12887 SW RIDGEFIELD LANE N
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12897 SW Ridgefield
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CITY
� � � �� ������ ___� ELECT R{CALPERMIT
/ \ PERMIT#: ELC2001-00655
DEVELOPMENT SERVICES DATE ISSUED: 12/27/01
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104DD-02400
SITE ADDRESS: 12887 SW RIDGEFIELD LN
SUBDIVISION: MOUNTAIN HIGHLANDS#2 ZONING: R-4.5
BLOCK: LOT : 021 JURISDICTION- TIG
Proiect Description: Installation of 2 branch circuits.
_ RESIDENTIAL UNIT_ TEMP SRVC/FEEDERS __ _ MISCELLANEOUS___
1000 SF OR LESS: 0 - 200 amp:—� PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 arnp: SIGN/OUT LINE LTG:
LIMITED ENERGY. 401 - 600 amp: SIGNALIPANEL:
MANF HM/ SVC/ FDR: 601+amus - 1000 volts: MINOR LABEL (10):
—_SERVICE/FEEDER _B_RANCH CIRCUITS ADD'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: 1 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION --
1000+
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only___ SVC/FDR >= 225 AMPS: CLASS AREA/SPE1- OCC:
Owner: Contractor:
LAUINGER, RICHARD D +SANDRA K OWNER
12887 SW RIDGEFIELD LN
TIGARD, OR 97223
Phone: Phone:
Reg #:
F_EES _ Required Inspections-------
Type
nspections ___ --
Type By Date Amount Receipt Rough-in
PRMT CTR 12/27/01 $53.50 2720010000( Elect'I Final
5PCT CTR 12/27/01 $4.28 2720010000(
Total $57.78
This Permit is Issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specially 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,ur if
work is suspended for mrna than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signature:
Issued By:
OWNER INSTALLATION ONLY
The installation is being ma property I o hich is not intended for sale, lease, or rent.
ll
OWNER'S SIGNATURE: — DATE: '
CONTRACT R INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:—
LICENSE
A";E:LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next bi.rsine s day
Electrical Permit Application
!— Date received:/: .Z) e" Permitno
c`�1..C2Q9/-OCLSS
City of Tigard Project/appl.no.: Expire date:
O'!ry r/7ifurd Address: 13125 SW Hall Hlvd,'Tigard,OR 9.1223 Date issued: Byte&) Receiptno.:
Phone: (503) 639-4171
Fax: (503 598-1960 Case file no.: Payment type:
Land use approval:
UVPE
1
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New construction U Addition/alteration/repiaccnI{ni J Other: _ U Partial
.1411111 44111 1 NFORMATION
Joh address: 'FB
bldg. no.: 5wte nu.: Tax map/tax lot/account no.:lot: Block Subdivision: y __
Project name: � I Uescription and location of work on premises:
Estimated date of cru ilhorm/insMx tion:
CONTRACIVA i
Job no: 1'cc Mat,
Urycripdrm C„�• ka1 111111 no.in'.p
Business name: _
Ncw msickni ial stngk•or could-famiiv per
Address' — dw citing uait.Incluresnvigr•
tfarlicitpr .
City: -state': 711: tiericehreluded:
Phone: Fax: E-mail: IMR)sq.11.or less _ 4
CCB no.: Elec.bus.lic.no: Each additional Nx1 sq tt.or portion thereof
Li citedenergyresidential 2
City/metro llc.no.: Lin.: .d energy,non-esidenlial 2
Each munulactured home or modular dwelling
Signature of su rvising cl equired)- _ pate _----- Service and/or feeder 2
Slip elect nantelpnnl — �i ,„ ,:, Services or feeders-Insullalon,
alteration or relocation:
PROPERAQWNER
2fX)A171p5 or less
Name(print): - 201 amps to 4(x1 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to I(XX)amps z
City: Ta4) State: 71P: Over I IXXI amps ar volts _ 2
Phone: r -L)o fl I Fax: I E-mail: Reconnectanly I
owner installation:The installation is being made on property I own temporary services or feeden-
which is not intended for sale,lease•rent,or exchange according to Installation,alteration,orrelocation:
21X)amps or less 2
ORS 447,455,47y 6�0,7 1. - —
201 amps l0 4011 nntps 2
Owner's si rnaturl�'' d Date: Z �� 401 is,boo am rs - 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: _ __ service a1 feeder fee,each branch circuit
(ily: --� -- Sec le:
zip _ B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: Fax: mail
Each additional branch circuit
Misc.(Service or feeder not Included):
D Service over 22S amps-commercial J l lrnhb care l'mibly Each pump onrrigmum ctrcic
•Service over 320 amps•rating of I&2 U Hazardous location Each sign or outline lighting - 2
fnmilydwdlings U Building over IO,INNI syuarc feet four or Signal circuits)or a limited energy panel,
U System over 6W volts nomiml more residential units in one structure aheration,ar extension* 2
U Building over three stories U Feeders,41X1 amps or mor,! *Description.
U Occupant load over 99 persons U Manufactured structures or RV park Foch additional Inspection over the allowahle In any of the above:
U Bgressllightingplao U Other __-_--- — Per inspection F-1 I Submit_^sets of plain with any of the above. Investigation fee
The above are not applicable to temporary construction service, Other
Not aft Juriedictiuu+accept credit card+,please calf junuficncwr for mare infrxrrutian. Notice:This permit application Permit fee.....................$ �•
r',SG
U Visa U MasterCard expires if a permit is not obtained Plan review(at _.-, %) $
Credit card number:_ _._- __.-___ within 180 days after it has been State surcharge(8%)....$ ye -Zo
accepted as complete.
Name of cardholder ar rhnwn nn c it Ord
Cardhol aiainttue� - Amount 440-461516M'OM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
p Restricted Energy Fee................... $75.00
...................................
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential-per unit
1000 sq ft.or less $145 15 4 ❑ Audio and Stereo Systems'
Eech additional 500 sq ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manurd Home or Modular
Dwelling Service or Feeder $90.90_ 2 ❑ Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installaliun,alteration,or relocation
200 amps or less $80.30 2
201 amps to 400 amps _ $106.85 2 U Vacuum Systems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 _ 2 ❑ Other
Over 1000 amps c volts $454.65_ 2
Reconnect only $66.85_ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL. ONLY
Installation,alteration,or relocation I'ee for each system................................................. ........ $75 00
200 amps or less $66.85 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75_ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel ❑ Boiler Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 _ 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire AlarmInstallation
171rst branch circuit $46.85 y� .
E ach additional branch circuit _L $6.65 ❑ HVAC
Miscellaneous ❑
Instrumentation
(Service or feeder not Included)
Each pump or Inlgetion circle $53.40
Each sign or outline lighting $53,40--- ❑ intercom and Paging Systems
Signal circult(s)or o limited energy
panel,alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) $125.00
Each additional Inspection over _ ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $6250
In Plant —_ $73.75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ e �• ✓ ❑ Other
8%State Surcharge $
-----Number of Systems
25%Plan Review Fee
See"Plan Review"rection on $ No licenses are required Licenses are required lot all other installations
front of application
Fees:
Total Balance Due $
Enter total of above fees
❑ Trust Account# 80,e Slate Surcharge $
Total Balance Due $
All New Commercial Buildings require 2 sets of plans.
i 41sts\fonnc\elc-fees.doc 0810/01
M' I
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVIS;ON Business L'ne: (503)639-4171
BUP _-
Received _ Date RP
,,equested__ . AM_ __ PM_ __ BU
Location __ k -4.; 1,41-�--Suite ____-__^_ MEG
Contact Person _ Ph(__ ) ,— ___ PLM
Contractor _-___ Ph( __ ) SWR
BUILDING Tenant/Owner ^ _ ELC
Footing -� ELC ''• �!S
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear C4 C
Int Sheath/Shear
Framing -
Insulation G
Drywall Nailing --- - --
Firewall
Fire Sprinkler - --
Fire Alarm
Susp'd Ceiling
Roof
Other: •c-�.f�.� .��
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 Q �-�l._.L:
PASS PART FAIL_ f - -
MECHANICAL __ __. _-___�__._�__.�. 4^ 1.� -%�•n __^ _-__�-�_
Post&Beam
Rough-In
Gas Line
Smoke Dampers - - - -- - --
Final
PASS PART FAIL - -
ELECTRICAL
Service
Rough-In -_- _ - -- -- --- ----
UQ/Slab
Low Voltage -_-_�-_-_--
Fire Alarm 11
AS PART FAIL -
J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Appronch/Sidewalk Ext-
Other
Final DO NOT REMOVE this Inspsctton record from the Jab A*.
PASS PART FAIL