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CITY OF TIGARD BUILDING INSPECTION NOTICE
,r Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection: �—
Footin, :o. Gelling 5prink. Rough in Appr/Sdwlk
Foundation g. Underslab Mech. Rough-in Fireplace
Post/Beam Struct t 'bg. Top Out Elec. Rough-in FINAL:
Pos''`-am Mech. San. Sewer Ga3 Line -Bldg. •
Plbg. Underfloor Rain Drain Frarr'�ig -Plumb.
j Alarm Water Line Insulation -Mech.
I Underflr. Insul. Shear Wall Gyp. Bd. j y
Date Requested:_ 5 Time: AM PM ^�
Address:—/ U
Bu1�e�' Q�tte�u �o � _Permit #:C,5 G,SC? l
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date:--� ��_
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APPROVED —DISAPPROVED —APPROVED SUBJECT TO ABOVE
� —Call For Reinsp. FA
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERWCES DIVISION
155 NORTH FIRST,HrLLSBCRO,OR 97124
y COON I I INSPECTION REQUESTS: 51)3/640-3561/693-.4415 0
PHONE: 503/848-8M
OREGON �T�Q.e
Date 04/29/94
Time 1.3 : 27
Permit 'Type : Residential Electrical Permit Permit- # 050526 /1
Permit Status APPROVED Applied : 04/29/94
Situs Address 12160 SW GRANT HV TI Issued : 04/29/94
Permit. T4 tle SFR - EI.EC'SERVICE Completed .
Permit Descr. To Expire : 10/26/94
Project Title SFR - SERVICE/CIRCUITS Project # : P0039701
Project Descr. * EROSION
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Parcel Number : 2S1T1 _. Land Use District
Valuation 0 j
Legal Descr . •
` Owner INSPECTION - T1GAPD Construction : OTH
Applicant Name WILLAMETTE ELECTRIC Classification : 900
Applicant Addr . : PO BOX 230547 occtt.pancy : R3
!' TIGARD, OR 97281 Validated by : KF
Applicant Phone: 624-3631 Inspector. Area :
CONTRACTOR : W1LLiAMETTE ELECTRIC Lic. C 34-2830 624-3631
Fee description Unitas FFe/Unit. Ext fee Data
~� - -- - +_--__-«'i --+- '- ---- -`
Service/E ceder2UU amps or lean 60 . 00 60 . UU
Subtotal Electrical Fees : 60 . 00
State Surcharge of 5% 3 . 00
Total Electrical Fees : 63 . 00
*** Fees Required *** k** Fees ."ollected & Credits **A
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r. Method Check # Peceipt No. Datte Payment
C'11 4744 04/29/94 63 . 00
7" TOTAL THIS DATE k******** 63 . 00
Ik Fees 63 , 00
AdjustmeTits : . 00 Total Credits : . 00
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Total Fees : 63 . 00 Total Payments : 63 . 00
Balance Due : . 00
NOTICE: This permit becomes,lull and vold If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction hits strrted,
the permit becomes null and void It construction Is Interrupted for a period of 180 days. I cenlly that the Information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. 1 acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All provlslone of applicable laws and o.dinances governing the construction and use
of this building or structure wll:be compiled wtin whether or not specified an the ptms or noted on the plans correction*.hoots. ;acknowledge that
the granling of■permit does not grant authority to access private property or to use onsements. 1 further acknowledge that the ise or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of const,7xilon and the building
Inr.peclinn staff verifying compliance with the vcrlous codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Oepartment Is solely at the risk of the applicant and such use or occupancy It revocable until all Inspection requirements are satisfied and 1
approval;s given by the Building Jfllclsl I further acknowledge that alien maybe placed on the title of the property upon which the permit Is Issued
+;pecilvl•�q that the use or ae:cupsncy of.ho bulleting or structure Is provlatonal and revocable until the satisfaction of all Inspection requlroments.
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APPLICANT'S SIGNATURE
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WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, #350-12 P P I��T I�'�
Hillsboro, Oregon 97124
Y.,. Information: (503)640-3470 Fair: (503) 693-4412 ProjecVPer ,t
PLEASE PRINTNumber 5 � Date
4. Complete Fee Schedule balow R
Number of Inspections per permit l ilown�
1. Location of installation -
Address_l . Ue a1L�L_CA��-�T S� Service included: Items Cost(ea.1 Swn l
Buildingg _ A. Residential-per unit II
City_ ,�� _ Suite fJ0._-
Tenant Name 1000 sq.ft.or less $110.00 4 •
Each additional 500 sq.ft
(if commercial)
--- ------- or portion thereof $25.00
Limited Energy $25.00 1
Tax Lot___�.._.�__� Map No. - Each Manurd H•)ne or Modular
Dwelling S. vita or Feeder $68.00 _-__ 2
Thomas Map Book: Page: �_. Section: _.__
Directions--__ - _-__ ._ B. Services or Feeders
-- - Installation,alterations or relocation/ or
200 amps or less __ $60.00 ._iel22` 2
Commercial Residential 201 amps to 400 amps
$80.00 12
401 amps to 600 amps __ $120.00 2
2a. Contractor installation only: 601 amps to 1000 amps $180.00 -- - 2
J Over 1000 empu or volts __- $340.00 _- 2
Electrical Contractor Reconnect only $50.00 ._ - 2
Address ye'e /e or 23o s Y i;c
Date. . z 2 -,7q _ Job Number o; I-Vis' _ C. Temporary Services or Feeders
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Property Owner " d. . w n Instellalion,alteration or relor:ntion
Contractor's License No. 200 amps or less $50.00 2 4I
Contractor's Board Reg. No. Sv S 61 201 amps to 400 amps $7F,.00 - 2
401 amps to 600 amps "100.00 __ T 2
Signature of Supr. Elec'n �^ Over 600 atnps to 1000 volts see"8'above
License No, Phone No.
� L L 3/_._. D. Branch Circuits ;
New,altos ati(,or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase o1 service or feeder fee.
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Print War's Namo - Each branch ci-mit $5.00 2
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b) T'he fee for branch circuits without
Address purchase of service or feeder fee.
First branch circuit $35.00 2
r5ty Jtate- - -- - Each add'nl branch circuit__.- $5.00 2 ° I
E. Miscellaneous (Service or Feeder not included)
The installation is being made on property 1 own Each pump or irrigation circle $40.00 2
which is ,sof intended for sale, lease or rent. Each signor outline lighting _�. $40.00 2
Signal circuit(s)or a limitod
Owner's Signature _ _ -. _ energy panel,alteration
or extenpion $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per;r•.pection _ $3500 _
Please check appropriate Item and enter fee In section 5B. Par hour $55.00 _ I
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4 or more residential units in One structure In F'Ianl $55.00
Rervice over 800 amps; feeder 800 amps or more 5, Fees A '
___System eve,-800 volts nominal A. Enter total of above fees $ __66
___Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
Submit 2 sets of plans with appllcat;on where any of the B. Enter 25% of line A for
Plan above apply. Not required for temporary cor.structlon $UbfOtal view if required (Section 3) $ -
servlcpn.
Less Bulk Label Fee $
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For inspections call Balance Due $
This permil becomes null end void M.he work authorized by the permit Is not commsnoud
640-3561 or 693-4415 within 180 day*from date of Issuance of such xrmM or 8 the work aullrorized Is
susecpended or sbandonad of any time altar work is commend tot a period of 180 days,
24-hour recorder, one working day in advance of need rlttI",PermNa aronon refu"do bb and non-ft analor able
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