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9405 SW NORTH DAKOTA ST
CITY OF TELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT *: ELC99-0008
AUZAINAW 13125 SW Mall Blvd.,Tlgsrd,OR 97223(503)639.4171 DATE ISSUED: 01/07/99
PARCEL: 1S135DB-10000
SITE ADDRESS. . . :O94O5 SW NORTH DAKOTA ST
SUBDIVISION. . . . :MAYFAIR ZONING:R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :OO4 JURISDICTION: TIG
Project Description: Alterntion of electrical service for residence.
------------------------------------------- --------------------------------------
---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- -----MISCELLANEOUS---- -
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADC'L 5O0SF. . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10). . . 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS----- ---ADD'L INSPECTION.----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 12ER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 let W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD'L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -• --------------PLAN REVIEW SECTION------- ---------
1000+ amp/volt. . . . . : 0 >=4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Rezonnect only. . . . . : 0 cVC/FDR >= 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: -------------------- -- ------•--------------------- FEES --------------- -
BARBARA DAVIS type amount by date recpt
194 ,5 SW NORTH DAKOTA PRMT $ 35. 00 DLH 01/07/99 99-312007
TIGARD OR 97223 SPCT $ 1 . 73 DLH 01/07/99 99-312007
Phone if:
Contractor: -- -----------------------------
AM ELECTRIC $ 36. 75 TOTAL
AUGU!;TIN MURAR
13050 SW FOREST GLEN CT ------- REQUIRED INSPECTIONS -----
BEAVERTON OR 97008 Rough-in £lect 'l Final
Phone #: 626-1925 Elect'l Service
Reg #. . : 80818
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all o,her
applicable leve. All work will be done in accordance with approved plena. This permit will expire if work is not ,farted within '.82
days of iseuence, or if wore is suspended for more than 184 days. ATTFITIORc Oregon In requires you to follow the rules ec^,t, by
the Oregon Utility Ratification Center. Those rules ere set forth in BAR 932-101-4110 through OAR 952-101-1987. You say ob',ain a ropy
of these rules or direct questions to MMC by calling 55431246-1."7.
Permittee Signntur e: LE-1 Issued By:
CL
------------------- --------
a
N ------------------- --------OWNER INSTALLATION ONLY------------------------------
The installation is being made on property I own which is not intended for
J sale, lease, or rent. i
_m OWNER'S SIGNATURE: /�� DATE:
W -------- --- ------------ -CONTRACTOR INSTALLATION ONLY----------------------------
RIGNATIIRF OF SUPR. ELEC'N: �',Z!� L���%/0� DATE:
LICENSE NO:
++++ ►*++++++r+ *r.++++++++t*++*++t+t+t+.4....tt+♦+tr+ +t+++♦++♦r+♦++tt............
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
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CITY OF TIGARD Electrical Permit Application Plan Check K -
13125 SW HALL BLVD. Rec'd By
Data Rec'd 7 y
TIGARD OR 97'223 -
Date to P.E. -
Phone (503)639-4171, x304 Date to DST
Inspection 503 639-4175 Prirlt or Type ���'/
p ( ) Incomplete or illegible will not be accepter) Permit r `Cc7
Fax (503) 6134-7297 called
11. Job Address: 4. Complete Fee Crhedule Below:
Name of Development_ Numbor of inspections per permit allowed
Name(or name of business), Service Included: Items Cost Sum
Address,_ t/S 4a. Residential-par unit
City/State/Zip ?/(-A g!) D- ZZ Tj i sq.n.or less $110.00 4
Each additional 500 sq.ft.or
Commercial ❑ Residential® portion thereof $25.00 �! 1
Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder __ $68.00 _ _ 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor Oq/)I F e ecT-R I c Installation,alteration,or relocation
Address 3CGJ7J SW 200 amps or less $60,00 2
201 amps to 400 amps :80.00 2
City ge-4 yrlRTo N State 00- Zip q 7 c-1 0 8 401 amps to 600 amps $120.00 2
Phone No. 61.6•- /Q 2 J- 601 amps to 1000 amps $180.00 2
,lob N0. Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. 3 Y - le5 Exp.Date%� tasReconnect only $50.00 2
OR State CCB Reg. No. eco ! Exp.Date z vz-?;T' 4c.Temporary Services or Feeders
COT Business Tax or Metro No.� Exp.Date Installation,alteration,or relocation
200 amps or less _ $50.00 2
Signature of Supr. Elec'1,_, 201 amps to 400 amps $75.00 _ 2
401 amps to 600 amps $100.00 p 2
r- Ovor 600 amps to 1000 volts,
License No. 8 4 S Exp.Date_�ii�4N/o/. sea..b',above.
Phone No.
-� 4d.Branch Circuits
New,alteration or ortonsion per panel
2b. For owner installations: a)The foe for branch circuits with
purchmse of service or
Print Owner's Name--- feeder lea.
Address Each branch circuit $5.00 2
or branch crc
City State ._ Zip_ y b)rnwlfhor fee Ipurelrsseiofults
Phone No. _ service or feeder foo.
First branch circult �-.. $35.00 _ 2
The installation is being made on property I own which is not Each additional branch clrruit $F.00 � 2
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owner's Signature_ Each pump or Irrigation circle $40.00 2
Each sign or outline lighting $40.00 _-
3. Plan Review section (if required):* Signal circuit(s)or a IlmNed energy
d panel,alteration or extension $40.00 _ 2
Please check appropriate Item and enter fee in section 5B. Minor Labels(10) $100.00
__ 4 or more residential units In one structure 4f.Each additional Inspection r ver
Service and feeder 225 amps or more the allowable In any of the sho%n
System over E00 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
M as described In N.E.C.Chapter 5 In Plant $55.00 _
W *Submit 2 seta of plans with application where any of the above apply. Jr. Fees:
J Not required for temporary construction services. 5e.Enter total of above fees $ 35 V V
5%Surcharge(.05 X total fees) $ _l,�7 c
NOTICE Subtotal $
5h.Enter 250 of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review jtWyjLqd(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONE.0 FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. 0 Trust Account If____------- $ 34, '7S
Total balance Due
1 v!sTSTI cs6 APP naV s+as
I
CITY O TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT #PERMIT• . MEC�1�1-0003
13125 SW Hall Blvd.,Tigard,OR 97223(503)639-4171 DATE ISSUED: 01/04/99
PARCEL: 1S135DB--10000
SITE ADDRESS. . . : 09405 SW N0RT14 DAKOTA ST
SUBDIVISION. . . . : MAYFAIR ZONING: R-4. 5
BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . :004 JURISDICTION: TIG
CLASS OF WORK. . :AI_T FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. • . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GF . :R3 VENTS W/O APPL.: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . 1 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYKES-------------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS 3-15 HP. . . . t 0 COMML.. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLQ DRYERS. . : 0
NO. OF UNITS------ ----- AIR HANDLING LINITS OTHER UNITS. : 0
FURN ( 100K BTU: 1 <= 10000 cfm: A GAS OUTLETS. : 1
F URN ) =r 100K BTI..): 0 > 10000 r-f m: 0
Remarks : Installation of residential furnace.
e _--.--.----------•-----------.---------------
Owner ------------- FEES --------------
BARBARA DAVIS type amount by date rer_pt
5405 SW NORTH DAKOTA STREET PRMT $ 25. 00 DLH 01/04/99 99-311904
TIGARD OR 97223 SPCT $ 1. 25 DLH 01/04/99 99-311904
Phone #: 684-6616
Contract or: -------------------------------
BRUTON COMFORT CONTROL INC
IP855 SW .2ND ST ----------------------------- -------
$ 26. 25 TOTAL
BE.')VERTON OR 97008--5152
Ph o i,e #: 503-626-7477
Reg #. . 65296
----- - — REQUIRE,% INSPECTIONS
---- ---
This permit is issued subject to the regulations contained in the Gas Line Ins p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical I n s p _
i� applicable laws. All Mork will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started _
IL within 180 days of issuance, or if work is suspended for eor@
than 180 days. ATTENTION: Oregon law requires you to follow rules
U) adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 9M-001-0010 through OAR 952-00!-0080. You may
..� obtain copies of these rules or direct questions to OLK by calling
00 (5031246-9187.
W _
.J
Tssue By :/r�' Permittee Sigriatotre :
-f+++i.44..F+++++++++++....+++++++++++++++++++++++++++•F++++++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
++++++++++++++++++++++i-+.+++++++++++++++++++++++++++++++++++++++++++++•F+++++++++
CITY OF TIGARD Mechanical Permit Application Plan cheek
PP Rec'd By_
13125 SW HALL BLVD. Commercial and Residential Date Recd /Z
TIGARD, OR 97223 Date M P.E.
(503) 639-4171, x304 / Permi+Date to DST
& "—
N!
CITY OF TIGARD BUILDING INSPECTION DIVISION � MST
24-Hour Inspection Line- 639-4176 Business Line: 639-4171
atop
Date Requested_ / /A AM PM
— B
Location �/7�0_` -sCt.,, /ji�f`t_ L����, SuiteC�t- _
Contact Person � ZQ,ZCI )- Ph 7� PLM _
Contractor _ Ph SWR
BUILDING Tenant/Owner _ ELC
Retaining Wall ELR
Footing --
Foundation ACCESS:
FPS _
Fig Drain
Crawl Drain Inspection Notes: SGN _
Slab -1 L�� 1dc-d. .� SIT
Post&Beam ---
Ext Sheath/ShearCLcc — u r t
int Sheath/Shear r �j
Framing L� L_"— _ li _ ��`t(J-+,\ C
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �(\ J
Susp'd Ceiling
Roof �_ ✓Z �— _—_
Misc:
Final
PASS PART FAIL `-
PLUMBING
Post&Beam ---
Under Slab
Top Out - --
Water Service
Sanitary Sewer
Rain Drains _
Final -
PASS ART FAR
P-os-F&Beam
Rou /
as m -- .-
mo eDampers
(fin ---- - - -
RT FAIL `� ~/�/ L--VA �-
ICAL - - -
IL Service
hri'
Rough In
CO) IJG/Slab
Low Voltage
J Fire Alarm
ED Final
V, PASS PART FAIL
W SITE
J --
Backfill/Grading - - - - ------- --
Sanitary Sewer
Storm Drain I J Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hell Stvr'
Catch Basin ] ]Please call for reinspe ion RE: Unable to
Fire Supply Line Inspect-no access
ADA �j
Approach/Sidewalk Date ` ( Inas ctor ~ C/ L...� `�
Other Pe _ Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job slty.
CITY OF TIGARD {BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
SUP _
Date Requested i ___AM—__._PM —_ BLD _
Location � _L/ _ ��it� k<<-;,7 ,4 Suitt' _ MEC _
Contact PerFon Ph PI.M {
Contractor Ph SVYR
BUILDING Tenant/Owner
Retaining Wall ELR
Footing Access: —
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab —__ SIT
Post&Beam —.
Ext SheathlShear __—
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ----
Firewall
Fire Sprinkler
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 FAIL
MECHANICAL
Post&Beam -- -- ---- —
Rough In
Gas Line --- ------ --- ---
Smoke Dampers
Final -- — —— — —
__PART, FAIL
(ELECTRICAL _--
a service - -- --- —— — — - - _,-- — - — --
@= Rough In
H UG/Slab
Low Voltage ,rZi�' —_-__-- —___—__.– __-- ----- --
J F��rm J�
m PART FAIL
W
Backfill/Grading — — --- —` — — - —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _,—required before next inspection. Pay at City Hall, 13125 SW Heil Blvd
Catch Basin ( )Please call for reinspection RE: [ ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date
Other ,Z [1 �. _Insiaector _Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.