9850 SW PEMBROOK STREET-1 ADDRESS:
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i:\rer,,rds\microtlm\targets\building.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/Boam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: l A.M.
PP..MA Entry:
Address: '-JC=j!�{
Tenant-_ _ Ste:__- MST:
Con/Own: BLIP:_ _ MEC:
PLM:
ELC: �C)
THE FOLLOWING CORRECTIONS ARE 9EQUIRED: ELR:
Inspector: Date:
APPROVED �_DISAPPROVED/CALL FOR REINSP. CF CO
� rel:. ,A, ,r: I LCs2 1
CI TY OF T I GARD DATE 13CUED-. 03/01/S6
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (533)839-4171 ARS Cy!_. ;2,
711",R"'I—I— r rt:.
; ', '
��-
r..,F7MDPOOK HEIGHTO ZONING;R3. 5
QC!... . . . . . . . . . .
,'Gject Descr-iption . Recurtnec'; one ser—ice or feeder and install one bi-rRnL1
UNTr TrZMP -.r7r'",-,rrr:.DEr,-)"
100 SF OR LESS. . 0 amp. . . . . . . . 0 PlumP/IRRIGATION. . . . .. QA
fICI I nDD1 L -joizior. . 121 7-01 4.0071 am p. . . . 0 SIGN/OUT LINT LTO. . . 0
..'MITED ENERGY. . . . . 0 401 600 amp. . . . . . . : 0 SIGNriL/PANEL. . . . . . . : 0
mft r. iim/ rvc:,,FDR. . o ('01 vulti-, : 0 MINOR Lnr,0_ ( 10) . . . : 0
- - --SERV I,c/r E,E.DE R- ------- BRAINCH CIRCUITS INSP[-7.CTIONS
amp. . . . . . W/SCRVTf_-C OR rECDERt PER IrlSPECTTOH. . . . . to
211 400 amp. . . . . . QI 1st W/o 9RVC OR rnp, - 0 PER HOUR. . . . . . . . . . . . 0
M GOO amp. . . . . . ; 0 EA ACID' L 1APNCH CT.r%C- 0 IN PLANT. . . . . . . . . . . .
01 1000 amp. . . . . : LPN REVIEW SECTION---.._..
1100+ Amp"Vol.t. : 0 ) =4 RES UNITS. . . . . . . . . ) 600 VOLT NOMINAL— :
Pconnec-t only. I SVC/FDR 2,2, AMP'S. CLn7,,S AREA/SPEC L)Ct-.
TI e I". r E T__
JIM DAVIS type aM,:)L(-,It by date :-,ecpt
iso ow r,r PRMT t t'�7 CTC, 03101/96 9E 27 0�j G 0
m r�r r-o;
5PCT s 2. 75 CJS 0310119C, 9C., '.'7
OR 071'2-1.
lone
Titr-actol--. . ......
7LECTRIC "_9 ;7. 7 T' TOTAL
iw`u0 SW GREENBURS RD
rGARD OR 07223
,one #z ElecAl I Final
i pervit is issued subject U, the
hard Municipal Code, litate cf Ore. Spe_;a,ty _Ea., I'll Pe, mittve r5ijinati.o-Le
applicable laws, All work will be done in &LL_ 'EnCe with
approved plans. This pergit will expi,t if work is not started
within 180 days of issuance, or if wD,,P is suspended for sore
V-an 180 days, 1?y
OWNCR ',N'0TnLL()TI0N ONLY -
The instellaticirs is being made on property I ovin which i�- no'. intended for
sale, lease, ov i-pnt.
!WNr: R' S STC:3NnTUPr.,! D n 7'[7.-
.-CONTRACTOR INSTALLATTON ONL%' -
DATE., 3-
1"JO.
Call foi i-,,,mpec:tion E,30 -4175
------- Now"
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 96- 56
7
�-t
Permit # s;/LQ,6 .-
Phone (503) 6^P9-4171 Date Issued
FAX (503) 6F4-7297
CITY OF TIGARD TOD No. (503) 684-2172 Issued by
Inspection (503) 639-4175
1. Job Address: WORK ORDER 0 5 5 8 91 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections per permit allowed
Address 9850 S . W . P I N E B R O O K Service included: Items Cost(ea) Sum
City/StatefZ p T I G A R'� ,_ O R E G O N 9 7 2 2 4 4a. Residential• per unit 4
1000 aq It or lees $11000
Name (or name of business)____Ll I MA11 I,� _ _ Each additional 500 aq 1t or
portion thereof $25 00 _ 1
Commercial❑ Residential 1XI Limited Energy $2500
Each Manu"I Homo or Modula
Dwelling Service or Feeder $88 00
2a. Contractor installation only: 4b.Ssrvlc-a or Feeders
Installation,ai.iralion,or relocation 2
Electrical Contractor F R A H I F R F I F C.T R 1 C. _ 200 amps or leas $6000 2
Address 1 1 8 6 0 SW G R E E N B U R G R O A D 201 amps to 400 amps �_ $8000 2
Cjty T State Zi _ 401 amps to 900 amps ___ $12000 2
`�� O R. p .�.Z22�� 801 amps to 1000 amps $18000 2
Phone No. h_3 c�_4 6 2 7 _ Over 1000 amps or Vohs $34000 2
Contractor's License No. 'i a- i i r T Reconnect only �- $5000
Contractor's Board Reg. No. 37410 4c. Temporary Services or Feeders
/ J Installation,alteration,or relocation 2
Sl-iature of Supr. Elec'n yam/ r l/f�fj` 200 amps or less $5000
Licet Ise No. 1816 S Phone No. 639-4627 201 amps to 400 amps $7500
-- 401 amps to 800 amps $10000
over 800 amps to 1000 Vohs
2b. For owner installations: see V above
Print Owner's Name—REM" ils[
EM � CATION
4d.Branch Circuits
�! New,alteration or extension per panel
Address nnnu a)The fee for branch cironte with
City_ S jjp� purchase o/service or Neder ties
Phone N0. — Each branch circuit 1 $1,00 `r_()0
b)The lee for branch circuits without
The installation is being made on property I own which is purch ss,of service or tinder roe. �
not intended for sale, lease or rent. First branch circuit :.35 00
Each additional branch circuit $5 0C
1"%rner'sSignature_— _ 4s Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or irrigation circle Ur 00
Each sign or outline lighting $4000
Signal circuits)or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel,sheration or extension $4000
4 or more residential units in one structure Minor Labels(10) _ $10000
—Service and feeder 225 ar-mos or more
_—System over 600 volts nomin:,! 4f. Each additional inscoclion over
Classified area or structure contah,ing special occupancy the allowable in any of the above
as described in N E C Chapter 5 Per Inspection �` $3500
Per hour $55 00
Submit 2 sets of plane with aIn plant $55 onpplication where any of the above --
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ J U
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 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 IS s'rbtotal $
COMMENCED 0 Trust Account N $
Balance Due $
—M-6004W.P.am
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