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12370 5W Duchilly Court
CITY OF TIGARD ___—_ELECTRICAL PERMIT
PERMI i#: ELC2002-00636
DEVELOPMENT SERVICES DATE ISSUED: 12/12/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110BB-01200
SITE ADDRESS: 12310 SW DUCHILLY CI
ZONING: R-1
SUBDIVISION AMES ORCHARD
BLOCK: LOT : 013 JURISDICTION: TIG
Project Description: Add (1)branch circuit for 10 recessed lights.
RESIDENTIAL UNIT TEMP_SRVCIFEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 50%jSF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL:
MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVi.,E OR FEEDER: PER INSPECTION:
2011 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLA_N_REVIEW SECTION
•1000+ amp/volt: — =4 RES UNITS: > 600 VOLT NO,'ViINAL-
- Reconnect only: _ SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KLUNE,JOHN G + LOIS A TRUSTEES OWNER
12370 SW OUCH ILLY CT
IIGARD,OR 07124
Phone: Phone-
Reg #:
FEES _
Description Date Amount
_ —_ __T465
Required Inspections
ilil.l'RM fi l I t I' rnn, I' I.'. n' y$46.t35 — — ------- —
i
12 12 n $3.75 Rough in
Elect]Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty 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 a t forth in OAR 952-001-0010 through OAR 952-001-0100. You m>>obtain copies of these ruleg; rdirect questions to OUNC at(503)
246-66P9 or 1.800-332-2344.
Issu By: ��-t� j Permit Signature: `, , --
_ \' / - OWNER INSTALLATION ONLY -
The installa Ion is being made on prop rty I own which ,s not intended for sale, lease, or rent.
OWNER'S SIGNATURE: k �'� _ — -- DATE:_ --
i
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N:
LICENSE NO' -- - - -------- -- --_----- ------ -
::all 639-4175 by 7:00prn for an inspec't,on the next business di y
Ueetrical Permit Jkpplication
Uatereceived:/ IIO` Permit n-.� I ?
City of Tigard Project/appl.no.: date:
Cirvq%7'igurd Address: .3125 SW I Jall Blvd,Tigard,OR 97223
Phone: (`iO3) 639-4? I Date issued: .13A Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
LJ I &2 family dwelling or accessory L7 Commercial/utduslnal U Multi-family U Tenant improvement
U New construction MAddition/al(era(ion/re placement J Other:_ U Partial
INFORMATION(
Job address: Bldg,no.: Suite no.: Tax map/tax lot/account no.:
L,04; 3 Block; Subdivision: A.,ee?y Cin C r/w ..
Project name: 'Te' Iocrdion of work on premises: plc e e,ss 64 L.
r
/�,
Estimated date of complclion,'inspcctinu - - ,••y
tt I
Job no:
I ec Max
Business nanic: _ !`,,criptiorn _ (tfy. (ea-) tidal nn.insp
Address: Net r mldernaal-single or multi-famll Iry r
dncllbng unil.Include~altac•hed garage
City; Stale: I ZIP: Service included:
Phone: -- -Fax: &mail: loot)sq.ft.or less t
CCU no.: Elec.bus, lie.no: Each additional 5W sq.II.or porton thereof -- —
Limited energy.residential 2
City/metro lie.no.: I.inniiedenergy,non-residential 2
_
Each manufactured home or modular dwelling
Si nature of su r ng electrician(required) Date Service and/or feeder 2
Sup.elect.nunte(print): Liccnseno: I Servlcesorreeders-Installation,
PH t alleratlon or relocation:
200 amps or less 2
Name(print): 7,--,^rye. 7 t ._. 201 amps to 41`10 amps 2
Mailing address: /z w S�,• / ,., r> c c y ! 401 amps to 0110 amps _ 2
—7 601 amps to 10(10 Amps 2
City: (�i9,.�J StatC:�- ZIP: cy 7 7 1 V
Over 10(10 amps or voles 2
Phone: ,C'3G-,moi y3,5"r Fax: ;,f—F- E-mail: Reconnect only
Owner installation:The installation is being made on property I own Tecgrorary serslc•esorfeeders-
which is not intended for sale, ase,rent,or exchange according to Installation,alteratlot,or relocation:
ORS 447,455,479,670,701. �/ / 2W amps or Icss 2
/Wy.- 201 rw!ps to 4W amps 2
Utvner's si gnature: _ /< - l "Yate: 401 to 6(N)ams ,
Branch circults-new,allerallon,
Name: or extension per panel:
- Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: Seale: ZIP7- R. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee,first branch nc�uit: ' 2
Each additional branch circuit:
111111 W 11101 TZ Misc.Orm lee or feeder not Included):
LI service over 225 anis-commercial U Health-care facility Each pump or irrigation circle 2
O Service over 320 amps-rating of 1&2 U Hozardous locatinn Each sign or outline lighting 2
family dwellings O Building over 1001,0 square feet four or signal circuits)or u limited energy panel.
U System over600 v^Its nominal more residential units in one structure alteration,or extension* ,
U Building over three stories U Feeders,4fW amps or more +icscri tion.
U occupant load over 99 persons U Manufactured structures or RV park Each additional Impaction over the allowable In any of the.above:
U F:gressnightingplan U Other: _. EachPer pectiun
Submit_sets of plat s with any of the above. Investigation fee
The above are not applicable to temporary construction service. _ Other -
Not all Jurisdlcurra oaccept credit cerdx,please call Juriuii,rian for more infnrmador. Notice''This permit application Permit fee.....................
$ _
U Visa U MasterCard expires il'a pennit is not obtained Plan review(at __ %) $ _
Credli card number � --� within IRO days after it has peen State surcharge(8%)....$
Exp1fes accepted as complete. TOTAL $
Name of cardho r as shown on credit cent
Cardholder signature Amount
- -- 410J611(NOr1TOM)
it
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
- - "_— TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
complete Fee Schedule Below: Rosiricted Energy Fee................. ......................... ........ $75.00
Number of Inspections per vertnit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit ❑
1000 sq ft.or le $145 15 4 ss Audio and Stereo Systems'
Each additional 500 sq ft or 1 ❑
portion thereof $33.40Burglar Alarm
Limited Energy $7500
Each Manufd Horne or Modular 7 ❑ Garage floor Opener'
Dwelling Service or Feeder _ $90.90
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
installation,alteration,or relocation $80 30 2
200 amps or less _ -- 2 F-1VacuumSystems'
201 amps to 400 amps —_ $106.85
401 amps to 600 amps $160.80 7 ❑
601 amps to 1000 amps $240.60 Other
Over 1000 amps or volts $454.65 _ 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED • COMMERCIAL ONLY
Fee for each system.................................. ...................... $7500
Installation,alteration,or relocation (SEE OAR 918-260.260)
200 amps or less _ $66.85
201 amps to 400 amps $100.30 1
401 amps to 600 amps $13375_ Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems
see"b"above.
Branch Circuits ❑ Boller Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑ Clock Systems
with purchase of service or
feeder fee. — ❑
Each branch circuit $G 65 _`_, ___ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee. $48.85
First branch circuit ❑ HVAC
Each additional branch circuit $6.65_
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Interrr,,n and Paging Systems
Each sign or outline lighting $53.40 _
Signal circult(s)or a limited energy ❑ Landscape Irrigation Control'
panel,alteration or extension $75.00 —
Minor Labels(10) $125.00 ❑
Medical
Each additional Inspection over
the allowable In any of the above $62.50 ❑ Nurse Calls
Per Inspection —
Per hour _ $62.50 — ElIn Plant $73.75 Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other — — --
8%State Surcharge $ —_ _--_-__Number of Systems
25'%Plan ri:view Fee � No licenses are required Licenser>,re required for all other :don•.
See"Plan f:gview-section on -
f,oni of appli abon ------ Fees:
Tot,11 Balance Due $ :
Eater total of above fees
1[1 s
. Trust Account fP _.__..__— ___ 8•/.State Surcharge
- — — --� f — Total Balance Due :
All New Commercial Buildings reciulre 2 sets of plans.
i:\dsts\forms\eIc-fecs.doc 0830/01
n
CITU' OF TIGARD 2:1-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
�
�/ SUP _
Received _ Date Requested `may — AM_ _ PM BUP
Location 1�-� 7U �� a!-` 1/ z Suite_ –._ MEC —._—
Contact Person — _._ _ Ph(— y C Sj __ PLM
Contractor G Ph( —) �9� _ SWR
BUILDING Tenant/Owner ELC aV Q
Footing
Foundation � ELC
Access:
Fig Drain ELR —__._--
Crawl gain
Slab Inspection Notes: �� , SIT
Post&Beam
Shear Anchors —"^-" --
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ---------- ----- ---- -- --- ----
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _- - - - -------
Roof
Other: ---
Final
PASS PART FAIL — __ .----------_ - -- --- ------- ---�.._—_._
---
PLUMBING
Pont&Beam � LL
Under Slab -- --- -- -
Rough-In
Water Service �—
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain _ ------- -- ---- -- -
Shower Pan
Other. __...... ----- _ ---- ----------—..---
Final --- -- i
PASS PART_ FAIL
MECHANICAL —
Past& Beam ----- -- --- —
Rough-In --- --- --� _- ---�--- --
Gas Line
Smoke Dampers ---------- --�- --
Final
PAS! PART FAIL
CTRICALewv rim
-
Service
bl�la6
Low Voltage
Fire Alarm
Aeffffn> [_1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
- __—- Please call for reinspection RE — —__ —_ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date -TD tcCs__J_�,n c Inspector �_ '�� � � Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection *39,4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _
PUP -- - --
Received _ _ -_-_Date Requested `/� -- AM - PM ____ ___ BLIP
Location __- -__ _Suite_- __ MEC
Contact Person _ , q, h( ) _-( _� 2— PLM
D
Contractor _— Ph( ) — 5- ----!j SWR��- — --
BUILDING Tenant/Ownel EL.0 4P
Footing E L C _
Foundation Access:
Fig Drain ELR - _—
Crawl Drain _
slab Inspection Notes: /? —�-_ s!1' ---
Post&Beam -
Shear Anchors —
Ext Sheath/Shear AA
Int Sheath/Shear ( —
Framing - - - - ----
Insulation
Drywall Nailing - -- — ----
Firewall
Fire Sprinkler -- --- — --- - --- —
Fire Alarm %
Susp'd Ceiling — , --
Root
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 FAIT. — —
MECHANICAL
Pc st&Beam --
Rough-In ---- -- ---�. _- -- ---- — --
Gas Line
Smoke Dampers --_—
Final
PASS PART FAIL --
ELECTRICAL
Service
Low Voltage
Fire Alarm --
(_� Reinspection fee of$_— required before next Inspection. Pay at City Hale, 13125 SW Hall Blvd.
PASS PART AIL 1
SITE _ Please call for reinspection RE:,— __---- CJ Unable to inspect-no access
Fire Supply Line
ADA Date � Inasoctor Ext
_ut , �r� f —1�� —
Approach/Sidewalk
Other:_
Final DCS NOT REMOVE this inspection record from the Job site.
PASS PART FAIL