11515 SW DURHAM ROAD STE E-6-1 ADDRESS :
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Orecordslmic,oftltargetstuilding.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Bearn Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Fir/Slab Plbg. Top Out Insulation e-75
PosVBeam Struct. Mech, Rough-in Gyp. Bd. -Rldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: ._._
�� A.MW. _P.M. Entry:
Address: ��L�s
Tenant: -__-_ --- Ste: p MST:
Cori/Own: °Y W _ __--L ___ MEC: _
PLM: _
ELC: —
THE FOLLOWING CORRECTIONS ARE REQUIRED EL R: _
n [.�f
Inspector: 1C-• Dater—
f APPROVED ._DISAPPROVED/CALL FOR REINSP. CF CO
i
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
METZGER ELECTRIC INC
8780 SW LEHMAN ST
TIGARD OR 97223
Electrical Signature Foran
Permit # . . . . : ELC96-0257
Date Issued. : 04/24/96
Parcel . . . . . . : 2S110DC-00400
Site Address : 11515 SW DURHAM RD #E-6
Subdivision. : WIL!,OW BROOK PARK
Block. . . . . . . Lot : 16
Zoning. . . . . . : C-G
Remarks :
ADDING 1 BRANCH CIRCUIT AND ONE ADDITIONAL CIRCUIT
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the Supervising Electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
EDWARD D JONES & CO. METZGER ELECTRIC INC
1153.5 SW DURHAM RD, BLDG.E, SUITE 6 8780 SW LEHMAN ST
TIGARD OR 97224 TIGARD OR 97223
Phnile # ; Phone # :
Reg # • . : 96805
x 1
,,ignature o upervismg�Fectrician
Please return this completed form to the addresq ah;;ve.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
ELECTRICAL. PERMIT-
CITY
ERMIT I TIGARD DATEIISSUED: 04/24/96
COMMUNI fY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tlga►d,Oiagon 07223.6169 (503)636.4111 PAPCEL: 2S 1 10DC'-00400
SITE ADDRESS. . . : 11515 SW DURHAM RD #E_.-6
SUBDIVISION. . . . : WILLOW BROOK PARK ZONING:C-•G
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 16
Project Descriptions ADDING 1 BRANCH CIRCUIT AND ONE ADDITIONAL CIRCUIT
__RESIDENTIAL.. UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-•-.__._-...
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP!IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 _. 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANE. HM/ SVC:/FDR. . : 0 601+•amps-1000 volts. $ 0 MINOR LAPEL ( 10) . . . : fit
-----SERVICE/FEEDER---_ ----.--BRANCH CIRCUITS----- -- _-ADD' L INSPECTIONS----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDQ. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' t_ BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -- ---__._._._______--p'I_AN REVIEW SECTION___..__.___________..
1000+ amp/volt. . . . . : 0 ) s•4 RES UNITS. . . . . . . . .. ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC:/F'DR > w 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: - ------- --- -___ .---_.___.___.__________________.____.___-- FEES
EDWARD D JONES & CO. type amount by date recpt
11515 SW DURHAM RD, BLDG. E, SUITE 6 PRMT >$ 40. 00 JMH 04/24/96 96-278564
5PCT % 2_. 00 •JMH 04/2.:4/96 96--278564
TIGARD OR 97224
Phone #:
Cont Tact or s
MF_TZGE=R ELECTRIC INC 42. 00 TOTAL
67010 SW LEHMAN ST
REUU I RED INSPECTIONS
- -•__.._
TIGARD OR 97223 Ceiling Lover Wall Cover
Phone #: 503--244-9025 Ceiling Co�►(gr Wall Cover
Reg #. . : 96SO5 V-11
{•� �NJJ�
This permit is issued subject to the regulations contained in the _ _
Tigard Munir.ipal Code, State of Ure. Specialty Codes and all other Per m�i t a gntat _Ire
applicable laws. All work will be done in accordance with
approved plans. This permit will expiry if work is not started
1 ��p {„
within 180 days of issuance, or if work is suspeneled for more -.
than 180 days. S,.(ed By
--- --.---.-•--__.._.__.__._._._._-_-...__.__--UWNE_R INSTALLATION ONLY- - ----- --- _.___._.-----_____.---•_
The installation is being made on property 1 own which is not intended for
sale, ).ease, or rent.
OWNER' S SIGNATURE: _ DATE:
---------------------------CONTRACTOR INSTALLATION
SIGNATURE OFSUPR. FLEC' N s — DATE:
LICENSE NO s
Call for inspPction - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
P 13125 SW Hall Blvd. -7,+�
Tigard, OR 97223 Permi' # ���� �t�i 2'S
Date Issued
Phone (503) 639-4171
FA?: (503) 684-7297
CITY OF TIdARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1, Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 + Number of Inspections per permit 3Ilowed
^.ddress I �, d U C Vie M R_�13149 ,E 9 Service included: Items Cost(ea) Sum
City/StatelZip^—rt.gc4_r_A-t.o.�--- �� _�y_ 4a. Residential -per unit
1000 sq ft or less A_ attOclo
Name (or name of business)_ 4_ D. J QK-s A CV, Fach additional 500 sq fl.or
portion thereof x2500
Commercial �_�� Residential ❑ Limited Energy ^— $2500 __ 1
Each Menurd Home or Mcfular
Dwelling Servl:e or'eeder $88.00
2a. Contractor installation only:
4b. Services or -eeders
Installation,aflorafloi,or relocation
Electrical Contractore+'-t r (_ ,rc r%r, "ItA ec. 2
�!L741�__�.- +-- 2ca ar,ps on leas $80.00
Address' l.�' N.t4 +� 201 amps to 400 amps $80 00 2
Pity :T" cs rd _ State�� Zip`�7a d_� 401 amp-to 600 1060 mpsamp $120.00 2
-� 801 ernes to 1000 amps $180.f)D 2
Phone No. .3 U l b t 4� _ Over 1000 amps or VOM. $34000 — 2
Job NO. a 1_ Reconnect only $5000
2
contractor's license NO. q4c. Temporary Services or Feedorn
Contractor's Board Reg. No. Cts 4 i—~— Installation alienation,or relocation
Signature of Supr. Elec'n 200 Amps lir less 2
License Pio. a /� Phone No. p 201 amps 10 400 amps $50 00 2
� a� 001 Amps to 800 amps $75.00 2
Over 800 amps to 1000 volts Ileo 00
2b. For owner Installations: "h"above
Cd. Branch Circuits
Print Owner's Name___, .— __. New,alteration of exlension per pane
Address a)The fee for branch circuits with
purchase of Rarvfce or reader tee.
Gity_T
—
State Zip_ _ Each branch Orcu4 $5.00
Phone. No. _ b)The fee for branch r,Irculs without
The installation is being made on property I own which is purchase of service or reader nae.
First branch cG
not intended for sale, lease or rent. $3500 J Q
Each addHlonal branch circuit $500
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Fach pump or Irrigation circle $40.0'3 _ 2
Fach sign or oulbne lighting $40 00
Signal r,Ircult(s)or a limited anergy
Please check appropriate Item and enter foe In section .58. panel,alteration or extension $4000
4 or more residential units in one structure Minor Labels(10) _ $10000 —
Service and feeder 225 amps or more
_ 4f.System over 600 volts nominal
Each additional inspection ever
Classified area or structure cc(iiaining special occupancy the allowable in any of the above
as described in N.E C. Chopter 5 Per Per hour
rh,n ---_ $5500
In plant $5500
Submit 2 sets of plans with application where any of the ahov- -
apply. Not required for temporary construction strrvices. 5. Fees:
Sa. Enter total of above fees
NOTICE 5% Surcharge 105 X total fees) $ -2.-c^5
PERMITS BECOME VOID IFWORK OR CONSIRUCTION Subtotal
AUTHORIZED IS NOT 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)
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK I'S ISubtotal $
COMMENCED. .,•,m�. I Trust Account # �_
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