Permit ELECTRICAL PERMIT ✓
�C�TY OF TIGAR®
PERMIT
DATEISSUED: 07 /23/96
�..
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 19 133AD -03 00
SITE ADDRESS...: 10700 SW SUMMER LAKE DR
SUBDIVISION....: AMART SUMMERLAKE ZONING:R -7
BLOCK.... ......° LOT ............. :6 -5
Project Description: Installing one branch circuit.
- -- 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 /FUR..: 0 601 +amps -1000 volts.: 0. MINOR LABEL (10) ...: 0
----SERVICE/FEEDER---- - - - --- BRANCH CIRCUITS- - - - - -- _ - -ADD' L INSPECTIONS--
- 200 amp......: 0 W /SERVICE.OR FEEDER: 0 PER INSPECTION : 0
201 - 400 amp......: 0 ist W/O SRVC OR FDR.: 1 PER HOUR : 0
401 - 600 amp : 0 EA ADD'L BRNCH CIRC: 0 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 --
y`: type amount by date recpt
10700 SW SUMMER LAKE DR PRMT $ 35.00 CJ•S 07/23/96 96-- 281803
SPCT $ 1.75 CJS 07/23/96 96- 28180
TIGARD OR 97223
nhn
Contractor: -• - -- -- ---- - ----
i - HE ELECTRIC GROUP $ .36. 7'5 TOTAL_
4726 SE MILWAUKIE AVE
REQUIRED INSPECTIONS -----
PORTLAND OR 97202 Wall Cover Elect'l Final
Phone #: 503-232 -2499 Elect'l Service
Reg #..: 43851
This peroit is issued subject to the regulations contained in the - ___
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm 9. t t e e Si gnat ure
applicable laws. All work will be done in accordance with
approved plans. This peroit will expire if work is not started _
within 180 days of Issuance, or if work is suspended for oore /J% _�
than 180 days. Issued By
-
---------OWNER I NSTALLAT I ON ONLY -•-----------•- --
The installation' is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: _ - DATE:
•
- - - - - -- CONTRACTOR INSTALLATION ONLY--- . - - - ---
SIGNATURE OF SUPR. ELEC'N: -/ ').QI-ed • DATE: 7 ;, , /6 . 3 , 29 / 5 -
LICENSE NO:
Call for inspection - 639 -4175
•
!JU ✓e
l Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # FLC46 -6 ( 47a
Date Issued //a/Rs
� i I ,i Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number Of Inspections per permit allowed
Address /0 SW Suirtone.0 zr . ,ea- O#V (' Service included: Items Cost(ea) Sum
City/State/Zip—T1640.—D 'f 72.23 4a. Residential - per unit
1000 sq. ft. or less $110 00 4
Name (or r+am.Pwf blrcinass). ,P'Y1 Each additional 500 sq ft. or
portion thereof $25.00 1
Commercial 111 Residential Limited Energy $25.00
/ . Each Manuf'd Home or Modular
isl t i n G ) yCi,G `a yn Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor 7W' 6"GeGTR /G G20t tp Installation, alteration or relocation 2
200 amps or less $60 00
Address `1726 S E ./t7/4. 4 i4 If/ A ttie - 201 amps to 400 amps $80 00 2 00 2
City VoKrt'o State O 2 Zip 97 07, 401 amps to 600 amps $ 2
� '
Phone No. - 2.-5-2..-- 2 5, to 1000 amps
�9 Ov er 1 1000 Over amps or volts $340.00 2 •
Job NO. 9 G — � Reconnect only $50 00 2
6
contractor's license NO. .. yy.S.._ 4c. Temporary Services or Feeders
Contractor's Board Reg. No. a Installation, alteration, or relocation 2
Signature of Supr. Elec 200 amps or less 2
License No. .ZO Err '' P one No. 23 Z `>`I7 201 amps to 400 amps $50.00 2
— 401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. r�fi 2
not intended for sale, lease or rent. First branch circuit / $35 00 �J
Each additional branch circuit $5.00
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) $100 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 inspection $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. $. Fees: r""- -=---- 5a. Enter total of above fees $ j
NOTICE 5% Surcharge (.05 X total fees) $ . 7
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. wardlcomdaNela. ❑ Trust Account #
arm app
Balance Due $ 16
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: -^ 6iitig A.M. P.M. MST:
Location: / d / d BUP:
Tenant: Suite: Bldg: MEC: 9 62, c)_1 4 /1.
�
Contractoor )_ i (
/ l' ¢ Phone: PLM:
owner" l /lam C�Q.C'� Phone: d_ 3 - c)-- ELC: ( d 7:2. ` ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service 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
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
V."* t t■yx 19..0_, „.. .-4.4 c _te: L. j
� - / 0
0 )0 l (1)
1
, ,/
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: Page of