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Permit C T Y OFTIGARD PERMIT #: ELC99 -0184 44, DEVELOPMENT SERVICES DATE ISSUED: 04/01/99 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S 134CC -03800 SITE ADDRESS...:12414 SW WINTERLAKE DR SUBDIVISION -CAPSTONE ZONING:R -4.5 PD BLOCK ° LOT •005 JURISDICTION: TIG Project De scr i pt i on : Add two (2) branch circuits. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS - 0 0 — 200 amp ° 0 PUMP /IRRIGATION • 0 EACH ADD'L 500SF...: 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 MATT ZAPP type amount by date recpt 12414 SW WINTERLAKE DR PRMT $ 40.00 GEO 04/01/99 99- 314159 TIGARD OR 97223 5PCT $ 2.00 GEO 04/01/99 99- 314159 Phone #: Contractor: D & L ELECTRIC, INC. $ 42.00 TOTAL PO BOX 1047 REQUIRED INSPECTIONS OREGON CITY OR 97045 Elect'1 Service Phone #: 656 -5623 Elect'1 Final Reg #..: 008806 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 sore 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 952101 -1987. You lay obtain a copy of these rules or direct questions to OUNC by calling (503)246 -1987. Permittee Signature: Issued By: laO4 (r ' t------ 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 SUP R. ELEC' N : DATE : 11•11 LICENSE NO: OZ �! ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ ' _ - - - -- - - - RECEIVED CITY 9F,TIGARD MAR 019 ectrical Permit Application Plan Check # 13125 SW HALL BLVD. Recd By TIGARD OR 97223 Date Recd COMMUNITY DEVELOPMENT Date to P.E. Phone (503) 639 -4171, x304 Print or Type Date to DST Inspection (503) 639 -4175 Permit # r@'G Incomplete or illegible will not be accepted L° L`l /$ c/ Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) w S' siness) /la " .Z//, cc Service included: Items Cost Sum Address f rZ L t / i T 43 ;14 i-e l- Acs A 17 j- 4a. Residential - per unit n 1000 sq. ft. or less $110.00 4 City /State/Zip 7__ �t�' y 0,e9'j? Each additional 500 sq. ft. or Commercial ❑ Residential f2t portion thereof $25.00 1 Li mited 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 pH._ ,F/4' a / . -Z-.� r- Installation, alteration, or relocation 200 amps or less $60.00 2 - Address ,P 9 )3a r (d t-re 201 amps to 400 amps $80.00 2 - City 4- 0 *.o t"' l - State D/ - Tip q jo'f 5 401 amps to 600 amps - $120.00 2 Phone Nor G 5 - 4' 2 / 601 amps to 1000 amps - $180.00 2 Job No. Over 1000 amps or volts - $340.00 2 Elec. Cont. Lice. No. ;3 -/l 1--C... Exp.Date • ' - q Reconnect only $50.00 2 OR State CCB Reg. No. £791V 45. ' Ex .Date ._ CIO . �4c. Temporary Services or Feeders COT Business Tax or Metres 470 Q 2 17 .. Installation, alteration, or relocation 200 amps or less $50.00 2 - � � �/ - � 201 amps to 400 amps $75.00 2 . - Signature of Supr. Elec'n I - , - .'..//, ' . / _h'1.,2 «..-.1 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. Z4lr X - .5" Exp.Date • • i . II' see "b" above. Phone No. 45 5Z A3 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit l $35.00 3S . 2 The installation is being made on property I own which is not Each additional branch circuit / $5.00 S 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required) :'' 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 described 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: 46 eye 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 TIME AFTER WORK IS COMMENCED. ❑ Trust Account # ', 4� ZJ $ Total balance Due I: \DSTS \ELC96 APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP q Date Requested AM PM BLD Location 12 LI I L4 L) 1 ✓j&4 1A - or Suite Logo MEC Contact Person Ph (oS4 " -S(o23 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC qq a a q Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: /' Slab V SIT Post & Beam Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing --'2 ���T `'` -- Firewall Fire Sprinkler 6/44 d 7 ym 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 frECTRICAL, Service A/C Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART A 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 Other Approach/Sidewalk D ate /� `�� Inspector Other 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 qq k BUP Date Requested t — L / M PM BLD Location / ZL/ (T (A)l ✓ ►t(/L L f_ f 10/• Suite MEC Contact Person T Ph (,c(D — SCD23 PLM Contractor p Ph SWR �} �i BUILDING Tenant/Owner ELC `7 n - ( - 0 /1� L/ 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 re...44d,- a 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 CTRICkL) Service A/C Rough In UG /Slab Low Voltage Fire Alarm 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 3d Inspector, / Ex Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.