Permit CITY OF T PERMIT #A
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/25/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 15133CC -01300
SITE ADDRESS...: 11735 SW TALLWOOD DR
SUBDIVISION • PEBBLECREEK ZONING:R -25
BLOCK LOT •007
Project Description: Installing one branch circuit.
- -- 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.: 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
TAHANNI ALESSA type amount by date recpt
11735 SW TALLWOOD PRMT $ 35.00 CJS 07/25/96 96- 282112
SPCT $ 1.75 CJS 07/25/96 96- 282112
TIGARD OR 97223
Phone #:
Contractor:
GRF ELECTRIC $ 36.75 TOTAL
15460 SE PARADISE LN
REQUIRED INSPECTIONS
MULINO OR 97042 Wall Cover Elect'1 Final
Phone #: 503- 829 -4146 Elect' 1 Service
Reg #.. : 101543
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 plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more Cho -ies e j rr? ,'c/-
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: /)lcc(►ec/ DATE: / o S/46
LICENSE NO:
Call for inspection — 639 -4175
4,
Community Development ELECTRICAL PERMIT APPLICATION
, A
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # E I- )R96 -OyRy
,M1, Date Issued ��ay96
1 i Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: I r 4. Complete Fee Schedule Below:
Name e€- Bevetopment 7 N C, Y1 ✓1 i , V - f $ 4 Number of Inspections per permit allowed
Address / / St.J -/-- 0 g4J1)o0l Service included: Items Cost(ea) Sum
City /State /Zip G faro ? 4 - 22-3 4a. Residential - per unit
J 1000 sq. ft. or less $110.00 4
Name ( ss) 4 - SC 1. Each additional 500 sq. ft. or
V ...... portion thereof $25.00 1 Commercial El Residential Limited Energy $25.00 Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
` Installation, alteration, or relocation 2
Electrical Contractor 1 200 amps or less $60.00 2 2
Address S (� 5, A r ail 4.71-e 201 amps to 400 amps 2
City 1,, � 4 A0 State _ 7jS� IG Zip Cr'1 expz, 401 amps to 600 amps $180.00 2
601 amps to 1000 amps
Phone o. �d 2Q1 1 Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. 9-(p r o 7 4c. Temporary Services or Feeders
Contractor's Board Reg. No. / > f D/ Installation, alteration, or relocation
Signature of Supr. Elec'n (J L 200 amps or less 2
201 amps to 400 amps $50.00 - License No. 3 un _ : o. 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 withou
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. First branch circuit $3s.00
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:
5a. Enter total of above fees / C
NOTICE 5% Surcharge (.05 X total fees) $ 1 '7c
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec.3)
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordkomdeheleo- ❑ Trust Account #
prm.apP $
Balance Due $ --
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location // 7Y3 5 ,t() Tam(t uor)d . Suite MEC
Contact Person Ph PLM
Contractor � 4.F /- / /r . Ph ..373 SWR , /
BUILDING Tenanj ca ner 1/2a.7I/1/ �/ E ELC q , _ /VOP
Retaining Wall ELR
Footing
Foundation AC FPS
Ftg Drain NOZREQUEST_ED -->
Crawl Drain Ins FOUND DURING RESEARCH SGN
Slab NO INSPECTION(s) IN FILE_ SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation - I
Drywall Nailing Ins iv i( one e h Ya vi cA Cr rct J
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /1/0 L _ ' /l eD r C P / /I 1 I h 5 (/`/ Dv.% r &c o) rP c
Roof /
Misc: No S'r° Y' 1iI C' e / h VD / v P CY
Final
PASS PART FAIL /
PLUMBING /4d p)r J h r /YJ.�' o c ivA //� S rr- rJ re cY
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
g
ervi9
Rough In
UG /Slab `
Low Voltage
Fire Alarm
t% PART FAIL
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 q
Approach /Sidewalk Date � � -9 0 Inspector a r-v yYLQl_ E
Other
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing
PIbg.Und /Flr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer J Gas Line Appr /Sdwlk Reins.
Other: U ' -C
Date: U / t 2 _9 Vi Co A.M. / P.M. Entry:
/
Address: / •7 ,35mo L �e�X
Tenant: Ste: MST:
0 � BUP:
/Own: g �✓ MEC:4 D.,),3g
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: �j�J Date: 5-L ?-76
b
_APPROVED _ DISAPPROVE ALL FOR REIN . CF CO