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9686 SW VENTURA COURT
9686 SW Ventura Court CITY OF TIGARD _ ELECTRICAL PERMIT PERMIT#: ELC2002-00629 DEVELOPMENT SERVICES DATE ISSUED: 12/6!02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S125DD-08800 SITE ADDRESS: 09686 SW VENTURA CT ZONING: R-4.5 SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 BLOCK: LOT : 0O(-) JURISDICTION: TIG Project Description: Installation of(1)branch circuit for new hot tub. RESIDENTIAL UNIT TEMP SRV_C/FE_EDERS _ MISCELLANEOUS _ 1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION: EACH ADD'I_5009F: 2P i - 400<^mp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL MANF HM/SVC/FDR: 601+amps - 1000 voits: MINOR LABEL. (10): SERVICEIFEEDER BRANCH CIRCUITS —_ ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st VV/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L SRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ PLAN REVIEW SECTION 1000+ amp/volt• >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: MEDLIN,TIM ULORI E NORTH BY NORTHWEST 9686 SW VENTURA CT 326 S 15TH ST. TIGARD,OR 97223 ST,HELENS, OR 97051 Phone: Phone: 503-348-0505 Reg #: LIC 142140 ELE 5-50C FEES SUI' 45125 Descriptioi+ Date Amount Required Inspections 11:1.PRMT1 EL('Pcnnil 12/6/02 $46.85 1TAXI 81%State Tax 12/6102 $3.75 Rough-in _ Elect'I Final Total $50.60 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,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAK 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-800-332-2344. Issued By: Permit Signature: _ 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: _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.,E/LEC'N: .e n' DATE:.- LICENSE NO: - Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application, -- P!ttcreceived: /� Permitno.:�LP1Bor-Gd(pe?9 City of Tigard Project/appl.no.: E ' cdote: City u(Tigard Address: 13125 SW hull Illvd,Tigard,OR 97221 Date issued: y-, Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ OF PiRFAIT I &2 family dwelling or accessory 0 Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacemcnt U Other: U Partial 1 . SITE INFPRNIATION Job address: WV6 S,„ Vr,VrAe.+ C_ Bldg.no.: Suite no.: ITax map/tax lot/account no.: Lot: Block: Subdivision: Project name: Description and location of work on premises: Y Estimated date of completion/inspection: 1 1 1SCHEDULE Job no: Fee Max ---- _ I/escrlption 01y. (ea.) lutal mo.imp Business name: 4)6,LC (3 c5v --.-- New residential-single ormulli-famllyper Address: �6 J f�j doellingunit.Inciudcsattachedgarage. Cily:sT t4's Stale: o,1 ZIP: `/'), I tiersiminchulrvl: Phone:aLf% cKiv'; F'ax:15,nLwii:`p 1' E-mail: 1000 sq.ft.or test. _ 4 CCB no.: /Ha BICC.bus.lie.no: c— Erich additional 500 sq.ft.or portion thereof Limited energy,residential 2 City/metro lie.no.: Lr o Limited energy,non-residential 2 Ort F.ach manufactured home or modular dwelling Si ng u,ure pervising electrician!regnired) Dote Service an,u'urfeeder — 2 Sup,elect.name(print): .y- I,- / i.icense no: o �/SIeZ S Serrates oreeden—Inslallnllon, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name(print): Teo 201 amps to 400 amps 2 401 amps to 600 amps _ 2 Mailing Address: 601 amps to 1000 amps 2 City: State: ZIP: Over 1000 amps or volts 2 Phone:p?y-i ' ,3t;t I E-mail: Reconnectonly I Owner installation:The installation is being made on property 1 own Temporary services or feeders. which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocatIon: ORS 447,455,479,670,701. 200 amps or less — 2 201 amps to 4tx)amps 2 Owner's si mature: Date: 401 to 6(x)ams 2 Branch circuits-new,alierallon, or extension per panel: Name. _ A. Fee for branch circuits with purchase of AddrLSS: service or feeder fee,each branch circuit 2 CityTStale: Zip: B. Fee for branch circuits without purchase Phone -- J_l __ Ii-mail:a -- of service(it feeder fee,first branch circuit: 2 j I . Each additional branch circuit: PLAN HEVI FW(Please check all that appl�) Misc.(Service or feeder not included): U Service over 225 amps-eonma retal U 11milth care facility Bach pump or irriganun circle 2 U Service over:120 amps-rating of 1&2 U Hazardous location Fach sign or outline lighting 2 family dwell ings U Building over 10,00()square feet four or Signal circuit(s)or it limited energy panel, U System over 6(x1 volts nominal more residential units in one structure alteration,or extension* 2_ U Building over three stories U Feedem 40(1 amps or more *Mscrition U Occupant load river 99 persons U Manufactured structures or RV park tAch addhlonal Inspection over the rllowable In anv of the above: U EgressMightingpinn U rather' -- -- Per inspection Submit_sets or pian.with any of the above. Investigation fee_ _ The above are not applicable to temporrary construction service. Other -- Permit fee.....................$ , n r Not All jurisdiction+accela credit cards,Please call iuri+dictim for more information. Notice:'This permit application U Visa U MasterCard expires if n permit is not obtained Plan review(at _ %) $ Credit card numlwf _ _ _ within 190 days atter it has been State surcharge(8%)....$ T� 'aMfe' accepted as complete. TOTAL .......................$ Name of cardho r u shown nn credit caroT� Cordli-ATer dtrtature — Amount 440.4615(frit WOM1 1 ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEZ3: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY /a Restricted Energy Foe..................................................... $75.00 Number of inspections per permit allowed (FOR AU SYSTEMS) Service included: Items CostI _ Total Check Type of Work Involved. Residential-per unit 1000 sq ft.or less ,._ $1,15 1` 4 ❑ Audio and Stereo Systems' Each additional 500 sq,ft portion theroof $33,10 1 ❑ Burglar Alarm Lir,wod Energy $75 00 Each Manufd Home or Modular Dwelling Service or Feeder $'+o s!(j _ 2 ❑ Garage Door Opener' Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 _ 2 ❑ 201 amps to 400 amps _ $106.85 2 Vacuum Systems' 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps $24060 _ 2 Other Over 1000 amps or volts _ $454.65 2 Reconnect only $66.85 _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, 4ee"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel 1 Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder foe. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 Intercom and Paging Systems Each sign or outline lighting $53.40 ❑ Sign.-circult(s)or a limited energy panel,alteration or extension $75.00 ❑ landscape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspection over F-1 Medical the allowable In any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 _ ❑ Outdoor Landscape Lighting' Fee::: ❑ Protective Signaling Enter total of above fees $ ❑ Other 8%State Surcharge $ __ _ Number of Systems 25%Plan Review Fee See"Plan Roview"section on $ No licenses are required Licenses are required for all other Installations fn int of application Fees: Total Balance Due $ �— Enter total of above tees $ _ ❑ Trust Account#- 8%State Surcharge $ -- ——-- --— ---- Total Balance Due $ All New ro, ierclal Buildings require 2 sets of plans. i:Asts\fo"ns\elc-fces.doc 09/30/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 IBUP Received _ -__-Date Requests 147-© _ AM _ PM - BUP Locations C- Suite MEC Contact Person -_ _ - _____ Ph ( _) �_ `��_ PLM Contractor -_�-_ _ Ph(__-_) -__-__ SWR BUILDING_ Tenant/Owner ___ _-__ ---_ ELC Footing ELC Foundatior Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT — Post&Beam Shear Anchors _ - -- - Ext Sheath/Shear 12 Int /Shear Framing Insulation �--- --------- Insulation Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling 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 FAIL �- ----__..._ -------------------------- -- MECHANICAL Post& Beam Rough-In -� __ _..._ ---- - --- --------- - - ----- --- ..__.- Gas Line Smoke Dampers ----- -�__.._ �_- -__---- ---- - Final PASS PART FAIL - - RI L Service - --- --_ - - -_ Rough-In _ -------- -- -- ---- -- UG/Slab Low Voltage F farm ART FAIL Reinspection fee of$-___._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ( n Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA DO".)2 C'O � 0p, inspector-- =�—�1�- - _--Ext---.- Approach/Sidewalk Other: _ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL