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15414 SW 815'Ave
CITYOF T I Geo R D ELECTRICAL PERP IIT
DEVELOPMENT SERVICES DATEEISS IED: 1/30/02 2 J0030
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171
PARCEL: 25112CE-11900
SITE ADDRESS: 15414 SW 81ST AVE
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R-'
BLOCK: LOT : 133 JURISDICTION: TIG
Proiect Description. One hour of inspection time to inspect as-built electrical work.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS_
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 HM/ S'JC/ FJ': 601+amps - 1000 volts: MINOR LABEL (1 )):
SERVICE/FEEDER BRANCH CIRCUITS
—� ----- -- ADD'L INSPECTIONS
l 0 - 200 amu: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 1
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _ _
1000+ amo/volt: >=4 RES UNITS: > 600 VOLT NOMINAL.:
'L- Reconnect onlv.__ SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MURRAY, JOHN ,JAMES + MARNIE 3 OWNER
15411 SW 81 ST AVE
TIGARD, OR 97224
Phone: Phone:
Reg #:
FEES _ Y _ _ Required Inspections
Type By Gate Amount Receipt Elect'I Final
5PCT CTR 1/30/02 $4.09 2720020000(
F RMT CTR 1/30/02 $58.41 2720020000(
Total $62.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,Stale 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 are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to
Permit Signature: y—�'k-,� . _. Issued By:
(` OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: /
DATE:_..,
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N
LICENSE NO.
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
IDatereceived: Permit no.:
City of Tigard Project/appl.no.: Expire date:
Cityn(Tigard h.ddress: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Pht.ne: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
TYPF'OF
J I &2 family dwelling or accessory U Commercial/indw;rial U Multi-falaily U Tenant improvement
J New construction U Addition/alterationlreplacrnu•ni J()Ilii r: _ U Partial
1 ' 1
Job address: > SyNy l Bldg. riu.: tiuitc nu.: Tax map/tax IoUaccount no.:
Lot: Block: Subdivision:
Project name: I Description and lavation of work on premises: I.
Estimated date of completion/inspection: --- --
Job no: Fee M1tnx
Business name: Description Q1 Y. (ca.i total no.snap
New residential-single or nitilti-famlh per
Address: divellingunk.Incln kw attached rarage.
City: State: 171P: Service Included.
Phone: I E-mail: Io(x)sq.It.or less _4
CCB no.: Elec.bus. hc.no: Fach additional 500 sq.(t.or portion thereof
Limited energy,residential 2
City/metro lic.no.: Limited energy,non-residential 2
Each manufactured home or modular deal'ng
Si nature of supervising electrician(reyuircd) pate Ser,ice and/or feeder 2
F, p.elect.name(print). License no.
Services orteedenr-Installation,
1� alteration or relocation:
1 1 Z� 200 amps or less 2
Nam_c(print): (�U. r i, '� �C't t c c0. 201 amps to 4(x)amps 2
T 401 am s to 600 amps 2
Malting address: I Sy ly S w 'yl �', 601 amps to 1000 amps 2
(-I1 [` Stale.-U P, ZIP: 4 Over IWO amps or volts 2
--Phone: f Fax: Y
E-mail: U Z^' Reconnect only
-_ ---
a.n & • I
f)caner installation:The installation is being made on property I own Temporary services or ft ederx-
which is not intended for sale,lease,rent,or exchange according to installation,alleratIon,,rrelocalion:
( RS 447,455,479,670,701. 2a)amp.%or less 2
I201 amps to 400 amps 2
Utvnet's signature: n Dare: / �_ ant toh(x)amps - - -- - 2
Branch circuits-nes,alteration,
or extension per par el:
km
Nat
tte: A. Fee far branch cit:uits with purchase of
Address: _ _ service ur feeder i t,each branch circuit
Clly: State:_ ZIP_ B Fee for branchciadtswithoutpurchase
of service or feeder tee,first branch circuit: 2
Phone: 14,x: E-mail: -- -- -- --
Each additional branch circuit:
Misc.(Service or feeder not included):
7fan_iil_ydwe1lmgq
amps-aimmercial U I lealth-rate facility Each wen or irrigation circle _ 2
over amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
U Huilding over lO,O(IO syuarr feet four or Signal circuilW or a limited energy panel.
voltsnominal more residentinlunits intine stmclure alteration.or extension* 2
U Building over three stoties U Feeders,400 amps or more 'Description
U Occupant load river 99 persons U Manufactured structures or RV park Fish additional bupedion over the allowable In any of the above:
U ligres.a/lightingplan U Odi r per inspection
Submit_sets of plans with anv of the ahove. Investigation fee
The above are not applicable to temporary construction serNce. other
Nol all lurinlictions accept credit cants,please rail jumdn imn far nm
oir h+murnart Notice:This permit application Permit fee.....................$ _
U visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $
Credit cad number [ y within 180 days after it has been State surcharge(8%)....$
L''p11et TOTAL
Name�eu3hi�u s o+-T, n en�cr ft cam_—_ accepted as complete. $
_ S
Cardholder eisnauue -murmt 4404615 trr0(WOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY'
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit aII0Ned (FOR ALL SYSTE VIS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq.ft.or less $145.15 4 ❑ Audio and Stereo Systems'
Each additional 500 sq.ft or
portion thereof $33.40 _ 1 ❑ Burglar Alarm
Limited Energy $75.00
Fach Manufd Home or Modular ❑
Dwelling Service or Feeder $90.90 2 Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioninc System'
Installation,alteration,or relocation
200 amps or less $80.30 2 EJ Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps _. $240.60 2 Othe,
Over 1000 amps or volts $45465_ 2
Reconnect only $66.85_ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system......................................................... $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved.
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Each branch circuit — $6 65 _ ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 _ ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or Irrigation c.,'le $5340 ❑ Intercom and Paging Systems
Each sign or outline lightin, $5340 _
Signal circuit(s)or a limitF d energy
panel,alteration or extension _ $75 00 _ ElLandscape Irrigation Control'
Minor Labels(10) $12500
Medical
Each additional Inspection ovror ❑
the allowable In any of the above
Per inspection — $6250 Nurse Calls_ ❑
Per hour $6250
In Plant $73 75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of aL ovp fees $ __ ❑ Other
6y.state Surcharge $ _ --_____Number of Systems
25%Plan Review Fee ' No licenses are required Licenses are required for all other installations
See"Plan Review'sedion on $
front of application _ —
Fees:
Total Balance Voe
—� Enter total of above fees :
❑ trust Account tY. —_ 8%State Surcharge s_
Total Balance Due :
All New Commercial Buildings require 2 sets of plans.
i Wsts',I rrms\eIc-fccs doc 08/30101
CITY OF T'IGARD 24-Hour
BUILDING Inspect!on Line: (503)639-4175 MST --
INSPECTKON DIVISION Business Line: (5:13) 539-4171 BUP
Received __. -__ Date Rquested Z r AM --- PM-.---- BUP
Location � Suite _ MEC
PLM
Contact Persons Ph
( )
Contractor Ph SWROGS- Q
BUILDING Tenant/Owner EI_C
Footing ELC _
Foundation Access: ELR
Fig Drain
Crawl Drain SIT
Slab Inspection Notes:
Post&Beam - - -- -- --� --
Shear Anchors
Ext Sheath/Shear - --
Int Sheath/Shear
Framing _
Insulation -
Dryw,II Nailing - -
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling \
Roof
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 FAIL
MECHANICAL -- - - - --
Post& Beam - -
Rough-In -- - - -- - -
Gas Line
Smoke Dampers ---
Final _-
PASS PART _FAIL - --
ELECTRICAL - - -
Service
Rough-In _ -
UG/Slab
Low Voltage --
Fire Alarm
[� Reinspection fee of$ required before next inspectlon. Pay at City Hall, 13125 SW Hall P,ivd.
PART FAIL Unable to inspect-no access
S Li Please call for reinspection RE.
Fire Supply Line
ADA �� Inspecto Ext _
Approach/Sidewalk
Aat�. L
Other.---
Final DO NOT REMOVE this Inspection record from the fob site.
PASS PART FAIL