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11950 SW 69TH AVENUE ADDRESS : 11950 i.Vecord s\microflm\targets\bu ild i ng.doc { m = /\f) ( §{ § » : o , k \}{ C3 En \ a2 { ) $) AE $ I E E E m $ � a § / j\ � 00 � a o 0 9 § § C � � & U � W 0 § k � 2 � cu 2 ) k � r $ % $ L- 2 & $ - 3 . $ .� rq � 2 > 3 2 . � ) { \ \ � / § 2 7 ) ) b b a t © k \ ) k I j E ƒ 0 o a / § $ \ ■ m p § W" j 2 j j j CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — ---- BUP _Date Requested ,\ AM PM —_— BLD Locauon Suite MEC — — Contact Person Ph _ PLM Contractor F-� yPh .>?9 - I Z1Zy/ SWR _ BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Foundation Ac NOT REQUESTED 3��—� (� FPS Ftg Drain �n FOUND DURING RESEARCHSGN Crawl Drain —_� Slab _ NO INSPECTION(s) IN FILE SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear - Framing r f v'i C c== i ho✓U Insulation Drywall Nailing Firewall — Fire Sprinkler —�L.E44 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 Lin, - -- Smok: Dampers Final -- - -- -- - PASS PART FAIL ELECTRICAL --- _-- --- Service Rough In — UG/Slab - Low Voltage --- - Fire Alarm v. Final ----- —— ---- -- --- F PASS PART FAIL - SITE Backfill/Grading ----- -- - --__.�---_---- __---_�— Sanitary Sewer Storm Drain ( ] Reinspection feP ai$ - _ ^required before next inspection. Pay at City Hall, 1 125 SW Hall Blvd Catch Basin Please cad for reinspection RF Fire Supply Line ( ] F [ ] Unable to inspect-no access ADA ,�,�, Approach/Sidewalk - %� ` ��9 Other Date —L ZZ.�- �' Inspector -� Ext F-inal PASS PART- FAIL- DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4174 r _ 763 { �11 C& H- CJ J Community Development ELECTRICAL PERF Il APPLICATION 13125 SW Nall Blvd Tigard, OR 97223 Planck/Rec. # Permit # --__ Phone (503) 639-4171 Date Issued CITY OF TIGARD FAX (503) 684-7297 Issued by TDD No. (503) 684277' — Insoection (503) 639-41'lj 1. Job Address: J 4. Complete Fee Schedule Below- Name elow-Name of Development tl number of Inspections per permit allowed Addrejs_�� n a-� `f' S r� C , T� Service included. Items Cost(ea) Sum Ci /State2i -r-- ty p / � t� Ar,,zla Q/C-. 4a. Residential-per unit 4 1000 sq It or ions $11000 Name (or name of business) Fath addd,onal 500 sq II or portion thereof $2500 1 Commercial ❑ Residential ❑ Limited Energy $2500 Earth Manuld Itome or Modular 2 [hvelhnp Semrn m Feeder $"A00 2a. Contractor installation only: 4b.Services or Feeders stallotw alteration,or relocation rQ Electrical Contractor L _ 200 amps or less $6000 (iy Address_ t 201 amps to 400 amps $8000 401 amps to 000 amps $120 00 City ,Stdte Zlp ^7 1301 amps w 1000 amps $18000 Phone No-'- `' �� �} Over 1000 amps or volts $34000 7 Contractor's Llcen,�e No. Reconnect only $5000 Contractor's Boar-1 Reg4c.Temporary Services or Feeders Installation,alteration,or relecahnn Signature of Supr. Elec'n 200 amps or lees $5000 2 License No. q'La<!4 Phone No. 201 amps to 400 amps -- $7500 401 amps to 000 amps $10000 Over 800 amps to 1000 volts 2b. For owner instaliations: 8"•b•above 4d. Branch Circuits Print Owner's Name _ New,alteration or extension per panel Address_ a)The fee for branch circuits with City State Zip_ purchase of service or seeder Ase. Each branch circuit $5 00 Phone No. b)The fee for branch clrcude Without The installation is being made on property I own which is purchase of service or bodw Ase. not intended for sale, ICdbc nr rent. First branch circuit $3500 Each additional branch circuit $5 00 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 oulhne lighting $40 00 Signal clrcuit(a)or a limited energy Plea"check appropriate item and enter fee In section 58. pant,alteration or eMension $4000 4 or more residential units in one structure Minor Labels(10) $ton no V� Service rind feeder 225 amps or more � — _System over 600 volts nominal 41. Each Hdditional inspection over a Classified area or structure containing special occupancy the allowable in any of the above as described in N E.C. Chapter 5 Per inspection $J5 00 Per hour b55 on In Plant $55 00 'n Submit 2 sets of plans with application where any of t!,e above apply. Not required for temporary construction servi.es. Jr. Fees: --I NOTICE 5a. Enter total of above fees $ j 5%Surcharge(.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal S t� AUTHORIZED IS NOl COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for -J C,-)NSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(SQc.3) $ A PERIOD OF 180 DAYS AT ANY TIME A,FTEH WORK IS Subtotal $ r JMMENCED. ❑ Trust Account N $ Balance Due $ LIU