Permit , 4
CITY OF TIGARD ELECTRICAL PERMIT
&v DEVELOPMENT SERVICES PERMIT #: ELC98 -0349
'^� j, :'���'I 13125 SW Hal! Blvd., Tigard, OR 97223 503 639.4171 DATE ISSUED: O6 / 26 / 98
PARCEL: 2S111CA -11000
SITE ADDRESS...:O9596 SW SATTLER ST
SUBDIVISION •LAKESIDE PLACE ZONING:R -7 PD
BLOCK LOT •001 JURISDICTION: TIG
Project Description : Installation of 1 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 /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: 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
0 NEEL, ALTA & DENNIS type amount by date recpt
9596 SW SATTLER ST PRMT $ 35.00 DEB 06/26/98 98- 306869
TIGARD OR 97224 5PCT $ 1.75 DEB 06/26/98 98- 306869
Phone #:
Contractor:
NORTHWEST ELECTRICAL SPECIALT $ 36.75 TOTAL
ROYAL EDWARD STEARNS II
616 SE 69TH CT REQUIRED INSPECTIONS
HILLSBORO OR 97123 Rough —in Elect'1 Final
Phone #: 848 -8678 Elect'1 Service
Reg it..: OO1E13
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 952-901-0010 through OAR 952-091-1987. You lay obtain a copy
of these rules or direct questions to OUNC by callin (503)246 -1987.
Permittee Signature: Issued B
g � / ! Y (Z7e4AA.AL-vi
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 : ...JUL ... Lac -(. �J DATE: CO �T/
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan C• eck ' - /
13125 SW HALL BLVD. RECEIVED Rec'd - ` -"i971 • r
TIGARD OR 97223 Date Recd l :
Date to P.E. -----,"
Phone (503) 639 -4171, x304 JUN 2 5 1998 Print or T e Permit # L j Date to DST ---
Inspection (503) 639 -4175 YP - d 9
IncomDIe Q, � ible will not be
Fax (503) 684 -7297 COP liviutunt u yr. r .J. accepted
9 P Called
1. Job Address: +� ` Iv 1 c 4. Complete Fee Schedule Below:
Name of Development D ( l €1 d Number of Inspections per permit allowed
Name (or name of business) C P Service included: Items Cost Sum
I
Address q� Iof ` & s' vCi le_. 1000 Reside ft. ntial -
es- per unit $110.00 4
City/State/Zip 1 I c r f c 9 1 Each additional 500 sq. ft. or
Commercial ❑ 1 a Residential Limited thereof $25.00 1
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 ■ _ =ram 2 o? Installation, alteration, or relocation
�. 2001 2
Address • • . 201 amps amps to or 4 00 l ess amps $60.00
$80.00 2
City .i . " W Zip I f - 401 amps to 600 amps $120.00 2
Phone No. ..LI i LD A 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 3 9CC.Exp.Date
OR State CCB Reg. No. i 21 '-;29 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Dat- Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr• / / Z s Exp.Date ZO P14 le see "b" above.
Phone Nr ___ _ 7.7 --35 .3
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. 0-0
First branch circuit I $35.00 C 2
The installation is being made on property I own which is not Each additional branch circuit $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. S. Fees: � o
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ • 1 S
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 #
$ � 5
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
Date Requested X13 6 AM PM BLD
Location q s 9( Suite MEC 9 -oC)2 y S
Contact Person Ph CP 7 0 - 0 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 9 - cO3 `7 /
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
IHANICKL
Post & Beam
Rough In AC-
Gas Line
Smoke Dampers
3. PART FAIL
TRIG
—
Service
Rough In
UG /Slab
Low Voltage
F' - larm
F1 •
• SS 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 0 , To
k') 0 V
Other D 3/ 3/ v Inspector
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.