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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ---
_ � BLIP
_
Date Requested /�� /d `�1 AM PM BLD
Location St l'y �l c-� r '� F'T/`�'_. Suite MEC
Contact Person 41 G 'K� 1Q C .,r f' Ph '� `�l U PLM
Contractor _ Ph _ SWR
GeA
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation C�tif C��.�1✓ FPS `
-}�� i
Ftg Drain -- --- SGN
Crawl Drain Inspection Notes: -
Slab SIT
Post S Be-,
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- --- -- -- - ---
Insu!ction
Dryw0 Nailing _---
Firewall
Fire Sprinkler ---- __ _-- -__ ----_
Fire Alarm
Susp'd Ceiling / G�
Roof ,_ . —. ---���_L__--�_�'� ✓lr S
Misc:
Final
PASS PART FAIL
PLUMBING
Post& Beam - — — -
Under Slab
Top Out —"—
Water Service
Sanitary Sewer
Rain Drains
Fina! .------ - ---
PASS PART FAIL_ -�-
MECHANICAL ^
Post& Beam
I
Rough In
Gas Line -- — -------
Smoke Dampers
Final __--�- ___---------_ -
PASS PART FAIL
Service
Jam_ r
Rough In -
UG/Slab
a-_ Low Voltage - --� - --------`--
Fiie Alarm
Fi
ASS PART FAIL
w
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Backfill/Grading ^---- '-- -
Sanitary Sewer
Storm Drain I I Reiiispection fee of$ ^required before n inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin i )Please call for reinspection RE: i I Unable to inspect-no access
Fire Supply Line
ADA / 2
chiSWewalk i-
Other Date / - Inspector _1� `-�'� - Ext
Other - ---
Final
PASS PART FAIL-- DO NOT REMOVE this Inspection record from the job site.
CITY OF TI GARD ELECTRICAL PERMIT
PERMIT M ELC1999-00680
DEVELOPMENT SERVICES DATE ISSUED: 11/10/1999
13125 SW Hall Blvd. Tigard, OR 972.23 (503) 639-4171 PARCEL: 2SI l lDD-00600
SITE ADDRESS: 15900 Sb'V 88TH AVE
SUBDIVISION: STRATFORD ZONING: R-4.5
BLOCK: LOT : 052 JURISDICTION: TIG
Proiect Description: Add two (2) branch circuits to an existing dwelling.
RESIDENTIAL UNIT TE_MP_SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION:
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: MINUR t_ABEL (10):
SERVICEIFEEDE_R _BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SftVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: — — > 600 VOLT NOMINAL:
Reconnect only;_ —_ SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
RARICK, MARK U + A B ELECTRIC
ANTONISKIS, DIANA PO BOX 805
18955 OLSON CT BANIKS, OR 97106-0805
LAKE OSWEGO, OR 97034
Phone: Phone: 324-0,'109
Reg M LIC 00000955
ELE 34-35C
SUP 2803S
FEES — Required Inspections
Type By Gate Amount Receipt Elect] Service
PRMT DST 11/10/1990 $42.85 99-31725 Elect'I Final
5PCT DST 11/10/1990 $3.43 99-319725
Total $46.28 ORIGINAL
This Permit i, imued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work wi i be done in accordance with approved plans This permit will expire if work is not started within 1.80 days of issuance,or K work is
�- suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregoil 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 ordirect questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATUR 'ISSUED BY:
OWNER INSTALLATION ON Y
The installation is being made on property I oNln which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _— __ ________ DATE:_
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ —_--__________ GATE:
LICENSE NO: X73--5 — ------ --
Call 639-4175 by 7-00pm for an inspect;on the ne,,t business day
CITY OF TIGARD Electrical Permit Application Plan Check#
131,25 SW HALL BLVD. Recd By
_
TIGAF;D OR 97223 Date RecdDate to P E.
Phone(503)639-4171, x304 Date to DST
Inspection (503)639-4175 Prirlt of Type i Permit#Fti e /�
Fax (503) 598-1960 Incomplete or illegible will not be acceptad Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_k✓ -L, i Number of inspections per permit allowed
Name(or name of business) _ Service includ�d- Items Cost. Sum
Address_/52 2 L1 d S�_� �k 4a. Residential-per unit
City/State/Zip T 1 cgj r(i�_�1^ 1000 sq ft.or less $ 1 1.75 4
Each additional 500 sq.ft.or
poi tion thereof $ 26.75 1
Commercial C-1 ResidentiaLwi Limited Energy $ 60.00
Each Manufd Home or Modular
7a. Contractor installation only: Dwelling Service or Feeder _ _ $ 7[.75 2
(Prior to permit issuance,applicar ust provide contractor license 4b.Services or Feeders
Information for COT data base). Installation,alteration,or relocation
Electrical Contractor 200 amps or less $ 64.25 2
Address 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps _ $ 128.50 2
City Slate^ Zip_ _ 601 amps to 1000 amps $ 192.60 _ _ 2
Phone No._ _ Over 1000 amps or volts $ 363.75 2
,lob No. Reconnect only _ $ 53.50 2
Elec. Cont. Lice No. _ 3 q '.3S C- Exp.Date 10 0 4c.Temporary Services or Feeders
OR State CCB Reg. No. rl S S Exp.Date /0- L oa-U Installation,alteration,or relocation
COT Business Tax or M tro No. p.Dat 200 amps or lest $ 5:1.50 2
201 amps to 400 a, .,is $ F.0.25 _ 2
Signature of Supr. Elec'n� U- `a. C 401 amps to 600 arnps $ 100.00 2
pp 2 'n Over 600 amps to 1000 volts,
License No.~ZO 03 '5.J Exp,Date_� 0 " L a°t see��b above.
I
4d.Branch Clrcui►a
Phone No. f 0-z> _ _ New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 1
Address b)The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit S 5.35
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or rent. (service or r,eder not included)
Each pump or Irrigation circle $ 42.75
Owner's Signature Fach sign or outline lighting $ 42.75
Signal circult(s)or a limited energy
if required):* panel,alteration or extension - _ $ 60.00
3. Plan Review section
Minor Labels(10) $ 100.00 _
r. Flee se check appropriate item and enter fee in section 5B. 4f.Each additional Inspection aver
4 or more residential units in one structure the allowable lit any of the abo re
r- - Per inspection $ 5000 _
- Service and feeder 225 amps or more Per hour _ $ 5000
System over 600 volts nominal In Plant $ 5900
Classified area or structure containing special occupancy as
LL described in N E.C.Chapter 5 5. Fees:
5a Lnler total of above fees 5 ��_�c 2
` Submit 2 sets of plans with application where an) of the above apply. 8%Surcharge(.08 X total fees) $
Not required for temporary construction services. Subtotal $
5b.Enter 25%of One as for '
NOTICE Plan Review if rS. uulred(Ser. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ ,
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account#
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
i.r dstsNortnslclect ric.doc