Permit ap, 6 CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00460
; i DEVE r S O ERVICES ) 639 -4171 DATE ISSUED: 8/10/00
PARCEL: 1 S133DC -14400
SITE ADDRESS: 11607 SW WINTERLAKE DR
SUBDIVISION: ARI GREEN ZONING: R -12
BLOCK: LOT : 035 JURISDICTION: TIG
Project Description: Feeder and 3 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 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: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
O'BIEN, JAMES M + HEBERLE ELECTRIC
NICOLETTE 19680 SW NEUGEBAUER RD
11607 SW WINTERLAKE DR HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Phone: 503 - 628 -2095
Reg #: SUP 3053S
LIC 42841
ELE 34 -160C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT DLH 8/10/00 $80.30 0004415 Elect'l Final
5PCT DLH 8/10/00 $6.42 0004415
Total $86.72
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 O / _, P4/e . 4770 , , , , ISSUED BY: / (0;14... /..zy _ s _ e ____
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
CITY OFD TIGARD Electrical Permit Application Plan Check #
13,125 SW HALL BLVD. RECEIVED Rec'd By
TIGARD OR 97223 Date Rec'd
Phone (503) 639 -4171, x304 & Date to P.E.
Inspection (503) 639-4175 AUG 0 7 2000 ,{ Il7 Date to DST
Print of Type I Permit #�LC ae�p �10 y6O
Fax (503) 598 -1960 Incomplete or ille � of oe0accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 141 Number of Inspections per permit allowed
Name (or name of business) � Service included: Items Cost Sum
Address 11400 t,�I'I'1'LfT+2�Lrnr '. - 4a. Residential - per unit
City/State /Zip 11A,„4--e.7 �e..._ 9" lZ3 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq ft. or
portion thereof $ 26.25 1
Commercial ❑ Residentialt4 Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders /
information for COT da base). Installation, alteration, or relocation
Electrical Contractor �[�C P� G-
-1 200 amps or less ( $ 64.25 . f• 2
Address (WAD -L� I) L. 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City 4 {ILL$(k State Cie-- Zip 9 _ 601 amps to 1000 amps $ 192 50 2
Phone No. 3 - ZOO q Over 1000 amps or volts $ 363.75 2
Job No. f Reconnect only $ 53.50 2
Elec. Cont. Lice. No.34 --I (,,O c- Exp.Date Lfll o ( 4c. Temporary Services or Feeders
OR State CCB Reg. No. 47Sh I Exp.Date o ( Installation, alteration, or relocation
COT Business Tax or Meto No. 1,n-71.__-Exp. ► ate - 7 0 ( 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
41 11W . _ , . 401 amps to 600 amps $ 107.00 2
Signature of Supr. E - `,/ / Over 600 amps to 1000 volts,
see "b" above.
License No. :. AIM Exp.Date LID O
Phone No. - . Z,p if • Branch Circuits
1 New, alteration,or extension per panel
a) The fee for branch circuits
2b. For • caner in . allati • -, with purchase of service or
feeder fee.
Print Owne - Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit -3 $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or imgation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. 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 600 volts nominal In Plant $ 59 00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
i 5a. Enter total of above fees $ 76
* Submit 2 sets of plans with application where any of the above apply. .6t Surcharge (05 X total fees) $
Not required for temporary construction services. Subtotal $
NOTICE S 5b. Enter 25% of line 5a for
Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # l- 1
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ � ,
I: \dsts \forrns \electric.doc
.,CITY OF TIGARD BUILDING INSPECTION DIVISION MST
, 24 -Hour Inspection Line: 639 -4175 Business Lin: 6p-4171
� BUP
/ gP Date Requested g 2-- ` 9. i --- C° AM's = - `"'PM BLD
Location / /YJ ? 5 u'J di%741l% Suite MEC
Contact Person V #44 _ _ 7 Ph ",2. 093 PLM
Contractor Ph
SWR
BUILDING Tenant/Owner ELC ed1 d
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 :! ._ , , / ,ice �� _
Fire Alarm i!
Susp'd Ceiling
Roof
Misc: ./ -e-e
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
L
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PASS PART
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date it 2/ on Inspector 6 Ext
Final
PASS PART FAIL 0 OT 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
BUP
Date Requested F / r AM PM BLD
Location a ; 01 Sw i/n• 1. -/d /(v Dr ' Suite MEC
Contact Person Ph G Z4 2� � l .) PLM
Contractor f'Ci- . Ph SWR
BUILDING Tenant/Owner ELC 2 " G G c/6 U
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Rough In
UG /Slab
Low Voltage
Fire Alarm
�inal
SS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Rein ection fee of $ required before next inspection. Pay at Ci all, 13125 SW Hall Blvd
Catch Basin /�
Fire Supply Line [ ' ease call for reinspection RE: L(� - rE2 - 0 Q nable to inspect - no access
ADA
Approach /Sidewalk _Za*
Other Date Inspector Ext
Final
PASS PART FAIL DO J T REMOVE this inspection record from the job site.
•
CITX'OF TIGARD BUILDING INSPECTION DI fd O
24 -Hour Inspection Line: 639 -4175 Business ne: 6 39- 4'1.
1J BUP
Date Requested 9 M 1 PM BLD
Location O "w 1v /fr)41 /441 d ✓ Suite MEC
Contact Person - - a' geo PLM
Contractor Ph / /� SWR
• BUILDING Tenant/Owner �� M � f /4) n 4 a /CQG/1. ELC 2 -" ' ° ` O
Retaining Wall CI /44 Se 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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
R5 FAIL
LECTRIC I b ->
Rough I //j ' 6
UG /Sla • ['t� ►
Low Vol': •e L I
Fire Alarm dede ,
Final
PASS PART FAI
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Rei pection fee of $ required before next inspection. Pay at Ci Hall, 13125 SW Hall Blvd
Catch Basin ,� /
Fire Supply Line [ lease call for r inspection RE: zi i 2.677D [ nable to inspect - no access
ADA •
Approach /Sidewalk
Other Date fl'� Inspector Ext
Final
PASS PART FAIL DO OT EMOVE this inspection record from the job site.
7
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1) AM PM BLD
Location / / 67 5 G✓ Gvi n ,&2, /Ghe lY Suite MEC
Contact Person Ph f '3 S Z f 0888 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC J-vvv - 00 1 / 4 0
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 Q Q S s
Roof
Misc:
Final
PASS PART FAIL // ff
PLUMBING f� /5,1,/� IS CV/ S — C DO h Q C e.d J
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
LECTRICAL�
Service /
Rough In �. 1L ,4
UG /Slab
Low Voltage
Fire Alarm
F' • -
S ; ART 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 1,0-04-
Approach /Sidewalk Dat 6 Ins an.a , Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.