Permit •
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00372
'?IA, DEVELOPMENT BMEN 639 -4171 SERVICES DATE ISSUED: 07/05/2000
/
PARCEL: 2S 103DA -01000
SITE ADDRESS: 13115 SW WATKINS AVE
SUBDIVISION: DERRY DELL ZONING: R -3.5
BLOCK: LOT : 010 JURISDICTION: TIG
Project Description: Installation of (1) circuit for A/C unit
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
HAMMES, ALFRED J HELEN L GRF ELECTRIC
13115 SW WATKINS AVE 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: Phone: 503- 829 -4146
Reg #: LIC 76751
SUP 1655S
ELE 3 -484C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Final
PRMT DST 07/05/200C $37.50 0003449
5PCT DST 07/05/200C $3.00 0003449
Total $40.50 ORIGINAL
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 ISSUED BY: c5 L,c ��-
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 7:00pm for an inspection the next business day
07/03/2000 08:06 5038295747 GRF ELECTRIC PAGE 01
CITY OF TIGARD
13125 SW HALL BLVD. Electrical Permit Application Plan Check*
Recd By f" /4` 7e
TIGARD OR 97223 Date Recd 7_ 5 -m o
Phone (503) 839-4171, x304
\/...-..‘-------
Date to P.E.
Inspection (503) 639-4175 Print of Type Date t tr Fax (503) 59 &1860 � (, G 2voo - 0071a
Incomplete Ill
• Incomp or will not be accepted caned l ; / r r
1. Job Address: ( Z a _ a d 4. .Complete Fee Schedule Below: -
Name of Development ` G ✓c_, k ik L Number of Inapsollons per pennh allowed
Name (or name of business) VA p S Service Included: Items Cost Sum y
Address U?, t 5 v I 4.0 1 /t4 4a. Residential • per wilt ■
City /State/Zip 1P prr4{ '1 (Se . ^i - 7227 1000 sq. e. or less _ 1 117.75 4
Each additional 500 sq. ft. or
CommercI u
al 0 Residential a portion thereof $ 20.25 1
limited Energy 5 80.00
2a. Cantractor installation only: Each M ling S Home or eedurer $ 72.75 2
Derailing Service or Feeder
(Prior to ptenelt hsuanca, applicants must provide contractor Scenes 4b. Services or Feeders
Information for COT data base). Installation. alteration, or relocation
Electrical Contractor (.2 V Pea+ . 200 amps or less $ 84.25 2
Address / 5T (/Q ,7 ad : ce Ir „ 201 amps to 400 amps $ 85.50 2
City f�/i v 1„.; A State pfL Zrp _ 9/0L f
401 amps w to 800 amps $ 128.50 2
201 amps to loco emits :122.50 2
Phone No.
�r2- - y-1 'Fr f A f 2.q - S••f�'j ove► 1000 amps or volts $ 393.75 2
Job No. Reconnect only 3 53.50 2
Elec. Cont. Lice. No. 3-4- g q C , Exp.Date (o tJ 4c. Temporary Services or Feeders
OR Stye CCB Reg. No. ? (s "7 S Exp.Date Installation, alteration, or relocation
COT Business Tax or Medro No. 72- t..tp.Date F e o 200 amps or less $ 53.50 2
201 amps to 400 amps $ 2026 2
Signature of Supr. EIec'n 401 amps l0 600 amps fi 107.00 2
Over two amps to 1000 rasps.
License No. _
6 c<- 5 Exp.Date I Imo- ()„k se. "b" clew.
Phone No. r2A-4-1Y-49 4d. Branch Circuits
New, alteration Or extension per parcel
a) The fee (or branch droi
2b. For owner Installations: with pun:haee ers4rwce or
Feeder fee.
Print Owners Name j `
. - koLwt. vte+a'-S • Each brand) circuit S 6.35 2
Address b) The fee for branch circuits
City _ Stets • Zi nvitttout purchase ofservice
p or feeder We.
Phone No. First branch circuit 3 37.60 3 Sit
Each additional branch thrall! $ 5.35
The installation Is being made on property I own which Is not ore, Misteetlarreous
intended for sale, lease or rent. (Sonoma or feeder not Included)
Each pump or irrigation Girds $ 42.75
Owners Signature Each sign or outline lighting 3 42.75
Signal drtxmq(e) or a limited energy
3. Plan Review section (if required) :' panel, alteration or extension $ 80.00
Minor Labels (10) $ 107.00
Please check appropriate Item and enter fee In section 5B. Si. 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 000 volts nominal In Plant $ 58.00
Classified area or structure Containing special occupancy as
desoibed in N.E.C. Chapter 5 5. Fees:
Si. Enter total of above fees 6 - 31.5" - o
Submit 2 mete of plans with application where any of the above apply. 5% Surcharge (.05 x total tees) S 3 , dQ
Not required for temporary construction cervices. Subtotal $
Gib. Enter 26% of One Sa for
NOTICE Plan Review if required (Soc. 3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal 5
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS g Trust Aocountd
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ q,o .60
i \dsts \forms\cicctric,doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
"24 - Hour Inspection Line: 639 -4175 `"' Line: 639 -4171
BUP
a09, Date Requested 1-- '' ,, / ( `� �' d AM /� PM .BLD
Location / 3 / / < �J £ 241 '4$ ,4v Suite MEC 22,10 — 2 q/
Contact Person I brit/.( Ph 4 /7 a? d S5 PLM
Contractor r/ 6sf,Z(//i r &al Ph , - SWR
BUILDING Tenant/Owner . ELC 01/00
Retaining Wall ; : f V ELR
Footing
Foundation
Ftg Drain Access: /i► �/ '� sc �. FPS
/^�
Crawl Drain Inspection Notes: p
Slab (pax r'�J ` '�'t/� SIT
Post & Beam c�
Ext Sheath /Shear •
Int Sheath /Shear
Framing
Insulation �i
Drywall Nailing /A1-7 / �J
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
_ Mis Roof : C-7)
Final -
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
L
Post & Beam
Rough In
Gas Line
Smoke Dampers
PART FAIL
CTI
Service
Rough In
UG /Slab
Low Voltage
Fir A larm
03 PART FAIL
E
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 a Inspector �` — Ext •
Other p _ —
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.