Permit CITY OF T R D ELECTRICAL PERMIT
A,, 4, DEVELOPMENT SERVICES PERMIT #: ELC98 -0718
-' ° ' � 13125 SW Hall Blvd., Tigard, OR 97223 (503)639 -4171 DATE ISSUED: 12/08/98
PARCEL: 1S125DD -09000
SITE ADDRESS...:O9678 SW VENTURA CT
SUBDIVISION •WASHINGTON SQUARE ESTATES NO.3 ZONING:R -4.5
BLOCK • LOT .098 JURISDICTION: TIG
Project Description: Berglund job #1204-006
- -- 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 • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp . 0 EA ADD'L BRNCH CIRC: 1 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
BERGLUND type amount by date recpt
9678 SW VENTURA CT PRMT $ 40.00 JSD 12/08/98 98- 311350
TIGARD OR 97223 5PCT $ 2.00 JSD 12/08/98 98- 311350
Phone #:
Contractor:
WEST SIDE ELECTRIC CO INC $ 42.00 TOTAL
1834 SE 8TH AVE
REQUI RED INSPECTIONS
PORTLAND OR 97214 Rough —in Elect' 1 Final
Phone #: 231 -1548 Elect'1 Service
Reg #..: 13306
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 law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set fo in OAR 952- 001 -0010 through OAR 952-001 -1987. You may obt . y
of these rules or direct questions to DUN n !
lli e ) - 87.
Permittee 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 : DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 - 4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
DEC -08 -98 06:58 RM WEST SIDE ELECTRIC 503 736 0677 P.01
V
ro(p
CITY OF TIGARD Electrical Permit Application Plan Check fl --
13125 SW HALL BLVD. Rec'd By
Date Reed r 2 � r
TIGARD OR 97223 Date to P.E.
Phone (503) 639.4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit • 6 LC- 9X •-Coln
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 22 Number of inspections per permit allowed
Name (or name of business).(! Jl Service Included: Items Cost Sum
-!
Address q6 7a sit✓ hot 7 et 4a Residential - per unit
t000 as R. or toss $110.00 4
City/State/Zip T�} `t+� 97ZZI Each additional 500 sq. ft. or
a
Commercial El Residential ® portion thereof - $25.00 1
Limited Energy - $25.00
Each Manufd Home or Modular
2a. Contractor Installation only: Dwelling Service or Feeder 568.00 2
(Anach copy of all current )Ice , s) / / J . 4b. Services or Feeder*
Electrical C9 actor . . T /G -� Cris /C Installation, alteration, or relocation
Addres. / ` #.�j;�' - , 200 amps or less $60.00 2
��� 201 amps to 400 amps 580.00 2
City arai 7ZI -' State OZ Zip ' FN 401 amps to 600 amps $120.00 2
Phone No. 2 / ...N • 601 amps to 1000 amps _ $180.00 2
Job No. /2- - 0 6 Over 1000 amps or volts 5340.00 2
Elec. Cont. Lice. No. 26 -! C Exp.Date Reconnect only 550.00 2
OR State CCB Reg. No. /33 6 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Dete Installation, alteration, or relocation
200 amps or toss $50. 2
p r.
Signature of Su Elec'n ( ` 201 amps to 400 amps • $75.00 2
401 amps to 600 amps $100.00 2
License No /C5-4 600 amps to 1000 volts,
Exp,Date eee "b" above.
Phone Nr 23/ / S`7g
4d. Branch Circuits
New, alteration or extension per penet
2b. For owner installations: a) The lee for branch circuits with
purchase of servlc. Of
Print Owner's Name feeder fee.
Address Each branch circuit $5,00 2
D) The foe for branch circuits
City State Zp without purchase of
Phone N0, service or feeder fee.
First branch circuit 1 $35.00 3 s 2
The installation is being made on property I own which is not Each additional branch circuit � 55.00 2
Intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not Included) 840,00 2
Owner's Signature Each pump or Irrigation circle
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):` signal dreult(a) or a limited energy $40.00 2
panel, alteration or extension $40000
•
Minor Labels (10) __
Please check appropriate Item end enter fee In section 58.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder X25 amps or more the allowable In any of the above $35.00
System over 600 volts n ominal Per Ins $35.00
Classified area or structure containing special occupancy Per hour -- $55.00
as described In N.E.C. Chapter S In Plant -
Submit 2 sets of plans With application where any of the above apply. 5. Fees: 1 10
Not required for temporary construction services. 6a. Enter total of above lees $ -
5% Surcharge (.05 X total fees) 5
NOTICE Subtotal 5
6b. Enter 25% of line 5e for 6
S
PEAMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review !�
(Sec. NOT COMMENCED WITHIN 190 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account fl = 4 f Z
TIME AFTER WORK IS COMMEN 7 ED.
�/ f/ /(--3c � Total balance Due T ,e4tS 1�
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/6/09 /6/09 Date Requested 12-17-96F AM PM BLD
Location ■ i • 40 /44_1/ Suite W-J53o
Contact Person %[/yf , i Ph PLM
Contractor ., MM/ i_i�_ L � / / Ph 2 33' 584J SWR
g -- 07/ef BUILDING Tenant/Owner
Retaining Wall R
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab •
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
SS —_PART FAIL
KylECHANICAL
Post & Beam
Rough In
Gas Line
oke Dampers
Final
P ART FAIL
(ECTRICA
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
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
Other oach/Sidewalk Date / 21i 7/ 9 ! Inspector J Ext
Final
. PASS PART FAIL DO NOT EMOVE this inspection record from the job site.