Permit 4 , CITY OF TIGARD ELECTRICAL PERMIT
,. ,, DEVELOPMENT SERVICES PERMIT •' ° �!-`�'��''
����' DATE ISSUED: 11/05/97
!+� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 -
PARCEL: .. S 133DB- 127012
SITE ADDi ESS... e1 3470 SW SUMMERWOOD DR #POOL
SUBDIVISION. SCHOL.LS FERRY ROAD TOWNHCMES Z ON I NG : R - -25
B'OCK... LOT .... ....... 0210A JURISDICTIONe TIG •
Project Description: Saahoing pool & spa (located between lots 33 s 421).
- -- RESIDENTIAL UNIT - - -- •--- TEMP SRVC/FEEDERS---- --MISCELLANEOUS--
1 000 SF OR LESS..... 0 121 - 2100 &mp.. . . .... 0 PUMP/IRRIGATION..— „ 0
EACH ADD' L 5021SF.... '2) 2211 -- 4010 amp......: 0 . SIGN /OUT LINE LTG... 0
LIMITED ENERGY...... 0 401'- 6010 amp........ 2: SIONPL /P °ANEL ..... . 0
MPNF. HM/ 'SVC /FD r.. a 0 601+amps -1000 volts.: 0 MINOR LABEL (10)...: 171
----SERVICE/FEEDER---- -- -.._.- BRANCH CIRCUITS- .___. -_ -. ' -• -•- -ADD' L. INSPECTIONS._-- -
21 - 20121 ramp......: 1 W /SERVICE. OR FEEDER: 121 PER ,T.NSPECTION... .: 0
201 -- 400 asap.....:. 0 1'st W/O SRVC OR FDR. e 0 PER HOUR............:. 0
41211 - -• 600 amp e 0 EA ADD' L BRNCH CIRC, 10 IN PLANT............: !C .
61711 - 117100 amp......: 0 ----- •---- .- ..- .- _J.------ -• - - -- •PLAN REVIEW SECTION-7' __ _.._.._.___::_- .........- 1000+ amp /volt...... 0 ) =4 RES UNITS........,: ) 600 VOLT NOMINAL:....
Reconnect only.....: 2! SVC /FDR >.= 225 AMPS... CLASS AREA /SPEC OCC. s
Owner: -- ------------------------
i_'OWEN DEVELOPMENT type amount by date recpt
15075 SW KOLL PKWY STE H PRMT $ 110.00 JSD 11/05/97 97- 31710703
BEAVF RTON OR 97206 5PCT ' 5. 50 JSD 11/05/97 97- 300706
Phone #e •
Contractors •---- •- •---- -• -• -- - - - -- - - - -_ - -- - - ----------
INTERSTATE ELECTRIC INC- v 11.5. 50 TOTAL_
- BOX 7342 •
------- REQUIRED INSPECTIONS - •- .. - - ---
SALEM OR 973213 - -0068 Rough-in • ' El ect' 1 Final
Phcane• # s MDL.. 393 Elect' 1 Service
Reg * ... 001 171 -- — .__�..
•
T,is peroit 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 perait will expire, if work is not started within i8d:• •
days of issuance, or if work is suspended for acre than 180 days. ATTENTION. Oregon law requires you to folln-•J'the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-e01 -0010 through OAR 952 - 22°1 -7. You may obtain a copy
of these rules or direct questions to C -'C by calling ( "3)246 -1987. 44°
Permitte'e Signature: / vk 'ssuer; By: - �% __
_._._.---- •-- ..._-- -. -_ -_ _- . - - - -__ -OWNER INSTALLATION ONLY- - - - - -- --- • - - - - -- ---- . -• - -.- -
The installation is being made on property. I own which is not a.rtended for.
sale, lease, or rent. .
OWNER'S SIGNATURE: •_-___ - -- DATE: _. ___
•
_....- _.- .._...-- .-- ._........_ ......._..• -- .... - -- .CONTRACTOR INSTALLATION ONLY---------------------------
SIGNATURE OF SUPR. ELEC' N: - - DATE a -- ____________
LICENSE _ _._ — ___.— __ _ �.� __ —__ - ___
-1- :.J_ "1- - - - -. . , . ; 1..i- L . S . - -- .- l.- (- J- • - - -L. J - - -- -- J 1..:. L.L:_...-.. 1... J °
. . -t• � -r I-- F•-r•r-1- -r + - -.. ,. --.--r . -I... r ^f•••� � •f••�-- ....;..- {-- i--i••i I 1•••i-- }•- F•�'•• �--1-^'F•-� i- -� r•. . •( --. t 1 ��•� --� f- r ....,F.... .}...}•i••-i••i-- ,• -!•J
Call 639-4175 by 7:00 p.m. for an inspect ion needed the next business day ,
+-,'--F4-4.4. + -'-1- - 4- +•-0••-: + ;-+ti-++-e -i•• +^}••i-•i +i• ++ ;-.a••.i...-l--: ++++4-h+ -h++++ ;--7--L-:--L-i-+A -t +i .--i--1••-ri -+ + ;--h.:- .{..- F-4. -F-F }
r. ,
. CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. {� Rec'd By ,I ,
TIGARD OR 97223 e tI P D (ta b Date Recd 1 i RN
Date to P.E.
Phone (503) 639 -4171, x304 1 I
Print or Type Date to DST J
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # �l, y7
Fax (503) 684 -7297 Called 11 I LI I q
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 'i Mivialt-It,l 2 1 iE , Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
Address 1 'N 4,1(1 GJ()IVIM 1 an 4a. Residential - per unit
- 1000 sq. ft. or less $110.00 4
City /State/Zip-- ' / Li
1 ( ( P1 f 4011---' Y2 Each additional 500 sq. ft. or ,.---- ,.---- Commercial III Residential C i portion thereof $25.00 1
Limited 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 fJTF9i("a.I.kS(.T--1 C/ I nstallation, alteration, or relocation 200 amps or less I $60.00 (0 J $60.00 2
Address 09.
7 f ICAL 201 amps to 400 amps $80.00 2
City 7 Ar(.tcw1 State 01 Zip X1730' 401 amps to 600 amps $120.00 2
Phone No. 5 .�" I - 5 D 3 - 'Xo 1 - /-, D`1 b 601 amps to 1000 amps $180.00 2
Job No. '( - 1'f10 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. a13 Site/ Exp.Date /0 /�J
OR State CCB Reg. No. /1 / II Exp.Date 99 9, 4c. Temporary Services or Feeders
COT Business Tax or Metro N ,
o. . . , • E. p.Date �r 7 ) Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n � / // , A. / � 201 amps to 400 amps $10.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No /1-71j Exp.Date //)?4 see °b° above.
Phone Nc 6 - 391"
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. 5-0--
Address Each branch circuit I b $5.00 n 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 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: b
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 N I,`
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 ` j3 TIME AFTER WORK IS COMMENCED. ID // Trust Account # r
Total balance Due $
1:\NSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 7 r /' 70 ,5 "1 " 0 A.M. P.M. MST:
Location: f3 / 0 d(A/rn- vroc / BUP:
Tenant &ur d._; 7 e _, Suite: Bldg: MEC:
Contractor: Fe,C , Phone: ( - 1 7 --- 2 -Z 2- 3 PLM: '�
Owner: Phone: ELC:' 7 G 73,E
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL LECTRIC SITE
Site Post/Beam Post/Beam Post/Beam 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 /Alm Crawl/Found Dr Heat Pump Low Volt & uvnilti 2 pore
Approved Approved Approved Approv -e Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ■ m._I N s roved Not Approved
FINAL FINAL FINAL FIN • FINAL
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i i - . ! -- 3 , 5 - o - / F- _
r�r 01)0 1/Q — Ya r ee-d Fbr Ye- / HSQ ec -I`(01--
O Call for reinspection Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: Lr Q / - i Page of