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Permit 4 TY O F TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00555 A , DEVELOPMENT SERVICES DATE ISSUED: 09/13/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41 PARCEL: 1S134DB-06600 SITE ADDRESS: 11170 SW TORLAND ST S • UBDIVISION: TORLAND ESTATES � 4 % ZONING: R -4.5 BLOCK: LOT : 004 � RISDICTION: TIG Project Description: Electrical alteration 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: 1 W /SERVICE OR FEEDER: 30 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: GREG LEE BEAR ELECTRIC 11170 SW TORLAND ST P 0 BOX 389 TIGARD, OR 97223 DONALD, OR 97020 Phone: ORIGINAL Phone: 503 - 678 -1355 Reg #: LIC 20919 ELE 24 -107C SUP 3162 -S FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 09/13/199E. $224.75 99- 318276 Elect'l Final 5PCT BON 09/13/199E $15.73 99- 318276 Total $240.48 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. , PERMITTEE'S SIGNATURE 0 ,_ 0 . 1 l u ti (U1^- 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 64 SIGNATURE OF SUPR. ELEC'N: gn / ( � _ I %t DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Plan Che ,fi312 SW HALL BLVD. RECEE1 trical Permit Application Recd By r i1 Date Recd l i TIGARD OR 97223 SEP 1 31999 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 COMMUNITY DEVELOPMENT Print of Type Permit# G( on 55 - � Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) ( 2,g6 LEE Service included: Items Cost Sum Address II / 7o SW 1 Sr. 4a. Residential - per unit City /State /Zip 1 /G;tfi,.0 00- • Each additional it or less $ 117.75 4 / Each additionn al 500 sq. ft. or Ivy portion thereof $ 26.25 1 IC Commercial ❑ Residential l 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 base). Installation, alteration, or relocation Electrical Contractor 5k-A ELEc rni L, N G. 200 amps or less / $ 64.25 (, y, . 2 Address P. 0 , B Qv 3 89 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 City _Po ,t/,4 -D State Oa- Zip 9 702. -o 601 amps to 1000 amps $ 192.50 2 Phone No. (0 7, - SS Over 1000 amps or volts $ 363.75 2 Job No. H /3 77 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 2 0 7C Exp.Date /0 / - 99 . 4c. Temporary Services or Feeders OR State CCB Reg. No. 09/ 9 Exp.Date 2- lo-o0 Installation, alteration, or relocation COT Business Tax or Metro No. 3057 Exp.Date / -/- 00 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n X - t,_../ 5 ca- c.. -._.ee 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, License No. 3 / / '2 C Exp.Date /a - /-e) / see "b" above. Phone No. '7 jf -1/05 4d. Branch Circuits 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 3c $ 5.35 /GO . ■12 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 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) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 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.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ 224475 * Submit 2 sets of plans with application where any of the above apply. 7% Surcharge (.07X total fees) $ /5. 73 Not required for temporary construction services. Subtotal $ �Y yg 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ )( PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 1 yp, yg 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 $ 7 L/ p , l/0 / i Msts \forms \electric.doc / �� 5/18/00 Activities for Case #: ELC1999 -00555 3:58:47 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 9/13/99 BON DONE No Hold BON 9/13/99 ELCA003 Permit created 9/13/99 BON DONE No Hold BON 9/13/99 ELCA730 Elect'l Service 9/13/99 9/13/99 9/28/99 CD PASS No Hold AKJ 9/28/99 ELCA799 Elect'I Final 9/13/99 9/13/99 No Hold BON 9/13/99 ELCA500 (F) Issue permit 9/13/99 BON DONE No Hold BON 9/13/99 ELCA700 Rough -in 9/28/99 9/28/99 9/28/99 CD PASS No Hold AKJ 9/28/99 ELCA580 Expired by limitation 5/8/00 HAP DONE No Hold AKJ 5/8/00 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / / 0 / /0/ AM )C PM BLD Location / � f re91-4 Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner f^ 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 CG. C/ ^-- �� �� r „ n Drywall Nailing 7 '"( `/ (/ J�''"� Firewall ky Fire Sprinkler i� -� ' et-l/L Fire Alarm //f LA PI • Ceiling �'/ L4i.A " 1 �. � 4 `� ` + vI ��LV - Moo f. VG L7 /1 V t ! — 5 / 1 .1-a��`7 q - A D Final 14 /44, 1 n V 11 64 4s ° PASS PART FAIL ` PLUMBING 00 Post e r S U lab aam N - '�_ / W4 Top Out I Under l A / _ ,� , ,� /� `„ j,L -l�� 1 / / �, � jJy 7 )_ j / -lG t Water Service �/� Sanitary Sewer l _ Final Rain Drains --C2)1-1/11 �y ��L�C �� � 1LO PASS PART FAIL ,7,1 jly/,!/1 MECHANICAL � � f \ Post & Beam l J Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 reinspection RE: [ ] Unable to inspect - no access ADA l 6 Other Approach /Sidewalk D ate f / ` Inspector • i/ , Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.