Permit CITY OF TIGARD ELECTRICAL PERMIT
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iiikho 1 A DEVELOPMENT SERVICES PERMIT #: ELC98 -0603
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=� ° = -. � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 09/30/98
PARCEL: 25111BC -03300
SITE ADDRESS...:1O375 SW VIEW.TERR
SUBDIVISION -DOUGLAS HEIGHTS ZONING:R -3.5
BLOCK • LOT •008 JURISDICTION: TIG
Project Description : Installation of 1 branch circuit.
- -- 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: 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
DOUG JOHNSON type amount by date recpt
10375 SW VIEW TERRACE PRMT $ 35.00 DEB 09/30/98 98- 309628
TIGARD OR 97224 SPCT $ 1.75 DEB 09/30/98 98- 309628
Phone #:
•
Contractor: .
DOUG JOHNSON '$ 36.75 TOTAL
10375 SW VIEW TERRACE
REQUI RED INSPECTIONS
TIGARD OR 97224 Elect'1 Service
Phone #: 639 -0737 Elect' 1 Final
Reg * a a: 000000
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 •,les ary et forth 'n OAR 952 -001 through i't 952- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC , all ..-,6;
Permittee Signature:,)(4t ! 'ssu-d By: _ ,
T
D 4 ,- . IN % • LLAT I ON ONLY----- -
The installation is be • , m.4.- / I own which is not intended for
sale, lease, or rent. / _ 9e
OWNER'S SIGNATURE: �� � f L, 17 • • DATE: —
CONTR / TOR 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
++++++++++++++++++++++++++- i-- t-++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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CITY Of TIGARD Electrical Permit Application Plan Chec ar 161'25 SW HALL BLVD. Rec'd By "
Date Rec'd q - 30 -1g
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # G1-e4 CO30_3
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 1 r- 4. Complete Fee Schedule Below:
P O Name of Development OM Number of Inspections per permit allowed
Name (or name of business) 1:4) O LAS E --)0 14)..) '5131Q Service included: Items Cost Sum
Address 1031 1 £ 7 •5 w Vi an1 - T - E-tZ 2Ps C-E 4a. Residential - per unit
City/State/Zip � iaArt2t� 01 2 e n 2.7..4 Eac ad additional o l 5 s $110.00 4
ty p Each additional 500 sq. ft. or
Commercial ❑ Residential portion thereof $25.00 1
L imited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Installation, alteration, or relocation
200 amps or less $60.00 2 -
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec 'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
�� L.AS � � purchase of service or
Print Owner's Name o H-..1 o J feeder fee.
Address Ic_13 SW 6E - tee-RACE E2ACE Each branch circuit $5.00 2
5 b) The fee for branch circuits
CityTt l ,A r t .r StateofZ Zip 9"127.4- without purchase of
Phone No. t:, ' - oZ 37 service or feeder fee. 3 5 a
First branch circuit I $35.00 2
The installation is being m- • an pr u • ,erty I own is not Each additional branch circui $5.00 2
intended for sale, lease : t. / _/ ' 4e. Miscellaneous
�i (Service or feeder not included)
Owner's Signature ._ia ✓ �' ■ Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review - 4ti on (if r,./. uired): * 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 descnbed 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: 26-. C O
Not required for temporary construction services. 5a. Enter total of above fees $ {
5% Surcharge (.05 X total fees) $ / •
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 / • 7C
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # (
Total balance Due
I \DSTS \ELC96 APP Rev 9/96
G /0 g(Ty OF TIGARD BUILDING INSPECTION DIVISION
24 - Ho u r Inspection Line: 639 -4175 Business Line: 639 -4171 MST . -
BUP
6 U 7�- I Date Requested 1U ' 7 - 0 AM PM BLD
Loca ion C Q 75 () W - 0) d JU2iL Suite MEC
Contact Person 0,. O t ` /yl,�Qif A'-J Ph 03q-c7 3 -7 PLM
Contractor Ph SWR �y /�
BUILDING Tenant/Owner ELC 9/? " )603
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 - . �L
Drywall Nailing _.._ _ • ! • Awl —
L_ i.. _ _ es _ r
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --e.-=', --o
Roof
Misc:
Final �`
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out •
Water Se rvice
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL •
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
p $S PART FAIL
ELECTRICAL jj
Service
Rough Int I q
UG /Slab l'otei.- II Low Voltag s - rm ► ' i
05 '- . , R il
I
Backfill /Grading 3 ® R
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line • lease call for reinspection RE: r [ ] Unable to inspect - no access
ADA '
Approach /Sidewalk
Other Date /D - 7- 3',f Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection' Line: 639 -4175 Business Line: 639 -4171
� - — /d BUD
loci
Date Requested .� / AM BLD
Location 10375 3'L( - 1/ Lew tL Suite MEC
Contact Person ,■1: � '1 .I 411,11 a)1 Ph (a 37 37 PLM
Contractor Ph SWR •
BUILDING Tenant/Owner 42) L -6 6 6 3
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 , edi �fl c '
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
fit' RICAL
Rough Rough In
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
Approach /Sidewalk Date JO — Inspector 97 Inspecor
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.