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9330 SIN OAK ST
CITY OF TIG /��y R® ELECTRICAL PERMIT_
PERMIT#: ELC2002-00487
DEVELOPMENT SERVICES DATE ISSUED: 9/17/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 PARCEL: 1S 135AC-03700
SITE ADDRESS: 09330 SW OAK ST
SUBDIVISION: ASHBROOK FARM ZONING: RA.5
BLOCK: LOT : 016 JURISDICTION: TIG
Project Descript!on: Replace damaged meterbase.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 arnp: – PUAP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 acro: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps-1000 volts: MINOR LABEL 1,10):
_SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS_ _
0 - 200 amp: 1 W/SERVICE OR FEFPER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC C c% ;DR: PER HOUR: �
401 - 600 amp: EA ADD". BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SUCTION_
1000+amp/volt: >�4 RES UNITS: _ _ >FAu VULT NOMINAL:
y
Reconnect only. >=225 AMPS_ S AREA/SPEC OCC:
Owner: Contractor:
FOREIGN MISSION FOUNDATION INC CAMERON THOMAS LLC
10875 SW 89TH AVE P.O. BOX 5324
TIGARD, OR 91223 ALOHA,OR 97006
Phone: Phone: 503-629-8938
Reg#: LIC 138773
ELE 34-5260
SUP 4633S
FEF3 Required Inspections
Type By Date Amount Receipt _ Elect'I Service
PRMT CTR 9/17/02 $80.30 2729020000( Elect't Final
5PCT CTR 9/17/02 $6.43 2720020000(
Total $66.73
This Permit Is issued subject to the regulations contained In the Tigard Municipal Code,SUte of OR.Specialty Codes and aA other applreable laws. All
work will be done In accordanoe with approved plans. This permit will a)pire if work K not started within 180 days of issuance,or if work is suspended
IL for more then 180 days. ATTENTION: Oregon law requires you to fol ow rules adopted by thi Oregon Utility NotI icntion Center. Tlxee rules are set
fcrth in OAR 952-001-0010 through QAF3 952-001-0080. You;,ray onta in copies of these rules or direct questions to OUNC at(503)248-8699 or
N 1-800-332-2344.
N
Permit Slgnature:� L/��r – �,\ Issued By:
_ OWNER INSTALLATION ONLY _
The installation is being made on property I own which is not intended for sale, lease, or rent. -
OWNER'S SIGNATURE: _ _ DATE:—
_ CO TOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: L " _ DATE: Q-z
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the next l,tusiness day
Electrical Permit Permit Application
Date received: 3F Z_ Permit no.:&ZC Zp
ZA
City of Tigard Project/app] no/: Expiredate:
CitynjTigard Address: 13125 SW Hall Blvd,Tigard,OR 972 Date issued: BYAW Receipt no.:
Phone: (503) 639-4171 ,(
Fax: (503) 598-1960 /I ! Case file no.: Payment type:
Land use approval: _ _
;addrmess: ��3oj
y dweilit,y,or accessory U Commerc-al/industrial U Multi-family U Tenant improvement
U uction U Addition/alteration/replacement U Other:_ _ U Partial
Job S 1/J Bldg.no.: Suite no.: Tax map/tax lodaccount no.:
Lot: Block: Subdivision:
Project name: _
Descripticn and location t,f work on premises iY1 6 7 EA A—4.-I Lr
Estimated data of com letion/intition:
Joh no: ree Max
Business name: 1 t _ (ra Total no.tram
f J– New nnbinMW-uM�ie or nwrltlda*r!y ger
Address: V3 taay laclaieaMhct�erigr.ge
City: State:p ZIP: 110(e SWVleeMelaie�
Phone: Fax: I E-mail: 1000 .ft.or leu; _ _ 4
(,3$ Each additional 300 sq.ft.or portion thereof
CCB no.: Elec.bus.tic.no: _ Umitedenergy,residential 2
City/m-trolic fg^1772 _
Lintitedenergy,non-residential 2
_ Each manufactured home or modular dwelling
Si n..urs of! e ectrician( uited Det Service and/or feeder 2
S�,p.eiect.nsrtx(print): / Li Dat
b Seniceaerfeeden—hsstallation,
alteratlon or relocation:
200 amps or less t2
Name(print): tot amps to 400 amps z
401 anips to NO amps _ 2
Mailing address: _M bot am a to 1000 amps 2
City: State: ZIP: Over 1000 Raps or volts 2
Phone: Fax: E-mail: Reconnect onli I
Owner installation:The installation is being made on property I own Teatgoraryservices orfeedery-
which is not intended for sale,lease,rent,or exchange according to bdanation,alrmefon,orrelocation:
201 amps or leas 2
ORS 447,455,479,670,701.
201 amps to 400 amps 2
Owner's si nature: Date: 401 to 600&me# _ 2
Branch drealts-new.attention.
or exteaslost ger panel:
Name: _ A. Fee for branch circuits with purchase of
I Address: smim o•feeder fte,each branch circuit 2
City: I State: ZIP: It. Fee for branch circuits without purchase
of service or feeder fee,Rat branch circuit: 2
0. Phone: Fax; E-mail: pachadditional branch citcuit:
(Service or feeder not loeladed):
Each um or iri ation circle 2
O Service over 225 amps-rommercid U Health-carefacility
U Service over 320 amps-rating of 1&2 U Hazardouslocation Each sign or outline lighting 2
familydwellings L]Building. er 10,000 square feet rour or Signal circuits)ora limited energy panel,
J U Svstem over 600 volts nominal more residential units in one structure alteration,or extension*
2
U Building over duce stories U'Feeders,400 amps or more •Descd on:
CD U Occupant load over 99 persons U Manufactured structures or RV park Fitch additioetal Imo. Im over Me allownMe M say of On shore:
W U Egress/lightingplan U Other - -- Per inspection
Submit_tett of plan+with any of the above. Invests &tion fa
The above are not applicable to temporary e0�ttrnctlplr service. aha
Nor all iarisdktions accept credi cards,please call)adsaktkm for mote Irtfonrratlan. Notice:ThPlan rois permit application Permit ie...................96)) $
U Visa U Maurch $
terCard expires if a permit is not obtained (at
Credit card namira _ _L__.1.-_ within 180 days after it has been State srcharge(8%)....S G•y3
r•piR, accepted m complete. TOTAL. $
.......................
Now a WD-6 on OWN cia
C iAnimal 4404615(&%"W)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMF;.FEES:
TYPE OF WORK INVOLVED-RESIDEN IAI.ONLY
Complete Fee Schedule Below: Restricted Energy Fee......................................................
_ Number of Inspections per pwmlt allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total `►' Check Type of Wotk Involved.
residential-per unit — -'
V
1000 aq ft a loss 5145.15 4 and Stereo System;F_ach additional 500 sq ft.or
portion thereof $3340 1 Alarm
Limited Energy $75.00Foch Manufd Home or Modular Door Oponer'
Dwelling Service or Feeder - 590.90 2
Services or Feeders ❑ Heating,Jenfilatkru and Air Conditioning System'
Installation,alteration or relocation �y
200 amps or less �� $80.30 O i �� 2 El Vacuum Systems'
201 amps to 400 ops _ $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps _ $240.60 2 ❑ Other_
�Over 1000 ampsi or volts $454.65 2
nnect only $66.85 2
Tempo�ry Sto elces or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY
Installation,glteration,or relocation Fee for each system.......................................................... $75.QQ
200 amps dr less — $66.85 2 (SEE OAR 918-260-260)
201 amps to 40G amps _ 5100.30 2
401 amps l0 800 d�pQpsq — 5133.75 7. Chet�c Type o1 Work Involved:
Over 600 amps to 1 volts, r�
see"b"above. \ l_1 Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New,alteration or extension pe I
a)The fee for branch circuits
with purchase of service or\ ❑ Clock Systems
feeder fee.
Each brancli circuit $8.65 2 Data Telecommunication Installation
b)The fee for branch circuits
wlthouf purchase of service ❑ Fire Alarm Installation
or feeder he.
First branch circuit HVAC
Each additional branch circuit .65
Miscellaneous Instrumentation
(Service or feeder not included)
Each ryimp or Irrigation circle $53.40 _ ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circui(s)or a limited energy
panel,alteration or extension $75.00 Landscape Irrigation Control'
Minor Labels(10) _ $125.00_ L , -
Each additional Inspection over / L dicot
the allowable In any of the above Nome C
Per inspw-tion $62.50 _i ❑
Per hour $82.50
In Plant $73.75 _ El
Outdoor Landsc4 ightine
Fres: [] Prolective Signaling
CL
Enter total of above fees5 A0 -�� Other _
y 8%State Surchsr9@ $�!J-3 _ T _--Number of Systems
25%Plan review Fee No licenses are required Licenses are required for all other Installations
See,-tan Regi w"sedkm $ ---a®- --- — ---
front of application. -
Fees:
W Total Balance Due $
Enter total of above fees =�r
❑ Trust Account M__ .. 8%State Surcharge S_�
Total Balance Due
All New Commercial Buildings require 2 sets of plans.
iAdsts\frmrnklc-fees.doc 08/30111
CITY OF TIGiARD 24-Hour
811.111WING x Inspection Line: (503)639-4171,
INSPECTION DIWS16N Business Line: (503)639.4171 MST �- --
BUIP
Received — �_Date Requested AM-_--_—_PM_ BUP
Location 3 3 U Sw GC
I & r _ -------_.Suite `___._ MEC .-- —
Contact Person ___-- Ph(_---) _1_ 'G G Y. PLM r _
Contractor_— _ Ph( ) _ SWR
BUILDING Tenant/Owner _ ELC
Footing
Foundation Access: ELC ---
Fog Drain ELR _ _--__—
Crawl Drain
Slab Inspection Notes: 1, SIT
Post& Beam
Shear Anchors -�-
Ext Sheath/Shear _--
Int Sheath/Shear O
Framing
insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'dCeiling — --- -----------..._._
Roof
Other:
Final
PASS PART FAIL ------- _— -- -- ---- -- __
PLUMBING --
Post&Beam
Under Slab —
Rough-In
Water Service
Sanitary Sewer
Rain Drains ---------
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final — ---__
PASS PART 17-All.
_MECHANICAL
Post& Beam
Rough-in
Gas Line _.-_---
0. Smoke Dampers
a Final
U) PAS PART FAIL —__—_---- - --------.—---..—
—
m Rough-In
j UG/Slab
Lu Low Voltage
Fire Alarm
0.� PARI FAIL Reinspection fee of$ required before neA inspection. Pay at City Hall, 11;25` W#roll S-lvd.
E Please call for reinspection RE:__ F1 Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Blab
Other:_ _
Final �— DO NOT REMOVE this IEItEt;pocOor� coIl'ofirom tho 06 fllltl.
PASS PART FAIL