Permit CITY OF TIGARD
ELECTRICAL PERMIT
w � � � , � ; � DEVELOPMENT SERVsCES PERMIT
PARCEL: 1S133AD -12200
SITE ADDRESS...:11329 SW SUMMER LAKE DR
SUBDIVISION -SUMMER LAKE ZONING:R -7
BLOCK LOT •003 JURISDICTION: TIG
Pro.j ect Description : Additional electrical service.
- -- 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 • 1 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 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
ROBERT SMITH & CADELL, SUSAN type amount by date recpt
11329 SW SUMMERLAKE RD PRMT $ 60.00 GEO 09/25/98 98- 309487
TIGARD OR 5PCT $ 3.00 GEO 09/25/98 98- 309487
Phone #:
Contractor:
ROSE CITY ELECTRIC CO INC $ 63.00 TOTAL
4012 NE CULLY BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97213 Rough —in Elect'1 Final
Phone #: 287 -6164 Elect' 1 Service
Reg #.. 000035
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calking ( 46 -1987.
Permittee Signature: 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: fit) 47 - DATE: 9
LICENSE NO: OZ I21
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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A � ' L To
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Community Development ELECTRICAL PERMIT APPLICATION - 1
, A 13125 SW Hall Blvd. �1 /�, OCi ,.�
Tigard, OR 97223 Permit # - "t
,��>r� Da - Issued �LG- - O7i5 -
Phone (503) 639 -4171 RECE V
'` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 FP 2 5 1998
Inspection (503) 639 -4175
1. Job Address: P5u5/r,J CONIV DIEI Om p lete Fee Schedule Below:
Name of Development aeLL I 1 1 Number of Inspections per permit allowed
Itb SuJSumr� � ' II
Address • Service included: Items Cost(ea) Sum
City /State /Zip l 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
$25.00 Name (or name of usi SS) Each additional 500 sq ft. or
portion thereof $25 00 1
Commercial ❑ Residential - Limited Energy
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation j / o ^
Electrical C ntrac or 4 A � � 20 0 amps or less { $60 00 C 2
Address * „_r 1 '' � r�l♦. 201 amps to 400 amps $80.00 2
City Stat -- • 4111 401 amps to 600 amps $120.00 2
�
1 601 amps to 1000 amps $180.00 2
Phone No. ,l CO 1 Co Over 1000 amps or volts $340.00 2
Job NO. y (� J Reconnect only $50 00 2
contractors license NO. ,..-L_ - I I 4c. Temporary Services or Feeders
Contractor's Board Re• . No. �. Installation, alteration, or relocation
Signature of S p . Elec' _ i / ' 200 amps or less 2
J 2
Lice Phone N • / `I 201 amps to 400 amps $50.00
401 amps to 600 amps $75.00
/ 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 $35.00
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: oo v
5a. Enter total of above fees $ 3
NOTICE 5% Surcharge (.05 X total fees) $ co
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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 ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wo,e omdeNdec- ❑ Trust Account #
$
prm app
Balance Due $
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST il►_
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested '2/'? ! /cv AM PM BLD %IMIMP
Location i i ;Z I 5Ll.rn miA ( ark, Suite MEC
Contact Person Ph PLM
Contracto Ph SWR
ILDI Tenant/Owner . S—co S / �
� J
aining Wall f7 S4 I In . L _co3 /A
Footing v
Foundation ! NOT REQUESTED � re tX"4-44 _ FPS
Ftg Cr awl Drain I Drain F OUND DURING RESEARCH — SGN
Cr
Slab _ NO INSPECTION(S) FOUND IN FILE rJ Ipp 112 /7./4
7 '/ 4 — SIT
Post & Beam •� ,� f � i
Ext Sheath /Shear X "�` 1 '!V""" " ' � � • � O 6 -/A
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
• AS • 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
E
Service
Rough In
UG /Slab
Low Voltage
giarm
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 reinspe ion RE: [ ] Unable to inspect - no access
ADA 00 Approach /Sidewalk Date 0 0 Inspector s Ext
Other
Final
PASS PART FAIL DO NOT R MOVE this inspection record from the job site.
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7
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST A.
BUP l
?1 / t037 Date Requested D "ga — q8 X PM BLD
Location f 13 2--9 •Q.,h,Q i Suite MEC
Contact Person 944V/V "� Ph 701- 355 PLM
Contractor 1?A2 flt Q/?. 2 t 7i1Qt7 O Y.. J Ph 655-08 /5 SWR
BUILDING Tenant/Owner c P r y /Re E 422 0C1 8 -0567 _
Retaining Wall EER G(G 99 —D5g5
Footing Access: C07A ( ,( -yam � ,
•
' �
Foundation ���"�" U FPS
Ftg Drain 6.04 LL 91) o , iNA P�/I4EG� /F(. Gc4uP SGN
Crawl Drain Inspec'fion Notes:
Slab SIT
Post h Beam . A I ,� , ► (C t2 � r g` , on - C _ \i/Cr f3TA41 N ED
Ext Sheath /Shear �,�N T I GF-�
Int Sheath /Shear � !,� of 4 . P 1D Cr I
Framing nV�u t'1w "\ I
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling P r //I p Q J�'$ 9-z4-- 7 C
e
Roof
Misc:
Final
PASS PART FAIL
PLUMBING ( / /
Post & Beam v
Under Slab
Top Out
Water Service
Sanitary Sewer n �?
Rain Drains 6j „ Or) 'Z - 2 9 zs C(, —
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CECTR ETA catee
o 7S n
l�G7Slab
Low Voltage het w,
Fire Alarm
�Finaf� 0
PASS PAR FAIL
SITE
BackfilUGrading
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 JJ /
Approach /Sidewalk
Other Date / < ' 9 Inspector p Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.