Permit ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2000 -00211
DEVELOPMENT SERVICES DATE ISSUED: 05/01/2000
'�I l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134DB-07600
SITE ADDRESS: 11222 SW TORLAND ST
SUBDIVISION: PP1997 -018 ZONING: R -4.5
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Branch circuit for exterior NC unit. •
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:
COWDEN, DIANE R + DANIEL L ALL -WAYS ELECTRICAL
11222 SW TORLAND 6032 SE BREWSTER PL
TIGARD, OR 97223 MILWAUKIE, OR 97267
Phone: Phone: 513 -6614
Reg #: SUP 1287S
LIC 0049032
ELE 3 -229c
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT BON 05/01/200C $37.50 0001797 Elect'l Final
5PCT BON 05/01/200C $3.00 0001797 (� (� �!
Total $40.50 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal 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 SIGN y- � 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:
CONTRACTO INSTALLATION ONLY
SIGNATURE OF SUPR. E -' • • ��:�� �- i /
DATE: �� /— U
LICENSE NO: /2_41 7
Call 639 -4175 by 7:00pm for an inspection the next business day
f.
GlTY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Recd By ea.)
TIGARD OR 97223 Date Recd 6 "'UN)
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit #CI. 4Ca9 002-1 I
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: d 4. Complete Fee Schedule Below:
Name of Development �LN� ■ d l /1 v (k ' Number of Inspections per permit allowed
Name (or n me of business) { Service included: Items Cost Sum 4 '
Address //22Z S, K/ , 7 5P /J /L S ,_/ . 4a. Residential - per unit
I I 1000 sq. ft or less $ 117.75 4
City /State /Zip
7 9 Each additional 500 sq. ft. or
r portion thereof $ 2615 1
Commercial ❑ Residential lik 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 provide contractor license 4b. Services or Feeders
information for COT data b. Installation, alteration, or relocation
Electrical C • ractor _
' _ 200 amps or less $ 64.25 2
Address !r ao a-- ;� 1♦'_ 201 amps to 400 amps $ 85 50 2
401 amps to 600 amps $ 128.50 2
City Ailf / , State 41 i - Zip 601 amps to 1000 amps $ 192.50 2
Phone No. S/ -lip f'o / - Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53 50 2
Elec. Cont. Lice. No. j 1 "l re' Exp.Date - /O-/ - 6I) 4c. Temporary Services or Feeders
r
OR State CCB Reg. No. 0 3 7 Exp.Date • ^ - d Installation, alteration, or relocation
COT Business Tax or Metro No. Ex.' ate 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of S • : r �. -- - - ,/, Gs-1-'1 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. , Exp.Date /0 "1-0f) see "b" above.
4d. Branch Circuits
Phone No. 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.
Phone No. First branch circuit / $ 37.50 3 7
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) $ 4,10 -90
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over OA OD
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 total of above fees $ .37
* Submit 2 sets of plans with application where any of the above apply. I0 Surcharge (.66•X total fees) $ .7j , a)
Not required for temporary construction services. / Subtotal . i g $
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 $ 4
I: \dsts \forms \electric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested S72/0/00 AM PM BLD
Location 1122. 2 'Toil S--)-- Suite MEC ?-12IY)—Cr) / S(
Contact Person . O i al e Ph (.P7o " d (0o 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC ZO)0 02 /
Retaining Wall ELR
Footing Access:
Foundation � �,� / FPS
/7 f'
Ftg Drain t- %/S _ / A " 7c- �7' sw� SGN
Crawl Drain Inspection Notes:
Slab C SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling g (.5
Roof ,_
Misc: LC ® �� /
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service 'r
Sanitary Sewer
Rain Drains
Final
P S PART FAIL
MECHANIC
eam
Rough In
Gas Line
Smoke Dampers
t PART FAIL
CTRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
41101--f"11._ 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 rei spection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector Ext
Final `
PASS PART FAIL DO OT REMOVE this inspection record from the job site.