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12245 SW ANN COURT
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERV:�,ES DATE T #: EL.C'1 1 /2177
DATE ISSUED: 1 1 /�1/9!
13125 SNI Hall 0!vd., TlgarJ,OF?97223 (503)639.4171
PARCEL: 2S 1.03BB- 1291 0
ADDREJS. . . : 1.2245 SW ANN CT
f-.iUBDIVIFION. . . . :LAKE TERR.'ICE NO. 2 :nNING:R--4. 5
B,LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . :022 JURISDIC "ION: TIG
ProJect Description: Installation of two (2) branch circuits to existing SFD.
----RESIDENTIAL UNIT—— ----TEMP SRVC/FEEDERS----. _-----MISCELLANEOUS-
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . . 0 PUMP/IRRIGATION. . . . : 0
F'.AC H ADD' L `;00SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
1-II1ITED ENERGY. . . . . . 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601.+amps;--1000 volts. : 0 MINOR LABEL ( 1.0) . . . : 0
_- -SE RV ICF"/F"EEDER----- _- -----BRANCH CIRCU.JIT'S-- ----ADD' L- INSPECTIONS--
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
x'01 - 400 amp. . . . . . : 0 1st W/0 SRVC 09 FDR. : 1 PER HOUR. . . . . . . . . . .. • 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCN CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 __.____.___.-_ _-_----PLAN REVIEW SECTION——-
1.000+
ECTION-- —-1.000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCL;. :
Owner: ------- ---- - - ______________ ._----.-•--•------._----_-.-.___..___.__-- FEES
ARDINGER type amoLInt by date recpt
12243 SW ANN COURT PRMT $ 40. 00 TJH 11/21/97 97-301 1.5"i
iIGARD OR 97223 5PCT E 2. 00 TJH 11/21 /97 97-301155
Phone #:
Contractor: - ___.._.__.__..._.-._-.-___-- ------------.____...___-._------•--•----••-------.__--_--
ALL CITY ELECTRIC FIRED $ 42. 00 TOTAL
13213 NE KE:RR RD / /60
STE. 130 / � ____..._ RED.0 I r D INSPECTIONS
VANCOUVER WA 98682 // Ro i.lgh- i n Elect' 1 Final
Phone #: 360-223--059.= Elect' 1 Service — _—
Reg #. . : 000870
This permit is issued subject tc 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 airproved plans. This permit will expire if work is not started within 188
days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR T-9_-WI-0010 through OAR W-881-1987. You may obtain a capy
of these rules or direct questions to OIJNC by calling 1583)246-1987./
Permittee rignati-ire : 4WAAPI Issi_1ed BY
---•--•-_-•--•--__._._---.___._._____------.__---OWNER INSTALLATION ONLY-
The installation is being made on property I own which is not intended for
sale, lease, 0- :nt.
PWNER' S S I GNATORE: _ DATE: ---•--_...._._.__.._
---------------------------CONTRACTOR INSTALLATION ONLY - _ -- ----------- -
SIGNATURE OF SUFIR. ELEC' N: _fdX�1!!R- --- DATE:
LICENSE NO:
+++++++4•+++ 1-++•+4-+4•= + "-+++++++++++++++4 +++++++-+4•+++++++++++++++++++++4++++++...4.4
Call 639-4175 Loy 7.00 p. m. for an inspection needed the next bi.lsiness day
++++: •+++++++4++++++++_4+ f-++++++++++++4+++++++++-F++++4 ++++++4+4•++++++++++++++4 4-++
Ia
NOV-21-37 FRI 12 . 04 PM P- 01
CITY OF TIOARD Usctricai Permit Application Plan Check 0rU 7t
13125 SW HALL BLVD. re.d By
TIGARD OR 87223 Date Recd I 9'7
Date to P,E. k)I Ar __�
Phone(50::)639-4171, x301
Pint or 7ypp oats to DST,
Inspection(503)639-4175 permit It�LC9
Fax(503)684-7297 Incomplete or illegible will not be acceptedPermit
,A/V-AAjCd
1. Job Address: 4. Complete,Fee Schedule Below:
Name of Developriient— _._ _ ___ _ Number of Inspections par permit allowed -- --
Name(or name of businebb)- a IFWel1 16--13" Service included: Items Cost Sum
Address_ ZZ, _ / a 4a, Residential per unit
• 1000 sq.R or lana _ 5110,00
_ --__-•- ---_ f
Clt�r/Stefe/Ztp � __ Each additional Soo eq.It.or
Commercial ❑ Residential portion cheroot $$2525..00
2 .
Limited Energy 25,00p0
( Each Manufd Home or Modular
Dwelling Service or Feeder
2a. Contractor installation only:
(Attach copy of ell cur ntIcens s) V L 4b.Services or Feeders
Electrical Contractor J Installation,alteration,or reloration
l - .O - 200 amps or less _— $60.00 2
Address._ / 201 amps to 400 amps 580.00 2
City r' State Zip �^ 401 amps to eoo amps $120.00 2
Phone No. L�512 601 amps to 1000 amps $190.00 2
Job No, - �-_ ___ Over 1000 amps or volts $340.00 z
Elec.Cont, Lice. No Exp.Date Reconnect only $nota 1
OR State CCB Req. No. Exp.Date 4c.Temporary Service-or Feeders
COT Business Tetx or Metro blo. Fxp.Dste______ Installation,alteration,of:.location
200 amps or lens $50.0029 1 amps to 400 amps $75.00
_
Signature of Supr.Fiec'n ',�[ -. 401 amps to Soo amps $10000 z
Over Orxi amps to 1000 voles,
License No. � �— Exp.Datetree"b"above.
Phone No_ �' 4d.Branch circuits
Nvw.alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Namefeeder too.
Address__ _ Each branch circuli $5.00
Ci State_— Zi b)The fee for branch circuits
fY_ -. _— P without purrhase of
Phone No. __ __ _ _ service or feeder fee.
r ret branch circuit $35.00
The Installation is being made on property I r -in which is not Each additlonal branch circuit 1_ woo
intended for sale,lease or rent 4e.Miscellaneous
Owner's Signature EaLh pump oor feeder igation circle $41)00 _
Each sign lir outllne lighting $4000 7
3, Plan Review section (if required)" Signal circuit(s)or a limited energy
panel,alteration or svtenslon 4 $40.00
Please check Appropriate Item end erter tee in section 50. Minor Labels(10) 510000
4 or more tesidentlel units In one structure If.Each addlilonal inspection over
Senice and feeder 225 amps or more the allowable In any of the above
y�System over 1300 volts nominal Per Inspection $35.00
Classlflad tires or structure containing special orrupat" Per hour $55.00 _
a6 descnbed In N.E C Chapter S In Plant $55.00
Submit 2 sets of plans with application where any of rho above apply. Jam. Fees: A") 01)
Not required for temporary construction services. 5a,Enter total of above fees $ -'j V,
5%Surcharge(.06 X total fees) $ O
NOTICE Subtotal $
5b.Enter 25%of line Sa for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Is Plan RAview#fsouired(Sec 3) :
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK subto►af $ -IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY �D
TIME AFTER WORK IS COMMENCED, Trust A-- -mt
�Vtal befence Due tt
1 -70/4
CITY OF TIGARD BUILDING INSPECTION DIVISION fn� C• � F/c,
24-Hour Inspoction Line: 639.4175 Business Phone: 639.4171 �'2_3 ... GS"y Z,
Date Requested: P.M. MST:
Loc;tion:
� __ � BUP:_
Tenant: l Z .5 ,d Lt� ��}' �_ _ Suite: Bldg: ?,4EC:
Contract �� ���
or: Q•� Phone. _ PLM:
Owner: Phone: __. ELC:
ELR:
SIT-
BUILDING BLDG(coti't) PLUMBING MECHANICAL ELEC CAL. SITE
Site Post/Beam Post/Beam Post/Beam -ro ervt� Sewer/Stour i
Footing Roof UndFl/Slab Rough-In Cei t --- Water Linn
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation luttletion Sewer Hood/Duct
uct Reconnect Vault
Bsmt Damp Drywall Stonn Furnace Temp Service M15C.
Masonry Ceiling Rain Drain A/C 110`:lab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt _
Approved Approved Approved Uroved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved N Not Approved
FINAL FINAL FINAL MAL FINAL
f]Call for reit:.Tertion 0 Reinstx:tion fee of S_ required before next inspection O Unable to inspect
btspector:_�_ lite: -/� dezp Page of
CITY OF TIGARD BUILDING �-
ILDING INSPECTION DIVISION
24-Hour Inspection Line- 639-4175 Business Line: 639-4'971 MST
BLIP
.�L Date Requested----------AM PM --
Location ( -) Z�,�`•, /-LIQ N --- F3LD
---------�' � _
Cun � Suite MEC
tact Person —__-�-
ContractoPh - -�—`
---- .-._ PLM
Contractor Ph
_ -��
SWR
Reta-i DING Tenant/Owner ELC)
Retaining Wall
Footing ------- ELR
Foundation A NOT REQUESTED
Ftg Drain FOUND DURING RESEARCH FPS --
Slab Crawl Drain Ir NO INSPECTION(s) IN FILF SGN
Post& Beam - SIT
Ext Sheath/Shear
Int Sheath/Shear --'------
Framiag -
Insulation
Drywall Nailing T-- - --
F irewall -- ---------------- - — —-
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling
Roof -.. - - - --—-- —-----
Misc: - ---
Final -- -- ---- -
PASS PART FAIL —-----.------ — - ---
PLUMBING -`-`_-
[(�Jnder
st& Beam
Slab �`�� - -
p Out --- . ---ater Gerviceanitary Sewer
Rain trains
Final ----- -- - ----- -----------
PASS PART FAIL --
MECHANICAL - - '--
Post& Beam
Rough In
Gas Line ------ - -- - --——-
Smoke Dampers
Final -- - -------------------
—-- --.—
�SS---FAIL —_
'P
rvice
Rn.rgh In / - ----- -- - ----- --------- -- ---
'�" ----
Slab
LO `v r
Low Voltage r —`—
Fire Alarm -------
{. �gi� -- ---- _
iApprOdrh(Siciewalk
SS PART FAIL _
'f lr/Bradingay Sewrr Drain Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Pasinupply Line f I Please call for reinspection RE:
—1 -- ---------- __ [ )Unable to inspect-no access
Other DateInspector
Final — — —-- —� Ext
PASS PART_ FAIL J DO NOT REMOVE this inspection record from the job site.