13580 SW VILLAGE GLENN DRIVE-1 ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business P hot : 639-4171
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Date Requested: A.M.
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Location:
Suite: Bldg: __— NEC:
PLM:
Contractor: w �—� `J1Phone: > Z � G O
Ownc�:
Phone: ----- Eu"
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BLDG coni) P UMBIN(; MECHANICAL LECTRIC SITE
G 1 PosUlieam Post/Beam Irover&Zr ice Sewer/Stonn
Site Posie Ceiling Water Line
Footing Roof tJndFVSlab Rough-In Rough-in gln UG Sprinkler
Slab Framing Top Out Gas Line Vault
Foundation Insulation Sewer liood/Duct Reconnect
(3stnt Uamp Drywall
Storm Furnace Temp Service MISC.
A/C UG Slab
Masson. Ceiling Rain Ihain
Shear/Sheath Fire Spklr/Alm Crawl/i'nurd Dr heat Ptunp Low Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Need Not FINAL Approved
FINAL FINAL. FINAL
0 Call for rein..Vation 0 Reinspection fee of S_ required before next inspection (7 l Inable to inspect
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Inspector
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TIGARD
CITY OF ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97-0248
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED• 04/24/97
PARCEL: 2S 102CA-00 f1,3
SITE ADDRF.S S. . . : 1.35A0 SW VILLAGE GLENN DR ZONING:R-4. 5
SUBDIVISION. . . . :VILLAGE GLENN JURISDICTION: TIG
BLOCK. . . . . . . LOT. . . . . . . . . . . . . :4;'.s
!=,ro.j ect De scr i.pt ion: instl 3 branch circuits//job t 6668
-------------------------------------------------------------
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS. . . . : 0 iT — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5WSF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 171 401 — 500 amp. . . . . . . : 171 SIGNAL/PANEL. . . . . . . . 0
MANF. HM/ SVC/I'DR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 1.0) . . . : 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS------ ---ADD' L TNSPECfIONS---
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 — 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 2 IN PLANT. . . . . . . . . . . : 0
601 -- 1000 amp. . . . . • 171 -------------------PLAN REVIEW SECTION-----------------
1000+
--------- --__1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) - 225 AMPS. . : CLASS AREA/SPEC—OCC
Owner: --------------------------------------------------- FEES —
DUANE SOILEAU type amount by date rer_pt
1.3580 SW VILLAGE GLEN DR PRMT $ 45. 00 TAT 0,4/24/97 97-293692
TIGARD OR 97223 SPCT $ 2. 25 TAI 04/24/97 97-293692
Phone #:
Cont ract or: —
JPC ELECTRICAL_ SERVICES INC $ 47. 25 TOTAL
4040 SE INTERNATIONAL WAY
___-_--.-- RE01-31 RED I N aPECl"I Qh15 - - --
MILWAUKIE OR 97222 Ceiling Cover Underground Cove
Phone #: 503-654-3325 Wall Cover Elect' l Service
Reg #. . : 000937
regulations contained in the
This perait is 155Ued subject to the re g
Tigard Municipal Code, Steto eF Ore. Specialty Codes and all other !germ i t t 7 Si.gnat� t�
applicable laws. All wark ,4ill be done in accordance with
approved plans. This perait will expire if work is not started
within 168 days of issuance, or if work is suspended for sore
than IAA days. t s s By
y
!_I_..ATION ONI..Y-----
INSTA
Theinstallation is being made an property I own which is nut intended for
sale, lease, or rent. DATE:
OWNER' S SIGNATURE:
---------------------
- -----CONTRACTOR INSTALLATION ONL ------ --
SIGNATURE OFSUPR. ELEC' N: Ot �- __�_ DATE a
G11 �
LICENSE N0: 1�L� ----
Call for inspection — 639--4175
i
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # E.L 0 1 I- ,
Phone (503) 639-4171 Date Issued _ Z
FAX (503) 684-7297
Issued by
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: F4_ Complete Fee Schedule Below:
Name of Development IAS e Sc,, r Leu Number of Inspections per permit allowed
Address 1 -3 S7-0 St&l kj, 1 Gf Q, r Seri,o Included Ilents Cost(ea) Sum
City/State/Z.ip r-A 7 D. 3 40. Residential- per unit 4
1000 eq 11 or lose $11000 _
Name (or name of business) Each it erel f eq h or
portionmon on fhaol $zF 00
Limited Energy $2500
Commercial❑ Residential
Each Menul'd Homo or Modular
Iavolhng Service or Feeder 388 n0
2a. Contractor installation only:
4b.Services or Feeders
Installation,alteration,or relocation 2
Electrical Contractor• 'ck r I(u_) OrL)I( Ps 200 amps or lees $6000 2
Address�1 U S Zn} rnu t i a.— 1 W A10:7 201 amps to 400 amps $80 00 2
Ci yY I �• R. � State ( ZI ��/ 401 amps to 800 amps $120 oU 2
�7 ]r .W`1 � p 801 amps to 1000 amps $18000 2
Phone No. let 5,-1 —33 1 S Over 1000 amps or volts $34000 2
Contractor's l-icense No. 34-- 3 2=C Reconnect only $5000
Contractor's Board Reg. No. ci-)ri 3 '17 y 4c.Temporary Services or Feeders
Installation alteration,or relocation
Signature of Supr. Elec'n _ _ 200 amps or lima $5n 00 '
Licen3e NO._ _- _ one No."y 201 amps to 400 amps $7500
401 amps to 000 amp, $10000
Over 600 amps to 1000 volte
2!). For owner installations: mea V above
4d. Branch Circuits
Print Owner's Name_ New,alteration or extension per panel
Address n)The lee for branch circuits with
City State Zip
purchaw of eertrks of AeeOer An.
Each branch circuit $500
Phone No. h)The fee for branch circuits wffholif
The installation is being made on property I own which is purchase of service or Nader IlN•
not intended for sale, lease Or rent. Firm branch circuit $35 no
Earh addalonnl branch circuit J� $500
Owner's Signature__ __ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or irrigation circle $4000 -
Each sign or outline lighting $4000 —
Signal circuit(s)or a limited energy
Please check appropriate Item and enter fee in section 5B. panel,alteration or extension $4000
4 or more residential units in one structure Minor I shale(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
Iwr nryw-I�:ri _
as described in N E.C. Chapter 5 $0500$5500 —
tr,i imd $5500 — --
Submit 2 sets of plans with application where any of the above II
apply. Not required for temporary construction services. S. Fees:
NOTICE 5a. enter total of above fees $
5%Surcharge(05 X total tees) $ -'
PERMITS BECOME VOID IF WORT. OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDru OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ _ _-
COMMENCED. ❑ Trust Account N $ I
Balance Due $ 4 �;
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