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CITY OF TIG/ARD BUILDING INSPECT!ON DIVISION
MST
24-Hour Inspection Line: 6394175 Business Line: 639-4171 _
BUP
Date Requested Z3-q AM_— PM BLD
Location cam. � l1 �?C� Y'1l/`� Suite' MEC
Contact Person �(� Ph � `7���(J PLM
Contractor_ Ph - SWR _
BUILDING Tenant/Owner
ELC !gets/-
Retaining Wall ELR —�
Footing F.r;ess:
Foundation FPS —_
Ftg Drain SGN
Crawl Drain' Inspection Notes: --�Slab I — C �- -E7��' �C ---- -
srr
Post& Beam
Ext Sheath/Shear �i -� fy c - --
Int Sheath/Shear
Framing _--- -
Insulation
Drywall Nailing ---
Firewall
Fire Sprinkler - --
Fire Alarm
Susp'd Certin9 - - -- - -
Roof
Misc: ----
Final
PASS PART FAIL_ ---- ------- -----
:PLUMBING
Post&Beam � -- -------. .-- - ---- ----------
Under Sla,.
Top Out
'Nate Service
Sanitary Sewer
Rain Drains -
Final
PASS PART FAIL ---
MECHANICAL -
Post & Beam ----- ------- - --- - --- --
Rough In _
Gas Line _--
Smoke Dampers
Final ---..._----- ------ -- ----__�.__ --- -
PASS PART FAIL
CTRL -- -- --
Service ---
r Rough In --__-------- --- ---
ZZ
UG/Slab - --___ -
Low Voltage
Fire Alarm -- - ------
vr -
S � •
rT- J ASS PART FAIL_ --
J
s Backfill/Grading - -- --
Sanitary Sewer
Storm Drain ( I Reinspection fee of$_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ) Please cr!I fog reinspection RE ( j Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sid;nwalk Date t(7C''o,� 3 Inspector d Ext
Other -
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
• C I Tl( �F T I��R® ELECTRICAL PERMIT
PERMIT#: ELC1999-00497
' DEVELOPMENT SERVICES DATE ISSUED: 8/12,'99
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S104DB-05300
SITE ADDRESS: 12980 SW 135TH AVE
SUBDIVISION: HANDY ACRES ZONING: R-4.5
BLOCK: LOT : 031 JURISDICTION: TIG
Proiect Description: First branch circuit
RESIDENTIAL UNITTEMP SRVC/FEEDERSMISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: — PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps -1000 volts: MINOR LABEL (101:
SERVICE/FEEDER BRANCH CIRCUITS
_ _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
261 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: J >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC 0,CC:
Owner: Contractor:
TIGARD WATER DIST PHOENIX ELECTRIC CO
8841 SW COMMERCIAL 7379 SW TECH CENTER DR.
TIGARD, OR 97233 TIGARD, OR 97223
Phone: Phone: 684-3600
Reg #: LIC 00052288
SUP 4140S
ELE 34-247C
FEES Required Inspections
Type By Date Amount Receipt
_ EI lect'I Service
PRMT BON 8/12/99 $37.50 99-317608 Elect'I Final
SPCT BON 8/12/99 $2.63 99_317608
ORIGINALTotal $40.13
This Permit is issued subject to the regulaticns contained in the Tigard Municipal Code, State of OR. Sp(=cialty 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 are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503)
246-1987
n
T Permit Signature: `, ( (( J Issued By:
r•-
-+ OWNER INSTALLATION ONLY _
The installation is being made on property I own which is not intended for sale, lease, or rent.
U
W
-� OWNER'S SIGNATURE: _ _ DATE:-_,. _
_
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: °L"� 1� I jU� DATE:__
LICENSE NO: --
Call 639-4175 by 7:00pm for an inspection the next business day
AIIG-09-99 MON 07;31 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02/02
�-I I T OF TIGARi
13125 SW HALL, BLVD, Electrical Permit Application Plan Check
•rIGARD OR 97223 Recd ay 0,
Phone(503)639-4171, x,304 011e Recd e — - 7
Inspection (503) 639-4175 Date;o P.E.
Fax 503 59 Print of Type Date to DST
( ) 8-1960 yP Permit# -/ e -,
_ Incomplete or illegible will not be accepted
1. Job Address:
4. Complete Fee Schedule BeloW:
Name of Qevetopmr�nt �� �.t ,
Name(or name of business)z 3F -- _Number of Inspections Per-t5,•U!\� "�= � P Perrniiallowed
Address t r -• - Service included; Items Sum
' �� `3 LL Cost
, � 4a. kesidential per unit
City/StatelZlp \ logo sq ft nr less
Each additional son sy,ft.or 5 117.75
Comrnercial�- .. z____"' 4
Each
❑ portion~~' thareol $ ,
(� �� Limited Energy 26Z5 1
2a.�Ontraefor frTS J \qtr 0 `�\ Each Manufd Home or Modular — S F,0.00
allain only, Dwelling Service or Feeder
(Prior to permit Issuance,applicants must provide conhacto►Ncense 72.)5
information for COT data base,. 4b.Services or Feeders 2
Electrical Contractor ` lo,tallalion,allcaratinn,or relocation
Address `� C �' \F' � 200 amps or loss
r �,c 1 201 ani 5 to 400 am $ A4.25
City c „Q_ r
state zip
401 amps to coo amps $ 8150 Y
Phone No) ( -� Fol amp000 a
s to 1mps S 128.50 - —
Z
Job No (i� _ — -- -- Over 1000 amps or volts — $ 192.50 2
Elec Cont Lice. No, R t connect only ---__ $ 383.75 2
Exp.Diate S 53.50 ------_____
OR State CCB Re ---- - — 4c,Tem 2
9. No.- ?�2:�L4�__._Exp,Date_ Temporary Services or Feeders "-
COT Business Tax or Metro No --- Installation,;tllerallon,or re)ocarion
x Exp.Eate lou amps"'less
201 amps to 400 amps --- 5 53.50
Signature of Supr. Elec'n 5 A0,25 -"
401 amps l0 500 amps 2
G./� S 107.00
License No, /b� Over t30u amps to 1000 volts, _ 2
Phone No. (1 ?�. Exp Date _ se® b^a:ova.
4d.Branch Circuits
2b. f"Or Owner if,St3llat%Oil S: NPW, allegation or extension Per anel
a)The fee for branch circuits
With purchase of service or
Print Owner• Name feeder foe
Address Each branch circuit
b 5.35 S
City -_ - - )The fee for branrh circuits — 1
StateTip wifhout purchesH of service
Phone No. — -- __
oe feed�r fee,
- - —--- -_-- _ First branch circuit
The in9la;Winn is beingEach additional branch circuit �- a 37 50
intended for sale, lease or rentor property I awls which is not - __� $ 5.35
4e,Misceltaneaus —
(Service or feeder not included)
Owner's Siq_rlature Each pump or Irrigalion circle
Each sign or outline lighting —�--•— $ 42.75 _
� -• signal circuii(s)or a limi►ed energy -' $ 42.76
3. Flan Review sectioir (if required):• panel,alteration or extension
Mmnr Labels(1o) -- ---.-_ 5 40,00
F'h•ase check nppropr?ate item and enter fie in section 56. 4t $ 107 no -
4 or more residential units in one-structure Each additional Inspection over ' ~�
a the alllcwabte In any of the above `
••� _Service and feeder Z25 ramps or more Por inspechnn
i= _System over fi00 yoRs nominal Per hour $ 50 00
V7
Classified area or stnicturecantaining special cu In plant — _ $ 50.co
described In N C Chapter 5 panty as - 59 00
F 5• Fees:
` Submit 2 sots o1 plans with application where any of the above I 5a,Enter total of Move tees
c. Not required for temporary construction services, pp y 5 Surcha e 0r K 5
nJ ( u• total`r,zs) S
c.� Su6fnfai
til N07fC� Sb,Enter 25%of Iinu 53 for 3
pErih11T5 BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Pren Revew'f re ulre (Ser 3)
15 NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR Sutrtatal Si
WORK IS SUSPENDED OR ABANDONED FOR A PFRIOD OF 18o DAYS
AT ANY TIME AFTER WORK IS COMMENCED fust Account#
Tocol
L balance Due
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