Permit cy OF TIGARD ELECTRICAL PERMIT
��E��U�U��U���U���~���U�R��U��U��� PERMIT #: ELC97-0292
14/ 13125 SN/���v��auiOR97�0��)�9�/7/ DATE ISSUED: 05/23/97
��������������� PARCEL: 15133DC-18000
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SITE ADDRESS...:13134 SW TAMERA LN
SUBDIVISION....:VILLAGE AT SUMMER LAKE PARK ZONING:R-12
BLOCK ^ LOT.............:35 JURISDICTION: TIG
Project Description: instl 1 branch circuit // joh # ?
_
---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/ 8VC/FDR. . : 0 601+amps-1000 volts.: 0 MINOR LABEL (10). . . : 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADDvL 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 --------
WAYMAN NORDSTROM type amount by date recpt
13134 SW TAMERA LN PRMT $ 35.00 TAT 05/22/97 97-294956
TIGARD OR 97223 5PCT $ 1.75 TAT 05/22/97 97-294956
Phone #:
Contractor: — — — — —
JPC ELECTRICAL SERVICES INC $ 36.75 TOTAL
4040 SE INTERNATIONAL WAY
------- REQUIRED INSPECTIONS
MILWAUKIE OR 97222 Ceiling Cover Underground Cove
Phone #: 654-3325 Wall Cover Elect'l Service
Reg #..: 000937
This permit is issued subject to the regulations contained in the ^~~~ 1 /
Tigard Municipal Code, State of Ore. Specialty Codes and all other Pe ignatur'
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 " AA/ a—, 1 , L^ ^.IIK
than 18N days. Iss ed By `nr
----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: 5— 73^-��
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LICENSE NO: ^f��»���
Call for inspection — 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
--1 Tigard, OR 97223 Planck/Rec. #
rn Permit # LLCg7. D 9-
/ 11' I�j`\
73 Phone (503) 639 -4171 Date Issued / Zl�
` n -' �+` FAX (503) 684 -7297 Issued by ��
. ITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development j Number of Inspections per permit allowed
Address /3i 3 5 r *Tamer 0 L V Service included: Items Cost(ea) Sum
City/State/Zip 1 1 l�C,/ , V/2 ''74?.3 4a. Residential - per unit 4
/,/ ��,� n,�,,,,/ 1000 sq. It or less $110.00
Name (or name of business) �(,(, '0 JYUf�F:( -I'� 1l Each additional l 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residentia igl Limited Energy $25.00 2
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
I nstallation, alteration, or relocation 2
Electrical Contractor, l PC E I e e- r
• Cal l S t v' i Ce5 200 amps or less $60.00 2
.
AddressA4 I ) S E t�ir,rfnfli c.) no 1 t,vCA ' ik!} Id"I 201 amps to 400 amps $80.00 2
City r ; l f, xtQ 1\e- State b Zip 1,� �� 401 amps to 600 amps $120.00
p 1
601 amps l0 1000 amps $180.00 2
Phone No. to '5 '3 D. J Over 1000 amps or volts $340.00 2
Contractor's License No. 34 - 310- (, Reconnect only $50.00
Contractor's Board Reg. No. ()Ci 3 4c. Temporary Services or Feeders
/ j:� Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less $50.00 2
License No. I, S /hone No.. . ` . 201 amps to 400 am $75.00
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
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. < U 0 2
not intended for sale, lease or rent. First branch circuit $5.00 3�: 2
$
Each additional branch 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 $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:
NOTICE
5a. Enter total of above fees $ 35 ,c
5% Surcharge (.05 X total fees) $ i
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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 Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ _3
wad‘comdaNaWcpm.app
r CITY OF TIGARD BUILDING INSPECTION DIVISION
,I 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: - ` 0`5 kl A.M. P.M. MST:
Location: 1 3 (3 I ,211,.e.,.._: BUR:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: / L
�`7 -- � PLM:
Owner: Phone: ELC: / 7 cd-,,D,
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 Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved , . :. Approved
Appr /Sdwlk Not Approved Not Approved Not Approved of A.'roved Not Approved
FINAL FINAL FINAL - LN .1 w FINAL
Aro Ogg /JoME
7 M c 10 ,' 3 a 7 -,z_5'- ? 7
EXPIRED
Call for reinspectio II R einspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: 2 ` A(...4
V — [ / Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ,, AM PM BLD
(
Location 1 31 1 �G e( L Lir) Suite MEC
Contact Person Ph PLM
Contractor . J /� C, A.r,C',Ph (S —332-5 SWR
BUILDING Tenant/Owner 1 p✓4-",/ p\/OL'1 (Trio4 EEO s r?'OO2 9 �
Retaining Wall ELR
Footing A
Foundation NOT REQUESTED FPS
Ftg Drain
Crawl Drain I FOUND DURING RESEARCH DtrZi SGN
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam l /' �
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof of EXPIRED
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
PASS PART FAIL
Service
Rough In UG /Slab Low Voltage �.:.
',Fire Alarm .
-S 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
Approach /Sidewalk
Other Date VS/en) Inspector ✓ A°°
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.