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CITY OF TIGARD BUILDING INSPEC'T'ION DIVISION
24-rtour Inspection Line: 639-4175 Business Line: 639-41711MST
/ BLIP -------
_ —Date Requested_ !� r_ AM PM —_- BLD
Location"_ ,,� Seet/LG z� _ Suite .� MEC — --- _
Contact Person �� _ c s�,�► Ph —32-Z) �yG,� _ PLM
Contractor _ _ _ Ph -7l>S' SWR _
BUILDING Tenant/fawner ELCJ 12
c)U/,S^Sf
f;etaining Wall -- —_ —� ELF!
Footing Access _
Foundation FPS
Fig Drain
Crawl Drain Inspection Notes: / SGN - --
Slab ,�.3 L,�—��F✓� _ �_ 1� SIT
Post lata/ I --- +--
Ext Sheath/Shea, •,(c��- t�J ��j�C _�
Irt Sheath/Shear
F aming - --- ez� ----
Insulation
Drywall Nailing
Firewoll
SpFire Sprinkler
Fire Alarm ------—----------_—_—^
Susp'd Ceiling --
Roof
Misc --- ---- ----- -- --
Final —
PASS PART FAIL
PLUMBING
Post 8 Beam - - -—- - . - ----—
Under Slab
Top Out
Water Service
Sanitary Sewer --` —�
Rain Drains
Final ----- — -_—__.—
PASS PART FAIL
MECHANICAL - —.r --- -_-------- --- ------ - --
Post& Beam
Rough In
Gas Line ---------- --- --
Smoke Dampers
Fina{ ----- - --_-- --- --��_
PASS PART FAIL
/ CT ICAL --
Rough in --- - _ -- �—'
UG/Slab _
I ow Voltage r
Fire Alarm
FAS- PART FAIT.
P-Ick.fill(Grading - ----- -- —_�.---_-_—�
Sanitary Sewer
Storm Drain I J Reinspection fee of$ required before next inspe tion. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ease call for reinspection RE
Fire Supply Lint Please[ J p [ J Unable to inspect-no access
ADA
Approach/sidewalk �
Other Date �• Inspector Ext
^—_ _ _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL- PERMIT
DEVELOPMENT SERVICES F'EKMIT #: E.LC98-0158
DATE ISSUED: 04/01/98
13125 SW Nail Blvd., Tigard,OR 97223 (503)639-4171
PARCEL: 2S109AD-00100
SITE_ ADDRESS. . . : 1'C
1585 5W BULL MOIJNTA I rl 12D
SURD I V I S I ON. . . . :BLUE R I DiiE /ON I NG:R-7
E1.0CK. . . . . . . . . . . LOT. . . . . . . . . . . . :001 ,JURISDICTION: URB
Pro i pct De 5c i pt i on : Install a 3b AMP service on a P3E poker pole 02217/NE corner
of Bull Mt Rd and 126th Ave.
____RE5IDENTIAI_ UNIT------- ----TEMP SRVC:/FEEDERS----- -----MISCELLANEOUS——-
1000 SF OR LESS. . . . : 0 0 - 200 anp. . . . . . . : 0 F'UMF'/IRRIGATICIN. . . . : 0
EACH ADD' L 500SF. . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE I-TG. . : 0
L- IMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL../PANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601.+amps-1000 volts. : 0 MINOR LABEL_ ( 10) . . . : 0
-------SERVICE/FEEDER- -- -----�iRANC:H CIRCUITS------- --ADD' L. INSPECTIONS----
0 - 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 1 PER INSPECTION. . . . . : 0
201. -- 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER H0UR. . . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 ISA ADD' L 13RNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ---_--- --- ----_- -F'l._AN REVIEW SECTION-_.____----.________
1000+" amp/vol.t. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC:/FUR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ----------------------------------------------------------- FEES ------ --____
PGE DOER POLE #2217 type amok_rnt by date recpt
PRMT $ 65. 00 GEO 04/01 /98 98--304592
SPCT $ 3. 25 GEO 04/01/98 9A-304592
Rhone #:
Contractor: ----- _.___-.-_--_--._____._.____.__.___. .-------------------__----
ANDERSONS INTEGRITY EL-EC'TRIC $ F,8. eni .v^?U�
18435 SW PACIFIC HWY
STE D -------- REQUIRED I NSPEC:T I L'NS - -
TUALATIN OR 97062' Elect' I Service _
Phone #: 524-4681 Elect' 1 F=inal _
Reg #. . : 000914
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialtv Codes and all ether
applicable laws. All work will be done in accordance with eaproved plans. This permit will expire if work is not started within IP
days of issuancF, or if work is suspended for •or _ an 138 days. ATTENTION: Oregon law requires yo„ to foil" the rules adopted by
the Oregon Utility Notification Center. Th a es a set forth in DAR 952-M14810 through OAR 452-01-1,W7. You aiy obtain a copy
of these rules or direct gaest1 n \ by lli g (504)246-1%7. i) /
Per•mi.ttep lii.gnat 1_tre
INSTALLATION ONLY---------------------..------
The installation is beivig made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
._.----------------..--------CON H INSTA I )N ONLY---------- _____--•--_--------
SIGNATURE OF SUPR. ELE:C' N: DATE:=
LICENSE NO: -7 c
.7 -7 � __.-__-
+-+++++++++++++ 1-+++++++++++++++++++++++++++ += ++++++++++++++++++++++++++++++-4-+++
Lall 639-417c by 7;Q0 U. m. for an inspection needed the next byginess day
++ 4 4-r++•+++-+++ 1+++4.+4--V++++++++++++++++++++ +.++++4 4 4- +++++++++++++A-4-++4 4-+4.++++++.f
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By.
'�
TIGARD OR 97223 r7 r-y Date Recd_
/� Date to P.E.
Phone(503)639-4171, x304 Date to DS
Print or Tyne �
Inspection (503) 639-4175 Incomrlete or illegible will not be accepted Permit# li!��
Fax (503)684-7297 Called
1. Job .address: 4. Complete Fee Schedule aelow:
a V ,P V%-krA y� tit vo�,-
Name of Development Number of Inspections per permit allowed
30
Name(or name of business) - _ Service included: Items Cost Sum
Address \?-t. �` �-'�l "-\Q X c\- 4a. Residential-per unit
1000 sqit.or less $1 10.00 ----- q
City/State`Zi \ Each additional 500 sq.it.or
Commerciale. Residential ❑ Lipott(on thereof $25.00
m�re.'6 irgy $25.00
Each Me nuf'd Home or Modular
Dv+elling Service or Feed,( � $66.00
2a. Contractor installation only: ,
(Attach copy of current licenses) 4b.Services or Feeders ry40
Electrical Contractor _ 'a 5----�V-u.)A*--LtA Installation,alteration,or relocation r
Address 3 200 amps or less $60.00 �o O 2
� �- 201 amps to 400 amps $80.00 _ 2
Cite. State Zip_ 41 1 Ute � 1 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amFs _ $it')00 - 2
- Over 1000 amps or volts $340.00 2
Job N0.
Elec.Cont, Lice. No.S 0��+3 C-Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No.'211 t .Q--D^Exp.Date 4c.Temporary Services or Feeders
COT Busine.3s Tax or KAbkD No.� Exp.Date rstallation,alleration,or relocation
200 amps or less $50.00
Signature of Su r. Elec `� 201 amps to 400 amps i $75.00
i '
g p - 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License Nr �^I1 O S __Exp.Date_ see"b"ebove.
Phone N, !j:Zy=���j_�_._ 4d.Branch Circuits
Now,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. $5.00
Address Each branch circuit __ ----
b)The fee for branch circuits
City ____ ,Mate_ Zip without purchase of
Phone No. service or feeder lee.
First branch circuit $35.00 _.
The Installation is being made on property I own which Is not Each additional branch circuit $5.00 1
intended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owner's Signature__ Each pump or irrigation circle $4000
Each sign or outline lighting $4000
3. Plan Review section (if required):" Signal circult(s)or a limited energy $40.00 -_ - 2
panel,alteration or extension $100 00
Minor Labels(10) --
Please check appropriate item and enter fee in section 5B.
_,1(• oor2 residential units in one structum 4f.Each additional inspection over
_ Service and feeder 225 amps or more the allowable in any of the above
-+System over 600 volts nominal Por inspection ___ $35.00 -
Classified area or structure containing special occupancy Pet hour $5500
as described in N.E.C.Chapter 5 In Plant $5500
Submit 2 sets of plans with application where any of the above apply S. Fees: a9
Not required ter temporary construction serv(cec. 5a.Enter total of above fees $ ,r-
51e Surcharge(.05 X total lees) $
N01 ICE Subtotal $
5b. Enter 25%of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it required(Sec 3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ --`�
IS SUS'ENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY I r--� 2
TIME A7Tr:R WORK IS COMMENCED El Trust Account
a
Total balance Due
IOSTSiELCN APP neo Ww