Permit `< �. ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2000 -00362
tfr;i‘ DEVELOPMENT SERVICES DATE ISSUED: 06/30/2000
=-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S105DD -01300
SITE ADDRESS: 14885 SW SUNRISE LN
SUBDIVISION: ZONING: R -7
BLOCK: LOT : JURISDICTION: URB
Project Description: One Brance Circuit
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 HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 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:
CASH, DWIGHT C PAULA L SHARPE ELECTRIC INC
14885 SW SUNRISE LN 22605 SW RIGGS
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt
PRM3. JMT 06/30/200C $37.50 0003402
5PC2 JMT 06/30/200C $3.00 0003402
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR. Speaalty 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 c9 ISSUED BY: C
1 U �
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
.pITY0'6f TIGARD Electrical Permit Application Recd By
13125 SW HALL BLVD. Rec'd By O / • ' ' iv
TIGARD OR 97223 Date Re4 '/ 7 - 0
Phone (503) 639 -4171, x304 ' Date to P.E.
(/{ A Date to DST
Inspection (503) 639 -4175 Print of Type Permit# e...2Q'dt7 - GYM
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of busin c Service included: Items Cost Sum 4 '
Address / y 8 W �J set S-e 4a. Residential - per unit
`�
City /State /Zip 1000 sq. ft. or less $ 117.75 4
��01
Each additional 500 sq ft. or
portion thereof $ 26.25 1
Commercial ❑ Residential 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 provid> contractor license 4b. Services or Feeders
information for COT data • , - :). Installation, alteration, or relocation
Electrical Co tractor i iL ' A / ; _ IC- 200 amps or less $ 64.25 2
201 amps to 400 amps $ 85.50 2
. • 401 amps to 600 amps $ 128.50 2
City / , • , . State Zip 4/00 601 amps to 1000 amps $ 192.50 2
Phone No. rj Y 3. - ?q3 ? Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No.. - . '7 Exp.Date I ° ,06 4c. Temporary Services or Feeders
OR State CCB Reg. No. . WV Exp. Date Installation, alteration, or relocation
COT Business Tax or Metro �� o Exp.Date /-1)/ 200 amps or less $ 53.50 2
// 201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec' >.i / / A, /_ -1 O 600 amps to 1000 volts,
see "b" above.
License No. 4.33 4d. 5 Exp.Date /0-/`61
Phone No. Y -5 S'7 l 7 4d. Branch Circuits
ar 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 Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee. r� 5�
Phone No. First branch circuit 1 $ 37.50
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 Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 107.00
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
Service and feeder 225 amps or more Per inspection $ 50.00
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.0 Chapter 5 5. Fees:
5a. Enter al of above fees $ 3 t 02 al
* Submit 2 sets of plans with application where any of the above apply. ° urcharge (.05 X total fees) S f $ �;i'
Not required for temporary construction services. Subtotal $
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 $
is \dsts \forms \electric.doc y/) _ v
.(--------?6
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171
1 /5 2 - W Date Requested 7-goo AM PM BLD War
Location 5 Lf v l4' 15-P Li Suite MEC ✓. a i 0 21/
Contact Person l'/ V6011 t f — CI 1. Ph 5 91) .F/ PLM _Gr_a __S
Contractor Ph SWR
BUILDING Tenant/Owner ELC -00 34
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: // /,
Slab V v alyetA, /e0o/
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
LUM
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
ter.,•;::_
1'!V% PART FAIL
•AL
Po :eam
Ro In
Smoke Dampers
i PART FAIL y�
Service
Rough In
UG /Slab
Low Voltage e'N
Fire Alarm
IL 0
r e.
A 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk 13 //�
Other Dat Ins c�9 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.