Permit CITY OF TI G A R D ELECTRICAL PERMIT
� 40liki
PERMIT #: ELC97 -0433
^^ .„ �� i � , � 1 DEVELOPMEN SERVICES DATE ISSUED: 07/07/97
PARCEL: 1S133DD -02100
SITE ADDRESS...:1289O SW VILLAGE PARK LN
SUBDIVISION :VILLAGE AT SUMMER LAKE PARK 2 ZONING:R -4.5
BLOCK • LOT •60 JURISDICTION: TIG
Project Description: instl 2 branch circuits w/w air conditioning / /air
conditioning units cannot be placed inside setbacks
- -- 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
CATHERINE PAUL type amount by date recpt
12890 SW VILLAGE PARK LN PRMT $ 40.00 TAT 07/07/97 97- 296806
TIGARD OR 97224 5PCT $ 2.00 TAT 07/07/97 97- 296806
Phone #:
Contractor:
AMP ELECTRIC $ 42.00 TOTAL
9400 NE 4TH PLAIN RD
REQUIRED INSPECTIONS
VANCOUVER WA 98662 Rough —in Elect'l Service
Phone #: 222 -1647 Underground Cove Elect'l Final
Reg #..: 000781
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 1 :
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 forth in OAR 952- 001 -10 thro 952 -001- '8 ou may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: Issued By: -.4/; _A4.1.4 t ..1
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 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
A MER. PAC. SPA /AQUA INTER. 5032533144 P.01
,, n 01 18:12 'E SUS 084 7297 CITY OF TIGARD Q1010'01;
CITY OF TIGARI) Electrical Permit Application Pian c'eoi *-
13125 3W HALL BLVD. Aec'd By_ ,
TIGARD OR 97223 Date Raced ___. ,,,
Phone (503) 039.4171, x304 Date to P.E.
Date to DST
P or Type $
Inspection (503) 639.4175
Fax (503) 684.7297 Incomplete or Illegible will not be accepted Permit N_ .1. yJ/ Paled
1. Job Address! 4. Complete Pee Schedule Below:
�O
Name of Development / ,. Number of Inspections per permit allowed
Name (or name Of business) ' _ Service Included: _ Items Cost Sum .
Address_._ 2 O � � q :• �l e 1 L rL. _ /if a 4e. Residential • per unit
City /State /Zip _ (TOE. t 1000 sq. fl or lose $110.00
Each additional 500 SQ n. or
Commercial CI aeeldenta portion thereof -_ 325.00 ----
Limited Energy 525.00 _
I Each Manure( Nome or Mod:tar
2a. Contractor Installation only Dwelling Sery
ice or Feeder Sal 00
(Attach COPY of all current Ifosnses) 4b. Svvlc09 or Feeders
Ciecf1lc l Contractor_. (=-7 !C Installation, alteration, or rOloCa110n
Address_4r ZG /li T L� 7 200 amps or less 56300 _.._ -_
City f/l�r. , State /. 201 amps to 400 amps 590.03 _ _
_�P 401 amps to eoo amps - $12000 -
Phone No. ?e- 601 amp. to 1000 amps 8160,00 _
Job No... _,fit Over 1000 arnps or volts „■ $340.04
•
FIec Cont. Lice. No - Exp,Date / p _ f� / z - $50.00 --
OR State COB Reg. No. 7 5 Exp.DateJ /'3 0 Y7 R eccnnec: only
4c, Temporary Services or Feeders
COT 8usness Tax or Metro No • ..• oaVla Exp,Dattapl_0 / -7'7 Installation, alteration, or relocation
200 antes or lass •-•-• 550.00 "�"' '
Signature of Supr, EIRC'n 201 amps to 400 $fires - _ 576.00
jj 401 amps to E00 amps 5100 00 .._
-
License No _ J1(� t o -/ -7, O ver 600 amps to taco volts,
Exp,Oate see °b" above.
Phone N, Z Z _lk't 7 _
4d. Branch Circuits
New, alters ran or extension p panel
2b. For owner Installations: a) The fee for branch circuits with
purchase of service or •
Pnnt Owner's Name _ feeder lea.
Address Each branch circuit 65 OC _- -
-
.�
b) The foe for branch circuils
City State _ Zip Without purchase of
Phone No, , _ Service OP Wear fee. s _1
Fist branch circuit (` 535.00
The ir.'ttallatien is being made on property f own which Is ne! Each additional branch circuit ,,, 65.00 , Y
intended for sale, lease or rent. 4a, Miscellaneous
(Service or feeder not incivded)
Owner's Signature _ Each pump or irrigation circle $40,00 --
Each aign or Outline lighting $40.00 __
3. Plan Review section (if reg►iired). ° Signal circuits) or a limited ener;,y _
Panel, alteration or extension $40.00 ✓
Minor Labels (10) $100.00 ___-
Please check appropriate item and enter fee in section 58.
4 or mars ravdonttat units in ore structure 41. Each additional Inspection over
_
Service find feeder 223 amps or mere the allowable in any of the above
_ .,,_ System over COO volts nominal Per Inepecrion $35.00 _
Classified area or armature containing speelal ocoupancy Per hour -_ SS5.00 --
as described In N.E.C. Chapter 5 In Plant S55•o0 --
Submit 2 sets of plans with application where any of the above apply. 5. Fees: e ll • *
Not required for temporary construetien aervieoS. So, Enter total of abode fees I
5% Surcharge (.05 X total foes) 5 --�--
NQ 10E Subtotal S '�� ``•'^'
&b. Enter 25': of line sa for
PERMITS B2COML VOID IF WORK OR CCNSTFIUCT:ON AUTHORIZED Is Piton Review It required (Sec.3)
h,OT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal s
IS SUSPENDED OR ABANDONED FOR A PERIC :D OF 180 DAYS AT ANY
0 Trust Account K Z
TIME APTER WORK IS COMMENCED. S r „��
Total balance Due
7 , ,
f.'
•
W 11
RECEIVED
• JUN 19 1997
COMMUNITY DEVELOPMENT
`Z HI ,-S _Tv kii me ylgke- v,ljee —1, Y'e-i7 ®w -1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP ����
Date Requested ,34/ AM PM BLD
Location / .24/0 li,, l,br ra.4 Pi Suite MEC
Contact Person )1 o Ph PLM
Contractor Ph G �, • R
E C � � D/ /3 �
BUILDING Tenant/ COW /l j at:,2 � '/
Retaining Wall ,51 / — i/366. 6j aL( 07/D ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
/ i L2_? - - 2¢'l` / J SIT
Post &
w
Ext Sheath /Shear v ! a ,
Ina Sheath /Shear P O D I Co Y Y j- i/2 i s
Framing e.!'
Insulation
Drywall Nailing C) ild) ill }/1 D II r i i) 4_ e_.
Firewall /� 42,/s> /
Fire Sprinkler ")^6 / SsA d mi Ye F Yo n4 P Gt / CYG l/k Atv_ev P , I
Fire Alarm
Susp'd Ceiling 1 /9 1 4 Yl P D Ci Al e tJ� Q 1 e S e
Roof
Misc:
Final
PASS PART FAIL j
PLUMBING • r £4.) ., i C V n i. /` S
Post & Beam
Under Slab 1 4- C'_ t > / I- s - o K,
Top Out
Water Service
Sanitary Sewer
Rain Drains /.� P vl CQ 1/7 ig rt re c spQ s - 7U C---_-.. / e r .Iv /c?)
Final l
PASS PART FAIL a l/ ni 1 [J` : "� j '/ j , c.4., vi ,
MECHANICAL
Post & Beam
Rough In 4 44 0 V 1 req. 14 ci eli �( c Spa s— o U i- op ,6 1)81
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL e
Service
Rough In
UG /Slab ( 61"."
Low Voltage
Fire Alarm
Final
PASS PARCFAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 C�
Approach/Sidewalk Date 3 ^ a I (9 Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .
E'LCct7 -Coo 3 3 '
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 ✓
Date Requested: A.M. P.M. MST:
\
Location: — �• - - k y BUP:
Tenant: Suite: Bldg: MEC:
Contractor: )n'L f Phone: , 2 . ^ M el 7 PLM:
Owner: Phone: ELC: •
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE _
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling • Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved - Approved
Appr /Sdwlk Not Approved . Not Approved Not Approved Not Approved Not Approved
FINAL FINAL . FINAL FINAL FINAL
6- -1 e • -e ( /iC s�7 P r ^- 4(6(,-I c .) c -6.,--
•
..,2 /-----,,, 7 r 1 ,r / � /J J -71---,-) hc-e el �r� ,.
,,, , 7
•
•
•
•
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: M c - i t ® e( P U e Date: ,v — ?..,3-
.., "J _- 7 Page ( of