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� �'�� O� �����® EL�:CTRIGAL PERMIT
DEVELOPMENT SERVICES DATE SSUIED: 7/21/99 9-00444
13125 SW Hail Blvd., Ticia.rd,OR 97223 (503)639-4171 PARCEL: 2S110DA-01900
SITE ADDRESS: 10580 SW NAEVE ST
SUBDIVISION: RENAISSANCE SUMMIT ZONING: R-3.5
BLOCK: LOT : 010 JURISDICTION: TIG
Protect Description: First branch circuit
_ 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 amp: SIGNAUPANEL:
MANE HM/SVC/FUR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS _ _AL1[i'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: —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
1000+amn/volt: >=4 RES UMTS: >600 VOLT NOMINAL:
Reconnect only_ SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: _
Owner: Contractor:
JED SCHROEDER OWNER
10580 SW NAEVE ST
TIGARD, OR 97224
Phone: Phone:
Reg M
_ FEES Required Inspections
Type By Date Amount Receipt
Flect'I Service
PRMT BON 7/21/99 $37.50 99-317031 Elect'I Final
SPCT BON 7/21/99 $2.63 99-317031 ORIGINAL Total $40.13
This Permit is issued subje-,t to the regulations contained in the Tigard Municipal Code,State of OP,. Specialty Codes and all Mher applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is rut started within 180 daye
s of issuanc ,or if work is
suspended for more than 180 days. ATTENT!ON Oregon law requires you to follow rules adopted by the iPgon Utility Notification Center. Those
Nrules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtt,,.! copies of these rules ordirect questions to OUNC at(503)
246-187.
Permit Signature: Issued By:
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C9 OWNER INSTALLATION ONLY
J The installation is being made on prop" I own which is not intended for sale, lease, or rent. j c�
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OWNER'S SIGNATURE: _� DATE
CONTRACTOR INSTALLATION ONLY V
SIGNATURE OF SUPR. ELEC'N: DATE: —
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the nowt business day
CITY OF TIGARD Electrical Permit Application Plan c
1-3125 SW HALL, BLVD. Recd By OE_ _
TIGARD OR 97223 Date Recd 7-Z
Date to P.E.
Phone(503)6394171, x304 Date to DST _
Inc;,ccriurt(503)639-0175 Print of Type Permit
Fax(503) 598-1960 Incomplete or Sllagible will not be accepted called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development E4(- ,�St.CCyu-M0.71 Numtrer of Inspection*per ft allowed
Name(or name of bl �rts)__ 1 Service included: Items Cost Sum
Address-4D-5 _'St/I N�� If 4a. Resk4mtial-per unit
City/State/Zip, 1�Q� �_�-�� ZZ-{ 1000 sq 11 or less $ 117.75 _ 4
Fach additional 500 sq R or
portion
Commercial❑ Residential LL thereof 26.25 - 1
Limited Energy
$S 80.00 _
Each Manurd Home or Modu:sr
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). Installation,alteration or relocation
Electrical Contractor 200 amps or less _ $ 64.25 2
Address 201 amps to 400 amps $ 85.50 _ 2
401 amps to 600 amps S 128.50 2
City i State Zip 601 amps to 1000 amus __- - $ 19250 2
Phone No. ` _ _ Over 1000 amps or volts t 363.75 2
Job No. Reconnect only S ;3.50 2
Elec. Cont. Lice. No._ Ex Date_
-. P� 4c.Temporary services or Feeders
OR State CCB Reg. N0.-_ _Exp.Date._ installation,alteration,or relocation
COT Business Tax or Metro No._______Exp.Date 200 amps or less S 53.50 - 2
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Eler.'n - Over 600 amps to 1000 volts, -
see"b"above.
License No _ Exp.Uate _ 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
J feeder fee.
Print Owner's Name � ; �rD f olW Each branch circuit $ 5.35 7_
Address_f 9Sf_3�__ e%& sf _ b)The fee for branch circuits
without purchase o/service
City State Zip_g�Z _ or feeder fee.
Phone NO.� (j L!- z 0& _ First branch circuit _ s 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e.Mlacallaneous
intended for sale,lease or nt. (Service or feeder not Included)
Es• or Irrigation circle _ _ S 42.75 _
Owner's Signature __ _ r oultine lighting Y $ 42.75
I(s)or a limited energy
Iaratlon or extension g 60.00
3. Plan Review section(if required):* Minor panels(10) $ 107.00
Please check appropriate Item and enter fee In section 58. 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 $ 50 00
hour �_ �___ E 50.00
System over 600 volts nominal In Plant _ .__
$ 59.00
Classified area or structure containing special occupancy as
W described in N E.0 Chapter 5 5. Fees:
8a.Enter total of above fees $
* Submit 2 sats of plans with application whore any of the above apply. I S 4°/6 Surcharge(05 X total fees) S
Not required for temporary construction services. Subtotal $ �O• �_
Sb.Enter 25%of line 6a for
NOTICE Plan Review If retrad(Sec 3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account S
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Dile $ 16,13
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CITY OF TIGARD BUILDING INSPECTION DIVISIO1% Mgr
24-Hour Inspection Line: 639-4175 Business Line: 839-4171 —
Zil BUP
Date Requested ? 'T7 AM �PM BLD
Location Suite MEC _—
Contact Person _ — Ph PLM
Contractor — Ph SWR � ,�, ,I—,�c. Lf�
BUILDING Tenant/Owner .Q a o C� g 9 — ELC -' i L-�-1�1. `—�—
Retaining Wall ELR —_-- _
Footing Access:
Foundation FPS —
Fig Drain SGN
Crawl Drain Inspection Notes: --
Slab __ _ SIT
Post&Beam
Ext Sheath/Shear I
Int Sheath/Shear
Framing —_ --
Insulation
Drywall Nailing _—G27C I h Aqn e —
Firewall � L/
Fire Sprinkler �LY�L—_. �✓� AMC 4 Ld.1 110-r (A ZZ Y 11! — — —
Fire Alarm ��
Susp'd Ceiling -- -- —
Roof
Misc. -----
Final
PASS PART FAIL — — ---
PLUMBING --
Post&Beam
Under Slab
Top Out
Water Service _ — _—
Sanitary Sewer —
Rain Drains
Final ------------ --- - — — --
PASS PART FAILMECHANICAL
[lost
Post& Beam -- — --- `— _ --�
Rough In
Gas Line -- —. _—_ -- — ---- --
Smoke Dampers
Final -----•-- —_.._—______ _ � --
PASS PART FAIL — —
LECTR
IL Servicerx
Rough In
y UG/Slab
Low Voltage — -- —
J Fire Alarm
m
PASS� ART FAIL —. -- -- — -- --
W
Backfill/Grading
Sanitary Sewer
Storm Drain [ Reinspection fee of S required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinspection RE: ( �Unable to inspect-no access
ADA (�
Other
Approach/Sidewalk Date y�f_ Q _ L Inspector. _ Ext
Other �—•— —'
Final
PASS PART FAIL DO NOT REMOVE this inspection (record from the job site.
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