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CITY OF TICARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-1+175 Business Phone: 639-4171
Date Requested: l `( � — — A.M. _T P.M. MST:
Location:_ _� , ✓ ---- —_ BUP:
Tenant:_ Suite- —_ Illdg: NEC:
Contractor: Phone: _ PLM:
Owner:_- --- ,11honc: — — — — _ ELC: '
ELR:
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELEC CAL SITE
Site Post/Beam Post/Beam Post/Beam o Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry, Ceiling Rain Drain A/C UG Slab
Shcar/Sheath Fire Spk1r/Alm Crawl/Found Dr I lent Pump I olt
Approved Approved Approved Approve Approved
AppnSdwlk Not Approved Not Approved Not Approved o pproved Not Approved
FINAL FINAL FINAL FINAL FINAL
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O Call for reinspection Reinspection fee of S required before next inspection O Unable to in.Vmt
Inspector: _._�T -` Date:_ Page of
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMTT #: E1-C96--0024
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01/16/98
PARCEL_: 1S136DD-03100
SITE ADDRESS. . . : 11800 SW 69TH AVE
SUBDIV15ION. . . . :WEST PORTLAND HEIGHTS ZONING:MUE
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :009 J(ARISDICTION: TIG
Pr,oject Descv-iption : Ei erg ency power outage.
UNIT----- ----TEM"
SRVC/FEEDERS----- -----M I SCELLANEOUS------
1000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L. 500SF. . . : 0 201 400 -imp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps- 1,000 volts. : 0 MINOR LABEL. ( 10) . . . : 111
------SERV T CP/FEEDER------- -----BRANCH CIRCUITS-.----- ------ADD1L INSPECTIONS----.-
go 200 amp. . . . . . : 1 W/SERVICE nR FEEDER: 0 PER INSPECTION. . . . . : 0
[x'01 'too all p. . . . . . : 0 1st W/O SRVC 9R FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
60J 1000 amp. . . . . : 0 REVIEW SECT I
1000+ Amp/volt. . . . . : 0 ) =4 RES UNIT'S. . . . . . . . : ) 600 VOLT NOMINAL. . :
Recon-ect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: FEES
BAUER type Amol.int by date reept
11800 SW 69TH PRMT $ 60. 00 DRA 01 /16/98 98-302549
TIGARD OR 97223 5PCT $ 3. 00 DRA 0I/IG/98 98-302549
Phone #:
Contr-actor:
OREGON ELECT CONSTRCTN/GRP INC $ 63. 00 TOTAL
1010 BE 11TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 RoLtgh--in Flect' l Final
Phone #: 234-9900 Elect' l Service
Reg #. . : 0026-9
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Sppcialty 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 the rules adopted by
the Origcn Utility Notification Center, Those rulp,, are set forth in DAR through OAR 952-08I-1987. You may obtain a copy
of these rules or direct questions to OUNC b-- calling (903)246-1987.
Permittee Signati-ire : A & S s 1_1 e d 9 y c
-----------------------------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:
cc INSTALLATION ONLY----------------------------
SIGNATURE OF SUPR. ELECIN:
DATE:
LICENSE NO:
+++4+++++++++-�-++++.......4-+4..................4.....................i ........4 4+
Call 639-4175 by 7:00 p. m. fnt- an inspection needed the next bits1i-.'.?ss day
+++++++•++++-1..........4.........4-4+++4....................4.................... +.+
Community Development ELf;CTRICAL PERMIT APPLICATION
13125 SW Flail 131vd.
Tigard, OR 97223 Peri-nit #
Date Issued
ne (503) 639-4171
FAX (503) 684-7297
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 630-4175
1. Jab Address: 4. Complete Fee Schedule Below:
Name of Development // G� Number of inspections per permit allowed// D
Address � b ,���[� w / Service included Items C--st(ea) Sum
City/State/Ziv L d _ 4a. Residential -per unit
� � 1000 sq. h. or less $11000
Name (or name of business) k/c o Each,additional 500 sq,ft or
portion thereof $25.00
Commercial (] Residential Limited Energy $25.00
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00
2a. C,)ntractor installation only:
4b. Services or Feeders
Installation,alteration,or relocation
Electrical Contractor tC, lac19 200 amps or less sro:)o & 2
Address 6, 201 amps tc 400 amps $8000 2
City late_ — Zip -(1714-3 401 amps to 600 amps $12000 2
601 amps to 1000 amps $180.00 2
Phone No. —D Over 1000 amps or volts $3.10 00 -` 2
Job NO. Reconnect only $5000 2
contractor's license NO. -0 --- 4c. Temporary Services or Feeders
Contractor's Board Reg. N _ Installation,alteration,or relocation
Signature of S,a r. F_lec'n 200 amps or less 2
201 amps to 400 amps $5000 2
License No. Phone No. -P 7S 401 amps to 600 amps $25.00 2
Over 600 amps to 1000 volts $100,00
2b. For owner installations: see"b°above.
4d. Branch Circuits
Print Owner's Name _ N+w,alteration or extension per pane
Address a)The tee for branch circuits with
_ purchase of service or feeder fee.
City__ State Zip_
Each branch circuit $5.00
Phone No. h)The fee for branch circuits without
The installation Is being made on property I own which is I purchase of service or feeder fee.
Firsnot intended for sale, lease or rent. Each
additional
circuit $$500
Each addltlonal branch circuit 15.00
Owner's Signature_ . _ 4e. Miscellaneous
(Service or feeder not Included)
3. Plan Review section (if required): Each pump or Inigellon circle $40.00
Each sign or outline lighting $4000
Signal circuit($)or a limited energy
I'lertsr check appropriate Item and enter fee In section 5B. panel,alteration or extension 140,00
4 of more residential units in one structure Minor 1,abets(10) 5100,00
CL Service and feeder 225 amps or more
r System over 800 volts nominal 4f. Each additional inspection over
N the allowable in any of the above
Classified area r structure containing special occupancy
as described It, N E C Chapter 5 P,,? fin" $3500
P, $58.00
15500
Submit 2 sets of pians with application where any of the above
m apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees GU l�
LL NOTICE 5%Surcharge (.05 X total fees) $
J I
PERMITS BE(nME VOID IF WORK OR CONSTRUCTION suotofel $
AUTHORIZED IS NGT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) E
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal y
COMMENCEDTrust Account M
rrrm�� $
f?alance Due $