 2
Job NO. __ I .$ 7") Reconnect only $50.00 2
contractor's Ir sense NO. 46 - f6 -C, 4c. Temporary Services or Feeders
Contractor's Board Reg. No f „, - / ,� Installation, alteration, or relocation 2
A`
Signature of Supr. Elec'n I//�.17"v. iI 200 amps or less 2
License No. /3O A 3 Phone No._(r,ceg--O735E 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00
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 withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
Each a
not intended for sale, lease or rent. Eact addch c dditional abr brt anch circuit / $5.00 ; 5, $$5.00 5 . i0
l (ti
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 $35.00
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 $ `{Q. 6
NOTICE 5% Surcharge (.05 X total fees) $ ,j, (/d
•
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordlcmndeNeleo- ❑ Trust Account #
prm.app
Balance Due $ 4-R.60
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST •
24- . our Inspection Line: 639 -4175 Business Line: 639 -4171 ����
oZ2 `7 � AM �� � PM D
I/ I
BU
Date Requested f� � -r BUD
Locati n �5 95 � /il &/ /
l ,..& Lille MEC
Contact Person Ph 6 V -CV / PLM
Contractor OE- etigc-r6itoge Ph SWR
BUILDING Tenant/Owner CO 7 f - 0 39 V
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab - C /..e_- , SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing M I G YD wcr ✓e, C/ )"C"V t
Firewall J C C
Fire Sprinkler �f �„ £ - q - 03 9 / S S
Fire Alarm
... --)
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL 1 �
PLUMBING � P GK ,Q a Q rJ / S �4 0 O/ N � , 2Y)v1 P S
Post & Beam
Under Slab EQ, b P Y.9 D 7,1 2. 1 < 4 y) i
Top Out
Water Service d v a h v Q ,rte / As () 11 i L A /-S / UCd Y S' r
Sanitary Sewer /
Rain Drains
Final _ r I
PASS PART FAIL M(' / R /4 D 04 P ee) w,i e r - a yj�Y sch r? d ✓ /°e
MECHANICAL /
Post & Beam d 1 4. Spec � ) v 4 s "—
Rough In
Gas Line / J
Smoke Dampers TA e_ 1.1./n r 4 / S / I/1 C a rn / 0/ /4YICto LU i! )i CD c/Q I
Final / L -. /
SAS FAIL CD r, /c1 � ��P be e✓) CIO n (>k? clPY YYi Y .4 cr lit° /S,
/_ L
e •
Rough In C/ nll / a
UG /Slab (� - 7 b 7 C4Sn �) NG / �7 '.�9 C 1 41 J
Low Voltage
Fire Alarm _ 9L 6 / L _( 1) D P /14C /) ?.
Final
CPASS) 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 call for reinspection RE: [ ] Unable to inspect - no access
ADA �/
p
Approach /Sidewalk
Other Date ID ---L 6 " q Inspector Ext4 AS
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.