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Permit CITY OF TIGARD ELECTRICAL PERMIT �� DEVELOPMENT SERVICES PERMIT #: ELC98-0256 1 I DATE ISSUED: 05/13/98 !+ -- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PARCEL: 1S134DC -09300 SITE ADDRESS...: 11514 SW TWIN PARK PL SUBDIVISION •TIGARD PARK ZONING:R -4.5 BLOCK LOT -009 JURISDICTION: TIG Project Description : Installation of 1 200 amp service and 22 branch circuits. - -- 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..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0 - SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- - 0 — 200 amp : 1 W /SERVICE OR FEEDER: 22 PER INSPECTION 0 201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR - 0 401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT 0 601 — 1000 amp • 0 PLAN REVIEW SECTION 1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..: Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.: Owner: FEES ANDY FREDERICKSON type amount by date recpt 11514 SW TWIN PARK PL PRMT $ 170.00 DEB 05/13/98 98- 305740 TIGARD OR 97223 5PCT $ 8.50 DEB 05/13/98 98- 305740 Phone #: Contractor: MT HOOD ELECTRIC INC $ 178.50 TOTAL 8900 SW BURNHAM RD UNIT F -7 REQUIRED INSPECTIONS TIGARD OR 97223 Rough —in Elect'l Final Phone #: 639 -5833 Elect'l Service Reg #..: 000011 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 la 'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001-00 '. through 952 -001 -1987. You may obtain a copy of these rules or direct questions to Iii by calling (5031246 -1987. Permittee Signature: 4 AI:, _ r _ i Issued B : / 4 .tiZit1 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 : �!J `�" 2 DATE: C I-1 3 -9 r LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ . Community Development ELECTRICAL PERMIT APPLICATION iii 13125 SW Hall Blvd. G Tigard, OR 97223 Permit # ELC Fb -0,-5 ,�., I ..� Date Issued 5 -/ 3 4 6 ' � I Phone (503) 639 -4171 FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Address I) &‘.l W I W «.., faa L. Service included: Items Cost(ea) Sum City /State /Zip 1(`G (:(..r J 0 R 4a. Residential - per unit J BA 1000 sq. ft or less $110 00 4 Name (or name of business)�J F t^eoJy(c. k s Each additional 500 sq ft or / portion thereof $25.00 Commercial ❑ Residential 11 .------- f Limited Energy $25.00 t Each Manurd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders /► / �/) �/ - 1 // 1 , j Installation, alteration, or relocation Electrical Contractor I • I r r(� c,�C (- o.�Ty, .�. c �- I $60.00 (per 2 rrr +++��9 /� _ $80.00 2 200 amps or less Addres f j o S C.L /`W✓ 44 c F-2-> ' 201 amps to 400 amps City t (5 G S Zip X777 >3 401 amps to 600 amps $120.00 2 601 amps to 1000 amps $180.00 2 Phone No. C . , l - cg 3 3 Over 1000 amps or volts $340 00 �+ $50 00 2 - Job NO. 1 G SZ 55 Reconnect only contractor's license NO. 34 9 C 4c. Temporary Services or Feeders Contractor's Board Reg. No. 1J' N/ Installation, alteration, or relocation 2 Signature of Supr. Elec'n 200 amps or less 2 License No. 3 Rot s Phone No. (�,39- S$ 3 201 amps to 400 amps $50.00 401 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 purchase of service or feeder fee. 1 2 City State Zip Each branch circuit 2.2 $5 00 I i 0 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 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or Imgation 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.0 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: 5a. Enter total of above fees $ I 7 0 NOTICE 5% Surcharge (.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 17 `� 5b. Enter 25% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF /, 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 $ ) 7 COMMENCED. word\comdernaeo- ❑ Trust Account # $ prm app Balance Due 17 52 .50 CITY OF TIGARD BUILDING INSPECTION DIVISION t 47 --//74,-.0 MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP /0 b Date Requested � — 96 AM PM BLD Location I I -1 ( - (4) ■- Pa/02- Pi-- Suite , G MEC Contact Person ��nn /�/t�( l/�1/ Ph lP ;-© �0 � PLM Contractor (At Eli Ph SWR c� ri BUILDING Tenant/Owner ELC - l0 ` 00 1 Retaining Wall ELR Footing Access: Foundation /0• ore .1 FPS Ftg Drain / SGN Crawl Drain Inspection Notes: ( L „ D �1 _ L Slab ll� � 0 SIT Post & Beam Ext Sheath /Shear �� ' Int Sheath /Shear Framing Insulation • Drywall Nailing yrlTi[/Z - Firewall Fire Sprinkler i/1 i _ _ __ _ ! s/. Fire Alarm Susp'd Ceiling Roof Final PASS 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 pfSS___ —RAJ FAIL CT MAP Rough In UG /Slab Low Voltage • Fire Alarm Fi ASS 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 / G Other Date • i 7 Inspector <� . E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.