Permit ELECTRICAL PERMIT •
~ ' OF TIGARD PERMIT #: ELC96-0426
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/01/96
1o125ow Hall Blvd. Tigard, Oregon e7ee3°8199 (503) e39-4171
PARCEL: 2S103CD-04700
SITE ADDRESS...: 11645 SW TERRACE TRAILS DR
SUBDIVISION ^ TERRACE TRAILS ZONlNG:R-4.5
BLOCK ^ LOT ^15
Project Description: Installing two branch circuits.
___
---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/O 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 --- ---
WAYNE SEDGWICK type amount by date recpt
11645 SW TERRACE TRIALS DR PRMT $ 40.00 CJS 07/01/96 96-281201
5PCT $ 2.00 CJS 07/01/96 96-281201
TIGARD OR 97223
Phone #: 503-620-9694
Contractor: --- - - - ----
ATLAS ELECTRICAL $ 42.00 TOTAL
4403 SE ROETHE
• REQUIRED INSPECTIONS --
MILWAUKIE OR 97267 Wall Cover Elect'l Final
Phone #: 503-659-2212 Elect'l Service
Reg #..: 1532 •
This permit 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 p\ans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for oore
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: rna/)r"'4 DATE: 7
LICENSE NO: ________ _
Call for inspection - 639-4175
•
• T . Community Development ELECTRICAL PERMIT APPLICATION
t% 13125 SW Hall Blvd. .
1 ( Tigard, OR 97223. Planck/Rec. # q6- a a,o f
• . Permit '# ELC96 O BI,A
�!�" � ' A . e ■ Ph one ( 50 3) 639 -4171
A- -! J. FAX (50 684 - 41 7 - Date Issued 7- /- 96
CITY OF TIGARD TDD No. (503) 684 -2772 ISSUed by C/i a tits S.
Inspection (503) 639 -4175 . . -
i . ,, 1. Job Address:. - - ' . 4. Complete Fee Schedule Below:
Name of Development Wayne Sedgwick 'Residence - Number of Inspections per permit allowed
Address 11645 SW Terrace .Trail Drive Service included: Items Cost(ea) Sum
City /State/Zip Tigard, Oregon 97223 4a. Residential - per unit 4
1 000 sq. ft: or less $110.00
Name (or name of business) Wayne Sedawick Each additional 500 sq. ft. o r 1
portion thereof $25.00
Commercial ❑ • Residential ® Limited Energy _ $25.00
Each 'Manuf d Home or-Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor Atlas Electrical 200 amps or less $60.00 . .
Address 4403 SE Roethe Road . ' 201 amps to 400 amps $60.00 2
M ilwaukie O Zip 9 7223 • 401 amps to 600 amps $120.00 2
City S tat e p 601 amps to 1000 amps . $180.00 2
/Phone No.. 659 -2212
O ver 1000 amps or volts $340.00 2
i Contractor's License No. 3 -2C Reconnect only $50.00 -
COntractor'S Board Reg'. -No. 1532 4c. Temporary Services or Feeders .
g Sup r. Jti id I nstallation, ateralion, or relocation 2
Signature of Su r. Elec'n • (�JA' � 200 amps or less . , $50.00' 2
. License No. 2581S - Phone No. 659 -2212 201 amps to 400 amps , $75.00 2
401 amps to 600 amps $100.00 •
Over,600 amps to 1000 volts
2b. Fo owner install see 'b' above. . .
Print Owner's Name - 4d. Branch Circuits '
New, alteration or extension per panel •
Address a) The fee for branch circuits with • ,
City .: State Zip - . - Purchase of service or feeder tee. 2
• Each branch circuit $5.00
.3 , • Phone No. b) The tee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. ' . 2
not intended for sale, lease or rent. r , _ First branch circuit 1 ' $3 35.00 1
Each additional branch circuit $5.00 9 _ nn
• Owner's Signature , 4e. Miscellaneous
•
- (Service or feeder not included) 2 ,
3. Pl 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 $4o.0o
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
•
Iri Plant $55.00
Submit 2 sets of plans with application where - any of the'above
apply'. Not required for temporary co nstruction services. . 5. Fee • NOTICE • ' 5a. Enter total of above 'fees $ '40.00 ,
5% Surcharge (.05 „X total fees) , ' $ 2 no
' PERMITS, BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 42,00
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 ANYTIME AFTER WORK IS Subtotal $
COMMENCED. ' ❑ Tr ust Account # $ , •
• Balance Due ' • ' • " • $ 42.00
Wed `tomdo •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
c BUP
/ /� Datte Requested / 2 5 K/ AM X - P BLD
/6 C
Location / 7 $ cid ejf ' / `
f �Qr Suite MEC
Contact Person l�ec y� SP� yi,d r _ Ph co 2 - 97 9' PLM
Contractor / / Ph SWR /
BUILDING Tenant/Owner ELC g6,-D1.-/, G j
Retaining Wall ELR
Footing Access: r
Foundation Z � J FPS
Ftg Drain ret _let �- �� 'r'rZr(.t,C�CXJ SGN
Crawl Drain Inspection Notes:
Slab
•
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing -.
Insulation
Drywall Nailing 1-4--.(L., — 1 4-L -I
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
i
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 C 7 W./ 9 q Inspector /42„ Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.