Permit 4: CITY OF TIGARD ELECTRICAL PERMIT
PERMIT n: ELC98 -0567
'APV0h,i DEVELOPMENT SERV6C DATE ISSUED 2+9/21/98
13125 SW PARCEL: 18133AD -12200
SITE ADDRESS, ..:11329 SW SUMMER LAKE DR
SUBDIVISION.,.. :SUMMER LAKE ZONING :R -7
BLOCK........... LOT ....... . ..... :003 JURISDICTION: TIG
Project Description: Electrical addition
•---- RESIDENTIAL UNIT - - -- ---TEMP SRVC/FEEDERS---- --MISCELLANEOUS
1000 SF OR LESS....: 0 0 - 200 amp.......: 0 PUMP/IRRIGATION....: 0
EACH ADD'L 5O0SF...: 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 6O1+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
4O1 - 600 amp......: 0 EA ADD' L BRNCH CIRC: 22' IN PLANT...........: 0
601 - 1000 amp.....: 0 PLAN REVIEW SECTION----------------
1000+ amp /volt.....: 0 >_!, RES UNITS......,.. > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC, OCC. :
Owner: - - -- - -- FEES - - --
SUSAN CADEL! type amount by date recpt
11329 SW SUMMERL!4KE RD oRMT �? 135.00 B 09/21/98 98-309308
TIGARD OR 5PCT v 6.75 B 09/21/98 98- 309308
Phone #:
Contractor: --
ROSE CITY ELECTRIC CO INC a 141. 75 TOTAL.
4012 NE CULLY BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97213 Rough -in Elect' 1 Final
Phone #: 287 -6164 Elect' 1 Service
Reg #..: 000035
This percit is issued subject to the regulations contained in the Tigard f.unicipal Code, State of Oregon Specialty Codes and all other
applicable laws. All morli ail! be done in accordance with approvd plans. This percit will expire if tcrlt is not started within 180
days of issuance, or if work is suspended for Dore than 180 days. RTTENTIOI: Cregon Ian; requires you to folio:: the rules adopted by
the Oregon Utility Motification Center. Those rases are set forth in CAR 3552 - 301 -C310 through OAR 952 -Z31 -1987. You Day obtain a copy
of these rules or direct questions to CUM by calling (533)246 -1987.
Permittee SignatureaalA O Tssued
- OWNER INSTALLATION ONLY -- The installation is being made on. property I own which is not in•~ended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE;
- -- - - - - - -- - CONTRACTOR I NSTAALLAT I ON ONLY - -- SIGNATURE OF SUPR. ELEC'N: (( DATE:
LICENSE NO: _
-L + + + + + + ++ + + + + + + + ++ +fi :- +- ++ + +++ + + + + +.:•-} +++++++++++ +++ ++ ++ + + + ++ + ++ + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :0O p.m. for an inspection neec d the net business day
+ ++±+++++--+--- + + ++ ++ +++ + + + +-1 + ++++ + + +Y +• - + +-: ++r +- r++++++ +-- ++ ++ + + + + + + + ++ + + +-r- + + + + + + + ++
1 ,.
, Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. // ,,. r '' Q4 '� ,r
Tigard, OR 97223 Permit # "lv - �t/c 0
s� , l ,� Date Issued c i - 7-.1
e l 1 Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development K Numbe r of Inspections per permit allowed
Address Z• A " Service included. Items Cost(ea) Sum
City /State /Zip / M ' b I 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name usiness) Each additional 500 sq. ft. or
portion thereof $25 00
Commercial ❑ Residential IX Limited Energy $2500 1
- Each Maned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor i I stallation only:
4b. Services or Feeders
/ i C.1 Installation, alteration or relocation
Electrical • in r c `��i � t 1 . `r 200 amps or less $60.0 2
Addr- - -.i�� � 1\_� 1l 201 amps to 400 amps $80 00 2
City UK ,'� 401 amps to 600 amps $120.00 2
_ -
( ^_ Sta i /� p �� $18000 2
601 amps to 1000 amps
Phone No. W Over 1000 amps or volts $340.00 2
Job NO. ,eqco 0
2 Reconnect only $50 00 2
contractor's license NO. _ 4c. Temporary Services or Feeders
Contractor's Board Reg. o. i /4 � Installation, alteration, or relocation
rj �� • =,
Signature of r 200 amps or less 2
- 2
llEle s�►; ._ 201 amps to 400 amps $50 00
License No....-110- • hone N!.. 3a�1 401 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
City State Zip purchase of service or feeder fee. 2
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 I /1 - 00
Owner's Signature 4e. Miscellaneous t �
(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: I
5a. Enter total of above fees $
NOTICE 5% Surcharge (05 X total fees) $ 1 ,
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 wadhc°mdeNeko ❑ Trust Account #
pm we $
Balance Due $ 1411
,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ■ir'
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested a /✓� 0 AM PM BLD
Location 11 32 I 51kl1 Th/4 ( are, Suite MEC
Contact Person Ph PLM
Contracto Ph SWR
ILDI�[ Tenant/Owner
<:4r ??–CO S ? _' • 4
aining Wall ('� >c1 J I J < Lf�[ -c3 (A
Footing �J
Foundation NOT REQUESTED t '- — FPS
Ftg Cr awl Drain Drain FOUND DURING RESEARCH — SGN
Cr I r�f IQ/714
_ NO INSPECTION(S) FOUND IN FILE r/ - / �
Post & Beam
Ext Sheath/Shear q ' 5 ` � / :(09g 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
Fir larm
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 tion RE: [ ] Unable to inspect - no access
ADA �/
Approach /Sidewalk D v n 00
Inspector
Other "� s Ext
Final VVV
PASS PART FAIL DO NOT R MOVE this inspection record from the job site.
,1.
GSQ 2 J ul
vr/ALv
CITY OF TIGARD BUILDING INSPECTION DIVISION
•
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST fl !(p�/)I g.
BUP a
? 1 / t037 Date Requested D "gc; - q8 X PM BLD
Location /13 Zl 11 lL 11 i Suite MEC
Contact Person Ir Ph 701- 3550 PLM
Contractor 1�J�QJYY Q L Ph 655-0815 SWR Q
BUILDING Tenant/Owner Mir FIe
y / CEP/ R- l 1 Q _
Retaining Wall CLR E( _ 1'O - 059
Footing Access: Cur n .t) ,( cte , �, PFEQ FPS
Foundation (J /�,,,��
Ftg Drain C (,0 4110 OL Bt�t P/M EG� CM f et c. h SGN
Crawl Drain Inspection Notes: a_
Slab SIT ' 1
Post & Beam
Ext Sheath/Shear tvbE I PEluul I BY Ofl gs- YET 4 TEt
Int Sheath /Shear f j Q V I ,1 Cr I I P 1DP
Framing t�Iw"\ Iv
Insulation
Drywall Nailing
Firewall
Fire Sprinkler C
Susp Ceiling � P r 1/I p �4 ��'S� C� - 9 - 7 e
Sus 'd Ceilin
Roof
Misc:
Final
PASS PART FAIL
PLUMBING 7 v� v! /
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer n n
Rain Drains Gj ! �, en 7 - —
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
' service
• oug n O V
lab
Low Voltage c_ Y L �n
Fi Alarm /� n/, hy� , � X. n
na re ge 2, v� (
PASS PAR FAIL
SITE
BackfilUGrading
Sanitary Sewer
Storm Drain [ I 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 Date
Approach/Sidewalk )D – „ 2! — 9 Inspector 6.4 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.