Permit 4 4,, , ;, CITY O F TIGARD. ELECTRICAL PERMIT
PERMIT #: ELC2000 -00517
,11 DEVELOPMENT SERVICES DATE ISSUED: 10/26/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CA -05100
SITE ADDRESS: 11510 SW TERRACE TRAILS DR
SUBDIVISION: TERRACE TRAILS ZONING: R-4.5
BLOCK: LOT : 001 JURISDICTION: TIG
Proiect Description: Installation of 2 branch circuits.
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 HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 0 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:
TAYLOR, CALVIN S JR/FRANCINE D OWNER
11510 SW TERRACE TRAILS DR
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 8/29/00 $42.85 2720000000( Elect'l Final
5PCT CTR 8/29/00 $3.43 2720000000(
Total $46.28
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 C,� 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 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Plan Check #
13125'ZW HALL BLVD. Electrical Permit Application
Recd By
TIGARD OR 97223 Date Recd g Z 7 -0 C- )
Date to P.E.
Phone (503) 6394171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit #FZG2 - ! 7
Fax (503) 598 - 1960 • Incomplete or illegible will not be accepted Called AO - >'3 - 9u
1 0,40..e__ / d6Fvc,r.-
1. Job Address: • 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) ^ 1 Service included: Items Cost Sum
1 t>
Address 1IG S'- R o c..c " tca :LS 'C- 4a. Residential - per unit
�1 � gr�2Z3 1000 sq. ft. or less $ 117.75 4
City/State/Zip T «tom O Each additional 500 sq. ft. or
Commercial 1:1 Residential ®-
portion thereof $ 26.75 1
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 A cL � -Tx9' . 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
^ feeder fee.
Print Owner's Name Ca ` V :ti S • - �I O,n/ Each branch circuit ( . $ 5.35 S, 3-S 2
/
b) The fee for branch circuits
Address 10310 S t3 L c.a_ I cc-Ac, N. r. )
without purchase of service
City - 1":, c., r-S) State c &_Zip Qi'7L or feeder fee.
Phone No. i:5 c.)�1 -- 1 - i - 2_, - lob3 Cc.4U) First branch circuit ( $ 37.50 37S
CS'v3o c31-7115 (fir. -e) 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 _ , - j Each sign or outline lighting $ 42.75 -
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( 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: l `/
5a. Enter total of above fees Ir • $ Z ' e
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) �m t1 $ _$F5
Not required for temporary construction services. Subtotal I) $
• 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 $ L i ( /
D . 2 6
is \dsts \forms \elcctric.doc
.C!,TY OF TIGARD BUILT INS INSPECTION DIVISION I
MST
. "24 -:;our Insp€ctioritine: 639 -4175 Business Line: 639 -4171 •
BUP
Date Requested 9 I r1�er) S AM PM BLD
Location 1/ 5 / 0 5 W / 4 7�i %%uite MEC
Contact Person Ph PLM
Contractor -• Ph SWR
BUILDING Tenant/Owner ( — 77 - 9"/401 1 41§20c0- CEOS?
Retaining g Wall ELR
Footing ":,,'S': ,: �al7.f 'Lea - ' 1 ?14: -. '.'` � �� ;.1^": "-' :,
Foundation rte 4•;, Y "� ',- �� ,,` Y .�, ;. " 1, • � 1 's5 .; ' . '';, . FPS
..1tt' �; ` t�i s7 <<�'f✓ ��y'_ ;, 1tr.,. -b
Ftg Drain = c�,,�_. ._. Scs � : . ` -� : . _`''1� �.. .:.� - ' o.v�• �`1;: - .IL:.._�_r t} �� ::N
Crawl Drain iftSpe • ion Noteq:
Slab (--- - 0 a,5- / toRe i3Y / i rV'r
4 4
Ext Sheath/Shear // f t`vUT • /� ery/1'�k ' S
•
Ina Sheath /Shear . �� ( !t/ //,e rel 1 ,9 E . Framing _ l L
Insulation _ - .
Drywall Nailing V
Firewall -
Fire Sprinkler .. • • .• V • -.
Fire Alarm V
Susp'd Ceiling _ V
Roof •
Final O A ` �
PASS PART FAIL D' ` �'� e . - 144
PLUMBING A • - A. ,� dY 4 ,
Post & Beam -
Under Slab O w e-e-c 4 O l.LT ' e - 4r'Z-
c.. ( . 7
Top Out
Water Service _ _ _ _ . J i/, lK..41 o ' �i� -
Sanitary Sewer - V V
Rain Drains /1/ r2 / C
Final / /. . _ -74N / •
PASS. PART FAIL _ / ��
MECHANICAL I
Post & Beam Ayr u • m� C /
Rough In • „ . aer_0, ---SP r�C •
Gas Line
Smoke Dampers
F AS
PASS PART F •• L �� -
ELECTRICAL . •
.
ervice .
:• -
UG ab
Low Voltage - • • V .
Fire Alarm
Final
PASS PART AIL
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 /)
Other Approach/Sidewalk Date g/' /ci v Inspector 6, ,, .t ��C_ ' . Ext
Other
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. .
CITY OF TIGARD
24 -Hour �.
BUILDING (, Inspection Line: (503) 639 -4175 . .
INSPECTION DIVISION Busin - ss Line: (503) 639 -4171 MST
/ 2 , t BUP
Received Date Requested ,,�� PM BUP
//��
Location O _ S / .l L� - ;' Ar� its MEC
Contact Person — Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4A "' D/ 3 32 — / 663 ELC ° ) 1 ) 7 7
Footing
ELC
Foundation Access.
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _ •
Int Sheath/Shear
Framing 1
Insulation 1 , ROM/ + v C VE M.\ 1 A
° "Vc5 \ 1
Drywall Nailing
Firewall 4 01 C Q V �\,` 10 C �j mil) 1'N ( ?O D W
Fire Sprinkler ` ```` W O . � ,, `
Fire Alarm v qx Q \A T? 1 \ t \ 41 \LALK , 41 D 1
Susp'd Ceiling r –o \
Roof
Other: j� \ l �� n1 ,C '�
Final 3 • � V �1 vii ‘ 1 �`'�� ` �TIL G 1 1 \. i 1 \
PASS PART FAIL J `'
PLUMBING ' r `� 1) � K) \i1/4)\ ` \ 1 / ro F0,
Post & Beam �I UI R_ � � Q %0V-1 � 1 V 1—N-LU 1 / O 'PD 0
Under Slab
Rough -In � *� �) \'��i \ LC ( ,/
Water Service a '0 Y \ -!J'b. G. / Y \) 1 1V U— CJ� C� �) N V �t 3 P1 a \V e
Sanitary Sewer 1tDO C\ (W.9 \N \` Jlc (1 \ ,. ) 1 . v c O \I
Rain Drains \\ 6 1� J ) l�
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
IL
ECTRICAL
- ough -In
- ..
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date/ - 2-- loop() 'or r � + fr ' Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 ,
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested Z — Z b AM PM BUP
Location 1 / /cit. Suite A-• MEC
Contact Person ( Ph ( ) - 71Y c l PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 2 O c-e)-S / 7
Footing
Foundation ELC
Access:
Ftg Drain ELR 1
Crawl Drain 507
Slab Inspection Notes: 6 ,,, _ SIT . �
Post & Beam (.� C�(J m
�
Ext Shear Sheath/Shear Anchors - � ,ter 1 Ext eah/h �Vl/I - ... �
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall I� 1 Vf
Fire Sprinkler t
Fire Alarm
Susp'd Ceiling
Roof C -C)cA \01 \� �Qi� C0-14
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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,_ larm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date U � - Inspect �� Chi Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL