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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
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Plbg.Und/FIr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct Mech. Rough-in Gyp. Bd. -Bldg. I
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
r' Date: C
� _ A.M. _ P.M. Entry:
Address:
Tenant:— --- --_—-- Ste:_ MST
BLIP:
wn (2
Con/ S Y--� MEG:
S 3�I S Z.SS PLM:
ELC: �__
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
C- r
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Inspector --
Wb
X_APPROVED _DISAPPROVED/C. LL FOR REINSP. F )CO
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PERMT
CAL
CITY OF TIGARD PERMITl#s LLC96I0420
COMMUNITY DEVELOPMENT DEPARTMENT DATE: ISSUED: 06/26/96
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13125 SW lull 2+vd.Tigard,Oropcn 67223.0199 (503)639-4171
PARCEL: 2S103DB-10300
SITE ADDRESS. . . : l c 0 OW GENESIS LP
+ SUBDIVISION. . . . : GENESIS NO. E ZONING:R-4. 5
FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :74
r' r iect Description-
---------------*------------------------------------------------------------
:,IDFNTIAL (JNIT-._-_ SRV::/FEEDEF.S---- -----MISCELLANEOUS--_-- �
SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
I JH ADD' L 50051 . . : 0 2201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
i LiMI I-E=D ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
j Mr• NF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 w
i
-------SERVICE/FEEDER----- -----BRANCH CIRCUITS--__-_ --•---ADD' L INSPECTIONS-_----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PEI3 INSPECTION. . . . . : 0
x'01 - 400 amp. . . . . . : 0 1st W/O SRVC Q FDR. : 1 PER HOUR. . . . . . . . . . . : 0
1 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ---.--------------PL'1N REVIEW SECTION----------------
10004-
ECTION----------------
1000+• amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Rerannert only. . . . . : 0 SVC/FDR )= 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: __.__._____.___..__.-....--._____-----__------_.___._.___-_______-_. FEES
STEVE CUTONILLI type amount by date recpt
1:s220 SW GENESIS PRMT $ 40. 00 CJS 06/26/96 96-281003
TIGARD OR 97223 5PCT $ 2. 00 CJS 06/26/96 96-281003
."hone #:
C-,ntract or:
42. 0,?? TOTAL
Owne r
-------- REUUI RED INSPECTIONS
Wall lover Elect' 1 1= inial
Phone #: Elect" 1 Service
Reg ___.__.__............
I
This persit is issued subject to the regulations contained in ''he
Tigard Municipal Code, State of Ore. Specialty Codes and all. other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This persit will expire if work is not started
within 18@ days of issuance, or if work is susper'?d for sore
than 18@ days. ISSUed By
INSTALLATION
The installation is be ` de on 7pr ,-ty I awn which is not intended
sale, lease, or rent. 1 ' `
OWNER' S SIGNATURE: n<.
DA`fE s
INSTALLATION
SIGNATURE OF SUF'R. ELEC' N: DATE:
LICENSE NO: L
Call for inspection - 639-4175
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_ fi►
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # F-C 96--Uy a0
Date fssuPd
Phone (503) 639-4171
CITY OF TIOARD FAX (503) 684-72.97
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. .lob Address: 4. Complete Fee Schedule Below:
Number of Inspections o. permit allowed
Name of Development4.
— p p
Address 0 G 5 __L -__ Service included Items Cost(ea) Sum
City/State/Zip._ �;,;>;1 -�—y- /2 � 2�_� 4a. Residential -per unit
1000 sq. ft. or less $11000 _ 4 t
Name (or name of business) �� 4.,7ll A//L L Each additional 500 sq ft or y q
11 portion thereof $2500 _
Commercial ) Residential 111 Limited Energy $2500 1
Each Manufd Home or Modular
Dwelling Service or Feeder �_— $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation,alteration,or relocation
Electrical Contractor�_T 200 amps or legs $6o 2
Address 201 amps to 400 amps $80.00 2
City –�� State �- Zip___--_ ^— 401 amps to 600 amps $12000 2
-- $180 00 2 r
601 amps l0 1000 amps 2
Phone No. over 1000 amps or volts
$340.00
Job NO. Reconnect only $50.00 2
contractor's license NO.-------- _ 4c. Temporary Services or Feed:rs
Contractor's Board Reg. No. Installation,alteratlon,or relocation
Signature of Supr. Elec'n200 amps or less 2
License No. Phone No. 201 amps to 400 Amps �_ $5000 2
401 amps to 600 amps $75.00 1
Over 600 amps to 1000 vn11., $100.00 --
2b. For owner installations: see"b"above
f act. Branch Circuits
Print Owner's Name-_ %L( ! New,alteration or extension per pane Y
Address_/_3�o �_��• ,�ES!s �- a)The fee for branch circuits with 2 c
City Statery �. purchase of service or feeder fee.
T% ✓�_ ��c Zip_ ?
--r--- �-- Each branch circuit _ $5.00 _
Phone No. k p�_ 9 ! Y,_ _ ___ _ b)The fee for branch circuits without
The installation is being made on properlyWI own which Is purchase of service or feeder foe ,,,///���� 2
not intended for sale se or renr
Firstbranchnalbrt ✓_ S3500 �'f 2
Each additional branch circuit (�� $5.00
Owner's Signature �- � 4e. Miscellaneous s
(Service or feeder not included) 2
3. plan Review section (if required): Each pump or Irrigation circle _. $40 oc � � 2 t
Each sign or outline lighting $4000
Signal clrcurt(s)of a limited energy 2
Please check appropriate Item and Anter fee in section 5B. panel,alteration or extension _ $4n 00
4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nomir3l 4f. Each additional Inspn:'.len over
_Classified area or structure containing special occupancy 'he allowable In any of the ibove
as described in N E.C. Chapter 5 Per inspection �_ 335.00 V
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
Sa. Enter total of above fees $ g0,0U
'! NOTICE 5%Surcharge (05 X total fees) $ 7—,M'-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
Plan Reevieww
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter vi line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED �w rr,•,�. .. _� Trust Account tY
$
Balance Due $ (�
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