Permit •
A CITY O F T I G A R D ELECTRICAL PERMIT
,� DE VELOPMENT SERVICES DETEIT S: D 02/10/9 / � ���Ii DATE ISSUED: 02/10/98
L. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 2S11OBD -00700
SITE ADDRESS...:1187O SW WILDWOOD ST
SUBDIVISION -SHADOW HILLS ZONING:R -2
BLOCK LOT °005 JURISDICTION: TIG
Project Description: Add two (2) branch circuits to an e xistin g single family
dwelling.
- -- 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/O 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
COUCH type amount by date recpt
11870 SW WILDWOOD PRMT $ 40.00 GEO 02/10/98 98- 303208
TIGARD OR 97223 5PCT $ 2.00 GEO 02/10/98 98- 303208
Phone #:
Contractor:
HEBERLE ELECTRIC $ 42.00 TOTAL
19680 SW NEUGEBAUER RD
REQUIRED INSPECTIONS
HILLSBORO OR 97123 -9446 Underground Cove Elect'l Final
Phone #: 628 -2095 Elect'l Service
Reg #..: 000004
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 forth in OAR 952-001 -0010 through OAR 952 -001- 1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503 1987.
ir
Permittee Signature: Issued B
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 : 1
DATE: ( , l
LICENSE NO: '05
5
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
1 I 1 1 1 1 F4 ? +4 ++ 1-+ r-I•-F4.+4.1 h *trt - r• rt tttttttttt tttttt tt+tttttt + + ++++ +++ + + ++++ + ++
r Community Development ELECTRICAL PERMIT APPLICATION
...._,, A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
, , Permit # 4. c..9 60 6.3
;�'l Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ( Number of Inspections per permit allowed —
Address 1 ' `,Z - 7 n , c 1 i, I J'L 1,-S Service included: Items Cost(ea) Sum
1
City/State/Zip 1 / c > 4a. Residential - per unit 4
/ 1000 sq. ft or less $110.00
Name (or name of business) Each additional 500 s ft or 1
portion thereof $25 00
-
Commercial ❑ Residentialt Limited Energy $2500
Each Manurd Home or Modular 2
Dwelling Service or Feeder $68 00
2a. Contractor installation only:
4b. Services or Feeders
H Installation, alteration, or. relocation ' , .o . '� 2
2
Electrical Contractor ELECTRIC 200 amps or less $60.00
Address
19 �V SW Neugebauer Road 201 amps to 400 amps $80.00 2
City 1 lill�bt� reg 9 23 -9446 401 amps to 100 amps $180 00 2
601 amps to 1000 amps $180 00 2 -
Phone No. Iii Over 1000 amps or volts $340 00 2
- Contractor's License No. 3 - • p Reconnect only $5000 -
Contractor's Board Reg. No. -7i11 / 4c. Temporary Services or Feeders
gl Installation, alteration, or relocation 2
/ 20 0 amps or less $50 00 2
Signature of Supr. Ellec'n _0:�� ■ . _ $75 00 ■ 2
License No. a 5 3 .S �10 01 amps to 400 amps
1: ' 401 amps to 600 amps $100 00
���� 4 - Over 600 amps to 1000 volts
2b. For owne install C " see 'b' above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase
branch circuit or feeder lire $5 00 2
Phone No. b) The fee for branch arcuds without
The installation is being made on property I own which is purchase of service or feeder fee. I 35 7 2 2
not intended for sale, lease or rent. First branch arcuit $3500 J
Each additional branch circuit -r- $5 00 5
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) $too 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.C. Chapter 5 Per ins $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: 4o /
NOTICE 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ - 7.--• 'C
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
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 $
COMMENCED. ❑ Trust Account # $
Balance Due $ 1 1 . 7.-• ° `
spew nc MaMCrrm app
1
.
•
RECEIVED
FEB 0 4 1998
COi.'If.1U iITY DEVELOPMENT
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
q BUP
Date Requested G / -99 AM PM BLD
o
Location ) I b ?O CIA2.0D c C Suite MEC
Contact Person ,Q OOhY)s :(5) Ph 3 ;C PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC O03
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
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 t
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
<.F. •
Service -•
Rough In
UG /Slab
Low Voltage
Fire Alarm •
414Ip •.
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
Other Date - 9- 5 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.