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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phoney): 63/9-4175 Business Phone: 639-4171
Inspection: .JLL,:.� E-y,'&- 4.`
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Ream Mach. San. Sewer Gas Line -Bldg.
Plbg. Uoiderfloor Rain Drain i raming -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall / Gyp. Bd, �y�
Date Requested: ' ( (y5� Time: AM PM
Address: ! (' � L/
Buildeef l//,,__a,61 'C 7: Permit C CZ C
THE FOLLOWING CORRECTIONS ARE REQUIRED:
06
Inspectoy��
APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
all For Reiinsp.
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hail Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # L LC C4 S— (11 _k
Phone (503) •339-4171Date Issued _ I
CITY OF TIGARD FAX (503) 684-7297 Issued by (r-•� �_
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. complete Fee Schedule Below:
Name of Bere+opment Endo
Number of Inspections per per-nit allowed -
Address DW SW /Zf'1L1 Service includod Items Cost(ea) Sum
City/State/Zi p 0(2 . 7223 Residential- per unit
100 --�
1000 a4 it or leas $11000
Name (or name of business).Pon La nd a i star-star- Each t eoaq II or
portion Ihhereof >;;6 00 1
Commercial ❑ Residential Limited Energy $21,00
Each Manuf d Home or Modular 2
Dwelling Service or Feeder $fa 00 r
2a. Contractor installation only: 4b.Services or Feeders
Installation•alteration,or relocation 2
Electrical Contractor r ICInc— 200 amps or less woo bo.002
Address 201 amps to 400 amps $8000
401 amps to 600 amps $12000 2
City r6aiid Stated Zip_= 601 swus to 1000 amps $18000 2
I I Over 1000 amps or volts $340 00 2
Phone No. 245-7774
Contractor's License No. 2to-5 24C. Reconnect only $5000 _
Contractor's Board Reg. 4c.Temporary Services or Feeders
Installalion,nlleralwn,or relocation 2
Signature of Supr. Elec' l ' il. 7 lou amps or less $6000
License No. (r E3 one No. --7 / 201 amps to 400 amps $7500
401 amps 10 800 amps $1()000
over eon aor to 1000 volts
2b. For owner installations: see V above
4d. Branch Circuits
Print Owner's Name New,alteralxon or extension per panel
Address a)The tee for branch Circuits with
City State Zip purchase or aeryke or Nader Am
Etirh brarch circuit LL $500 _aLLL
Phone No. b)The fee tot branch arcuts without
The installation is being made on property I own which is purchase or swvke r itreder Are.Firs -
not intended for sale, lease or rent. Each
branchcircuitbranch
$3500
Each addnlional branch Circuit $500
Owner's Signature _ _ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if requirlt Each pump or irrigation circle $4000 — —
Each sign or outline lighting $4000 _
Signal circuits)or a limlted energy
Please check appropriate Item and enter fee In section 5B. panel,alteration or extension $40 00 _
4 or more residential units in one structure Minor Labile(10) $10000 _
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection ever
Classified area or structure containing special occupancy the allowable in any of the above
r� as described in WE C. Chapter 5 Per inspection $3500
Per Trow $6500
to In Plant $5600
Submit 2 sets of plans with application where any of the above —`---
f-- apply. Not requirer+for temporary construction services. 5. Fees:
-� 5a. Enter total of above fees $
NOTICE 5%Surcharge(05 X total fees) $
LL PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
-' AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS,OR IF 5b.Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec.3) $
A PERIOD OF 160 DAYS AT ANV TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account IM $
Balance Due $ ,Sp
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