16125 SW GRIMSON COURT I
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lEi25 SIJ GRiMSON COURT
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-0175 Business Line: 639-¢171 --�-
'!�C;ice' �-- BUP
_Date Requested zL_� __:� _�AM /�-r PM _ BLD
Location_ /� 69a.5 1. /i lr 1 S Vin,' r" (Suite MEC
�. ---
uontact Person _ _ Ph o - , L Z PLN7 --
Contractor Ph SWR
BUILDIP:c.;_ — Tenant/Owner ---^ ELC
Retaining Wall — ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes. SGN _
Slab SIT
Post& Beam I ----- ------ ---------------_._---------____-- -- -
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insulation
Drywall Nailing ----- ----- ----- ---- --- --... — -----
Firewall
Fire Sprinkler
Fire Alarm �1 , ,- - -- ------- ---
Susp'd -eiling —_—
Root
Final --- - - ------- ---
PASS PART FAIL -- ---------_.
PLUMBING_
Post& Hearn --------
Under Slab
TopOut -- --_ __ ----- -----_._-_.�_----
Water Ser,ice
Sanitary Sewer -
Rain Drains
Final ---------�-
PASS PART FAIL_
MECHANICAL —
Post& Heam -- - ---- ---- -— - - - -
Rough In
Gas Line
Smoke Dampers
Final ___---
PART FAIL
ELECTRICA --- - -- -- -- -- ------ -
ce--
( ough In - -- -- --
U(;/Slab
Low Voltage
Fi r9p i
P PART FAIL.
Backfill/Grading ------ — ------- - -------_--_ —_ -- -
Sanitary Sewer
Storm Drain ( ] Reinspection fee of$ -__ _required before next Inspection. Pay at City Hall, 13.125 SW Hall Blvd
Basiasin
Fire h Basi line ( ) Please cab for reinspection RF - ! I Unable to inspect-no access
ADA
Approach/Sidewalk.
Date _ �✓-tom-� ----- Inspec:trr^�_ l -- `— �1r;c'- ---�•.� -
Firtal
PASS PART -FAIL. DO NOT/REMOVE this inspection record from the jots site.
CITYOF T I G A R D _ ELECTRICAL PERMIT
PERMIT#: ELC2001-00088
DEVELOPMENT SERVICES DA1, J,7D: 2/9/01
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 pi 2S1 inn 0100
SITE ADDRESS: 16125 SW CRIMSON CT
SUBDIVISION: PICKS LANDING NO.2 ZONIlk G: R-4.5
BLOCK: LOT : 128 JURISDICTION: TIG
Proiect Description: Installation of one branch cir,�uwt for new recessed lighting.
RES")ENTIAL 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 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR F�:EDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 • 1000 amp: _ PLAN REVIEW SECTION _
1060+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL
Reconnect only: � SVC/FDR >= 225 AMPS:^^ _^CLASS AREA/SPEC OCC_ _
Owner: Contractor:
ZAWADA, JEFFREY A + ELEANOR OWNER
16125 SW CRIMSON CT
TIGARD. OR 97223
Phone: Phone:
Reg #:
_ FEES Required Inspections
Type By Date Amount Receipt — --
-- — Rough-in
PRMT CTR 2/9/01 $46.85 2720010000( Elect'/ Final
SPCT CTR 2/9/01 $3.75 2720010000(
Total $50.60
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 approved plans. This permit will expire if work is not started within 180 days of issuance,or d wxk is
suspended for more than 180 days ATTENTION Oregon lew requires you to follow rules adopted by the Oregon Utility Notiii�;ation Center Those
rules are set forth in OAR 052-001-0010 trough OAR 952-001-0080 You may obtain copies of these rules cr direct questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURE ti� /� ISSUED BY i �L
OWNER INSTALLATION ONLY _
The installation is being made on property I rlwn which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: �` _ DATE:-
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR, ELEC N: DATE:-- _
LICENSE NO: ----------- -- --- ----
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
batereceived: Permit no.:
City of Tigard Project/appl.no.: Expire date:
r'in r./fit nrrl
Address: 13125 SW Hall Blvd.'Tigard,0,2 97223 pate issued: Ry: Receipt no.:
Phone: (503) 6394171
Fax: (503) 598-1960 Calc file no.: Payment type:
Land use approval: __—
all It t
U I &2 family dwelling or accessory U Commercial/indt„rrial U Mule-jamily _J Tenant improvement
U New construction (idition/alterution/replaceinent U(Wic U Partial
108 SUFE I NFOUNIA"11-11ON
Job address: 1 5W eo Ml�xrl�.l C.Z Bldg. r7,7 suite no.: Tax rtiap/tax lot/account no.:
Lot: I Block: Subdivision: PIt-jC(, L�&WL71N1 -
Project name: I Description and location of work on premises: E -Nil) t*.kl-1 POE Ll"e4-*"r�
Estimated date of completi•m/inspection: Z
Job no: Fee Max
_ --- - I)escrlptlon Qly. (e.., Total no.ins r
Business name:
----- - NewtealdenHal sinRkurnurltifamllvlrcr
Address: dwellltr(turth.Includes attached garaRe.
city:- " - Stuie: ZIP: servleehreluaea
1000 sy,ft.or less
Phone: Fax: E-r-rarl'
Each-additional 500 sq.ft.or portion thereof
CCB no.: Elec.bus. tic.no: Limited energy,residential
City/metro lic.no.: Limited energy,non-residential 2
F.ach manufactured home or rr adular dwelling
Si nature of
Service and/or feeder 2
supervising electrician(re uired) Date _
License no: Servieesorfeedero-Invtallat.vn.
Sup elect,nnme(printl; alteration or relocation:
2W amps or less 2
201 amps to 400 amps 2
Name(print): 7"t{ F 4 L-" c' �Q Jll D�• 401 ant rs to 6fxf amps _ _ 2
Mailing address: 4 t z S �vj Oe�:IC-Wi6 K) (:,1-• 601 amps to 1(100 amps _ 2
city, t - Slate: 8(4._ ZIP: 17'L•z-r Over IOW amps or volts
a.�
Phone: r," o• � ; Fax: I E-mail: ,0) Reconne tonly I
Owner installation:The installation is being made on property I own° k Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to +' Installation,alteration,or relocation:
200 amps or less _ 2
ORS 447,455,479,6 )1, n` 201 amps to 4W amps 2
Owner's signature: u' �' ' fy Date: i 401 to 61x1 ams ?
Branch circuits-new,alteratlop,
or extenslon per panel:
lame: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit '-
City: State: ZIP__ B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
I'hlnuc I as. I. twill Fachadditional branch circuit,
Misc.(Service or feeder not Included):
Nach um or irri anon circle 2
7Sfa le V,
U HCoIIII COrL`I7ICIIII� P P g 2
ce over 120 emps•rating of I k2 U Narnrdous location Each sign or outline lighting _
ydwellings UBudding over 10,(xx)square feet tour or Signal on,circuit(s)
ext n i limited energy panel,
U System over 6(x1 volts nominal mon:residential units in one structure alteration,or extension* 2
U Building over three stories U Feeders,4(10 amps or more •I)cscri tion: _ ---
U Occupant load over 99 persons U Manufactured structures or RV park Each odditMnal Inspection over the allowable In an)offt.above:
U Fgtessllightingplan U Other: Pet inspection
Submit__sets of plans with any of the above. investigation fee _
TMP above are not applicable to temporary construction service. either / /
Permit fee.....................$ J
Nn!011 iuri"ctions accept credit cards, ,team can Iunadictia!for asrxe!nfomraooi Notice: Phis pernut application Plan (at �)
U Visa U MasterCard expires if a permit is not obtained an review — --� �
credo card numberL- within ISO days after it has been State surcharge(9%) ....$
Expires accepted as complete. TOTAL $ f
Name or cardholder ii-shown on credit- t cr ---- s
Cardholder sir.nature -- Amount 44r}46IS:%4W UM'
Electrical Permit Fees: Limited Energy Fees:
- -- --- - --- --- - "- - — -�� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below Restricted Energy Fee...................................................... $75.00
Number of Ins ections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
itesidentinl-per Unit
1000 sq it or less _ $14•`1 1`' _- 4 ❑ Audio and Stereo Systems
Lach additional 500 sq ft or ❑
portion thereof _ $3340 t Burglar Alarm
Limited Energy _ $7500
Each Menufd Home or Modular ElGarageDoor Opener'
Dwelling Service or Feeder $9090
2
Services or Feeders ❑ Healing Ventilation and Air Conditioning System'
installation,alteration,or relocation
200 amps or less _ _ $8030 _ 2 ❑ Vacuum Systems'
201 amps to 400 amps $106.85 _
401 amps to 600 amps $160.60 ❑
Other
601 amps to 1000 amps _ $210.60 _ 2
Over 1000 amps or volts _ $454.65 2
Reconnect only $66.85 2
TYPE OF WORK INVOLVEL' - COMMERCIAL ONLY
Temporary Services or Feeders Fee for each system......................... ............................... V5.00
5.00
Installation,alteration,o,relocation (SEE OAR 918-260-260)
200 amps or less $66.85
201 amps to 400 amps $100.30 2
4Check Type of Work Involved:
01 amps to 600 amps $133.75
Over 600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑ Clock Systems
with purchase o/service or
feeder lee.
Each branch circuit $6.65 ❑ Data Telecommunication Installation
h)The fee for branch circuits
without purchase of service Fire Alarm Installation
or feeder fee.
First branch circuit _ $46.85 yC' -' ❑ HVAC
Each additional branch circuit $Fi 65 _
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $53,40 _ _._ F-1 Intercom and Paging Systems
F. sign or outline lighting $53.40 _-
Signal circuil(s)or a limited energy ❑� Landscape Irrigation Control'
panel,alteration or extension $75.00 __-
Minor Labels(10) $125.00 ❑
Medical
Each additional Inspection over
the allowable In any of the above ❑ Nurse Calls
Per inspection _ $62.50 _
Per hour --- $6250 _ ❑
In Plant $73 75 _ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ Other
8%.State Surcharge $ 751 __----Number of Systems
25%Plan Review Fee $ ' No licenses are required. Licenses are required for all other installations
See"Plan Review"section on _
front of application _ _.__--
Fees:
ElBalance Due $ -- Enter total of above fees =
LJ Trust Account If 8%State Surcharge :
-- - -� — Total Balance Due $
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