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12685 SW BEEF BEND ROAD N Cm 00 N CA W PTI m l ,.m � z v � v r I� I 12685 SW BE- F�BBE w CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-H011r Inspection Lone: 639-4175 Business Line: 539-4171 BBLIP_-- _Date Requ�^ted �r/ l b -I -Lr ,�4 AM F;�S BID -- Location Z � I`jQ_Q _:/ I e C( Suite MEC -- Contact Person _ _ �' Ph 3 �� PLM Contractor_— �� LN �� i�1_ Ph SWR BUILDING TF nant/Cwner _ ELC Retaining Wall ELR Footing Access. Foundation ' FPS Ftg Drain �b p �r�r��2-7 Crawl Drain Inspe,.;tion Notes: SGN — Slab �— _ r% ►'1� ► C 2. ,QLQ SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear — Framing Insulation --— ------ --_—_ Drywall Nailing - Firewall Fire Sprinkler Fire Alarm � ----- ----_-- -- Susp'd Ceiling Roof Misc _ ------ sscQ - ---— — Final PASS PART FAIL PLUMBING Post&Beam -- - - ---_--- Under Slab Top Out - —� ------- - ------- - - Water Service I Sanitary Sewer _---------.__._ Rain Drains Final PASS PART FAIL MECHANICAL - --- - - Post& Beam Rough In Gas Line - --------�.-- - - - Smoke Dampers - Final - - — -- PASS PARTT_ _ FAIL CT Service RougF In —- UG/SI ib — Low%oltage Fi P larm in — PART FAIL E Ba&fill/Grading — — Sanitary Sewer Storm Urairn ( ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE ( ]Unable to inspect-oo access ADA Approach/Sidewalk Other Date 1'L�'/ �� Ir-,Spector-- --. - Ext Final 7` PASS PART FAIL 00 NOT REMOVE this inspection rec;,rd from the job site. l_ �� ELECTRICAL PERMIT PERMIT#: ELC1999.00595 DEVELOPMENT SERVICES DATE ISSUED: 10/06/1999 13125 SW Hall Blvd., Tigzrd, OR 97223 (503) 639-4171 PARCEL: 2S109DD-00300 SITE ADDRESS: 12685 SW BEEF BEND RD SUBDIVISION: ZONING: R-7 BLOCK: LOT : JURISDICTION: URB Proiect Description: Installation of a 30AMP service and one branch circuit on a PGE Pole 92234 for TCI Cable/AT&T. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS_ _ 1000 SF OR LESS: �0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L .500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 arnp: SIGNAL/PANEL: MANF HMI SVC/ FUR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ` _ _ ADD'L INSPECTIONS_ 0 - 200 amp: 1 W/SERVICE OR FEEDER: 1 PER INSPECTION. 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW 1000+ amp/volt: s >=4 RES UNITS_ > 600 VOLT NOMINAL: s _ Reconnect only— SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: CHANDLER, JOHN A ANDERSONS INTEGRITY ELECTRIC JAYDENE L 18435 SW PACIFIC HWY 12655 SW BEEF BEND RD STE D TIGARD, OR 97223 TUALATIN, OR 97062 Phone: Phone: 524-4681 Reg #: SUP 3770S LIC 00091410 ELE 34-3630 FEES _ Required Inspections Type By iDate Amount ReceiptS Elect'I service PRM3 DST 10/06/199 $69.60 99-318879 Elect'I Final 5PC2 DFT 10/06/199 $5.57 99-318879 � Total _ $75.17 ORIGINIL This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws All work will be done in accordance with �,orovel 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 Al I ENTIUtI Oregon law requires you to follow rules adopted by the Oregon Utility Notificatior Center. Those rules are set forth in OAR 959-OD1-0010th ugfi v�.4R 952-001-0080. You may obtain copies of these rules ordirect questions to 0 / at(503) 246-1987 / 7 PERMITTEE'S SIGNATURE ISSUED BY: OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: _— DATE: C T CTOR INSTALLATION ONLY _v SIGNATURE OF SUPP.. ELEC'N: _.— —_— DATE:-9---,4- LICENSE ATE:., ---,4-LICENSE NU: Call 639-4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit application Plan Check# 13125 SW HALL BLVD, Recd By TIGARD OR 97223 Date Recd_ ,/ Phone (503)639.4171, x304 Date to P E`�� Date to DST Inspection 639-4175 Pflnt of Type Permit#,FC r/�y— Fax (503) 59898 1960 Incomplete or illegible will not be accepted Called v _ 1. Job Address: ` �i 4. Complete Fee Schedule Below: I Name of Development Number of Inspections per permit allowed Name(or name of business)4,o vAv X EV► JkCA C., Service included: Items Cost Sum Address�l7 4a. Residential-per unit City/State/Zip_. r 1000 sq n or less $ 117 75 4 --- -- — Each additional 500 sq ft ni portion thereof $ 2645 t Commerciallm Residential ❑ ---- - Limited Energy $ 80.00 _ Fach Manufd Home or Modular — ---- 2a. Contractor Installation only: Dwelling Service or Feeder _ $ 7275 z (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders information for COT da base). Installation,alteration,or relocation z.$ Electrical Contractor 200 amps or lase $ 84.25 (oq _ 2 Address t`•" t uJ -N y 201 amps to 400 amps $ 85.50 2 ., 401 amps to 600 amps $ 128.50 2 -t;y a� CIty `, State � Zip 1 7 L�'Z_ 601 amps to 1000 amps $ 192.50 2 Phone No. C v q 1 (-A C)!3 Over 1000 amps or volts $ 363.75 r 2 Job No —' Reconnect only $ 53.50 2 Elec. Cont. Lice. No. N j"3(_ Exp.Date - 4c.Temporary Services or Feeders OR State CCB Reg No ` It/ 1 U Exp.Date Installation,alteration,or relocation COT Business Tax or No. Exp Date 200 amps or less S 53.50 2 --- 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec' — 401 amps to 600 amps $ 107.00 2 - Over 600 amps to 1000 volts, License No. Ex Date see"b"above. Exp. 4d.Branch Circuits Phone No. --- New alteration or extension per panel a)The fee for branch circuits 2b. For owner Installations: with purchase of service or feeder fee. II 5 Print Owners Name Each branch circuit 1 $ 5.35 3 S'j '2 Address b)The fee for branch circuits without purchase of service City State Zip __ or feeder fee. Phone No. — First branch circuit $ 37.50 _ Each additional branch circuit $ 535 _ The installation is being made on property I own which is not 4e.Miscellaneous intended for sale, lease or rent (Service or feeder not included) Each pump or irrigation circle S 42 75 Owner's Signature Each sign or outline fighting — $ 42 75 Signal circuit(s)or a limited energy — 3. Plan Review section (%f required):* panel,alteration or extension _ _ $ 60.00 Minor Labels(10) $ 34;08 --�v- Please check appropriate item and enter fee in section 5B. 4f.Each additional inspection over 4 or more residential units in one structure the allowable In any of the above --.Service and feeder 225 amps or more Per inspection $ 5000 hour __ $ 50.00 System over 600 volts nominal In Plant $ 5900 Classified area or structure containing special occupancy as _—— described in N E C Chapter 5 5. Fees: �a.Enter total of above fees tC, Submit 2 sets of plans witn application where any of the above apply. A,X/6 Surcharge("A total fees) $ �— Not required for temporary construction services. Subtotal lie $ Sb.Enter 25%of line 6a for NOTICE Plan Review V required(Sec 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 18C DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS I-1 Trust Account# AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ i�dsts`,fhrms\cicctric.doc