Permit CITY OF T! GARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00511
1 DEVELOPMENT SERVICES DATE ISSUED: 8/19/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134DD-00102
SITE ADDRESS: 10505 SW TIGARD ST
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI
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: 8 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:
DONALD SCHAEFER R C COSTELLO ELECTRICAL
PO BOX 23697 ROGER COSTELLO
TIGARD, OR 97223 1439 SE 17TH LOOP
CAN BY, OR 97013
Phone: Phone: 266 -8483
Reg #: SUP 3834S
LIC 00087402
ELE 3 -344C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT BON 8/19/99 $80.30 99- 317764 Elect'I Final
5PCT BON 8/19/99 $5.62 99- 317764
Total $85.92 o6INA1
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 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.
Permit Signature: Issued By: I / /
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:
C ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: - DATE ;> c // //
LICENSE NO: 3 1 - S
Call 639 -4175 by 7:00pm for an inspection the next business day
<,
CITY OF TIGARD Electrical Permit Application Plan Chec
13125 SW HALL BLVD. Rec'd By
Date Rec'd t - 1
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # ��-- I I�C?OS 1
Fax (503) 684 -7297 Called
1. Job Address: / c 4. Complete Fee Schedule Below:
Name of Development boe ( 0 - 4/ 4 � Number of Inspections per permit allowed
Name (or name of business) (00,c 7 / JQP'f/idg C Service included: Items Cost Sum
Address /05 OS S� 1 r) A(7// S T' 4a. Residential - per unit
T7 A O . ( 3 Each ad or less $110.00 4
CI ty /State /ZI p ri /y Y.- Each addit tional 500 sq. ft. or
El Limited thereof $25.00 1
Commercial Residential
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all f ant nse) ` 4b. Services or Feeders
Electrical Contractor / C. Ste / /D Installation, alteration, or relocation
L # 200 amps or less $60.00 2
Addr- .s 201 amps to 400 amps $80.00 2
Ci State Zip q 401 amps to 600 amps $120.00 2
Phone No. • 2 6A- S' /R 5 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3 �l Exp.Date
G Reconnect only $50.00 2
OR State CCB Reg. No. L/n Exp.Date /1/13/ 0 ` 4c. Temporary Services or Feeders
COT Business Tax or Metro No. - 7 b Exp.Datd Installation, alteration, or relocation
/ 200 amps or less $50.00 2
Signature of Supr. Elec'n Gam 201 amps to 400 amps $5.00 2 •
,-. 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. S_ Exp.Date /0// /v / see "b" above.
Phone No. 3 / 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits �
City State Zip without purchase of / /
,0
Phone No. service or feeder tee.
First branch circuit , 4 - 3arSAtr 2
The installation is being made on property I own which is not Each additional branch circuit $5.e6 2
intended for sale, lease or rent. 4e. Miscellaneous NJ�
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ i ( Q ?
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 6 13
Total balance Due $ �
I \DSTS \ELC96 APP Rev 9/96
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(c; BUP
Date Requested / ( / AM PM BLD
Location /0S 5(-0 ( irz5l' -S1 Suite MEC
Person , LL S b �( 9 PLM
Contact C�`12 CU d Ph
Contractor �„ Ph SWR
BUILDING Tenant/Owner � ST 1 e (CAS ELC 1
Retaining Wall EL R / q 7o 03
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab V SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final C /
PASS PART FAIL �C
PLUMBING � / — aq' SS'
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
CtR ICAL
S�vf>r�
Rough In
UG /Slab
Low Voltage
Fire Alarm
.fir
PART FAIL
Ilt
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 Date / Inspector e/ll'(. Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.