Permit � CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00233
DEVELOPMENT r (503) 639 -4171 SERVICES DATE ISSUED: 4/19/99
13125 SW Hall
PARCEL: 2S114BB -12500
SITE ADDRESS: 10470 SW TITAN LN
SUBDIVISION: SWANSONS GLEN NO.2 ZONING: R -12
BLOCK: LOT : 066 JURISDICTION: TIG
Project Description: Add a first branch circuit to and existing dwelling.
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:
ERIC SCHULTZ SHARPE ELECTRIC INC
10470 SW TITAN LANE 22605 SW RIGGS
TIGARD, OR 97224 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C •
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 4/19/99 $35.00 99- 314640 Elect'I Final
5PCT GEO 4/19/99 $1.75 99- 314640
Total $36.75
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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)
2461987. �/
Permit 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: v 4 DATE:
LICENSE NO: '331
Call 639 -4175 by 7:00pm for an inspection the next business day
I.
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
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 #0Ie i�l c l - ODdt, sj `
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) L ' l ( �- et7 -+ Service included: Items Cost Sum
Address ) O `7 7° SC-0 77174'vl 4l 4a. Residential - per unit
�% / DI O n (77.....a.--t
/ / 1000 sq. ft. or less $110.00 4
t /
City /State /Zip 4 �%( T� Each additional 500 sq. ft. or
' portion 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 reent liven es)` 4b. Services or Feeders
Electrical Contractor+S / 721 - 1 - e 74iC hr._
- Installation, alteration, or relocation
200 amps or less $60.00 2
Addre s • S ' 1 �` 201 amps to 400 amps $80.00 2
City.G. < o��. State Zip • bo 401 amps to 600 amps $120.00 2
Phone No. e - - 79 3 601 amps to 1000 amps $180.00 2
Job No. ,‹ 6 c 7 7 9 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 3, af7e-- Exp.Date 0 1/ 9
OR State CCB Reg. No. 275 7 Exp.Date,'f 4c. Temporary Services or Feeders
COT Business Tax or Metro No. .,2.5.1 Exp.Date. / / /'C Installation, alteration, or relocation
200 amps or less $50.00 2
$75.00
Signature of Supr. Elec'� kp ! 401 amps to 600 amps $100.00 2
201 amps to 400 amps
Over 600 amps to 1000 volts,
License No. p 3 �S Exp.Date /6 �/ /a / see "b" above.
Phone No. l.7. - 7 7 3 7
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 Owners Name feeder fee.
Address Each branch circuit $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. t
First branch circuit 1 $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2 .
intended for sale, lease or rent. 4e. Miscellaneous
(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: 3
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ /, 71 7
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 # 3 Gi
am'
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
C7 p
BUP
��11 Date Requested �ZS - [ / AM PM BLD
LD
Location IV�7O ItiztA, Li/ . Suite MEC /997 — 00/C.26,
Contact Person E,A.441 t.J.LAPh 6,76 i3 PLM
Contractor Ph SWR �]
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing � C - / 7 a
9'? 0 6 — j ✓ 4 q D
Firewall
Fire Sprinkler
Fire Alarm / cz
Susp'd Ceiling /9 ? �r - Z-33
[.�C_. /
Roof
Misc:
Final
PASS PART FAIL
PLUMBING •
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
L. L
Post & Beam
Rough In
Gas Line
Smoke Dampers
m
PART FAIL A�
E ' ''' " _" ''L
Service
Rough In
UG /Slab
Low Voltage
Fire • larm
• S 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
Approach /Sidewalk Z �_
Other Date Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.