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11055 SW 95TH AVENUE ADDRESS: 0 Av .I cc �J I:VecrondsWlicro(Im\targets%uiiding.doc iW-7�, VVVV OF TIGARD BUILD G I ECTION DI ISION 34-Hour Inspection Line: -4175 Business Phone: 639-4171 Date Requested: ��- f S � A.M. (( U P.M. e_ MSI': Location: BUP: Tenant: _ Suite: 1311g: _ IvIFC: Contractor:— C GC Phone: ���O' Sr���� PLM: _ —� — Owner. i'honc: EiC1 7"" OlO E?,R:--_`_-— SIT: BUILDING BLDG(con't) PLUMBING MECHAMCALELECTRICAL , SI1i E `~ Site Post/Beam Post/Beam Post/I3eam Cover/Serv;ce Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Frxuning Top Out Gas Linc Rough-In U0 Sprirklct Foundation Insulation Sewer I3oocUlhtct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG slab Shear/Sheath _ Fire Rpklr/Aha Crawl/Fomtd Dr I leat I'urnp Low Volt _ Approved Approved Approved Approve Approved APer/Sdwlk Not Approved Not Approved Not Approved roved Not Approved FINAL FINAL FINAL FINAL F I VE,y /,-2 CV 45'x1 s 7-1 nr<_ Cc �L 4-CQ 4✓At-r-,6A /".It 4z—/3-TC/ 7-0 e C TD w d-A L, C©,6E �/ iQ T rz J 0 Call for reinspection Q Reinspection fee of S __required before next inspection L: Jnnblc to inspect Inspector-_ Date: �1 v/L6-7 9—Z— Page-- of-- CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 6394171 Date Requested: Z 1 I - A.M. _—_ �Pml f!' MST: Location:� �� 5 Lt% `� 71-4 J 13UP. -- Tenant: Suite: Bldg: _ MEC: _ Contractor: ' C .( �- _Phone: _73C ' C,,z 6z�a c7C Owner: Phone: ELC: — ELR: SIT: _ BUILDING BLDG(con't) PLUMBING MECHANICAL <,ELECTRICAJ, SITE Site Post/Beam PostAleam Posv73eam Cover/Service Sewer/Storm Parting Roof UndFUSlab Rough-In Ceiling Water Line Slob Framing Top Out Gas Line Rough-In 1JG Sprinkler Foundation hisulation Sewer Iiood/Buct Reconnect Vault I3smt Damp Drywall Storm Furnace 'Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Ahn Crawl/Found Ir 1 IVAlt Pump Low Volt Approved Approved Approved Approved Apprcved Appr/Sdwlk Not Approved Not Approved Not Approved of }rnv_^�1'1 Not Approved FINAL FINAL FINAL > FINAL o c -- F-- t) f- J rr D7 C.7 IJ.! Call for reinspection cinspcetion fce of$ required before next inspection t'nable to inspect /Inspector. 7"1 __ Date: � ' ___`�_ Page of CITY OF T ..LECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97-0642 6�� 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED. 09/ /97 'DARCEL: 1 S 1.35CA-00200 SITE ADDRESS. . . : 11O55 SW 95TH AVE SUBDIVISION. . . . :MEADOW VIEW ZONING:R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :OO5 JURISDICTION: TIG Project Descri pt ion ,. Installation, alteration, or relocation of a x'88 AQP service o feeder and add four (4) branch circuits to an existing single family dwelling. ------------------------------------------------------------------------------------- ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS----- -----MISCEuLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 5O0SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 -----SERVICE"/FEEDER----- ----BRANCH CIRCUITS----- ---ADD' L INSPECTIONS---- 0 _. 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 4 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . • 0 401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT.. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 -----------------PL..AN REVIEW SECTION------__----_--- -- 1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: -------------------------------------------------------- FEES LILLIAN M MOORE type amount by date recpt 4435 SW 179TH PRMT f 80. 00 GEO 09/30/97 97-299661 ALOHA OR 9'7007 SPCT $ 4. 00 GEO 09/30/97 97-299661 Phone #: Contractor,: ----------------_------..---------------.-.----------_-------------- D & l_ ELECTRIC, INC. $ 84. 00 TOTAL_ PO BOX 1047 ------- REQUIRED INSPECTIONS --- - OREGON CITY OR 97045 Roi.tgh-in Elect' l Service Phone #: 656-5623 Undergroi_ind Cope Elect' l Final Reg #. . : 008806 This permit is issued subject to the regulations contained in the Tiyard Municipal Code, State of Oregon 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 18A days of issuance, or if wcrk is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-901-NNIO through OAR 952-N1-1987. You may obtain a copy of these rules or direct questions to OX by calling (58 46-1987. N P e r m i t t e e S i g n a t i_i r e : c"..__ _------ —_- I s s i_i e d By : INSTALLATION CINLY------- - ----_- ------ -- _---- �? The installation i5 being made en property I own wtiich is not intended for sale, lease, or rent. OWNER' S SIGNATURE: � DATE: --------------------------CONTRACTOR INSTALLATION ONLY-------_-__----/_---__--__-.-.-._ SIGNATURE OF SUPR. ELEC' N: �CSL.__ DATE LICENSE NO: 19 �(Z os_ ++++++-f++++++4+++++++++++++++++++4+++++++++++++++++++4•+4•++++++++++++++++++4++++ ++4 ++++++++++++++++++r++++++++++++4++++++++++++++++++++++++++++++++++++++++++++ CITY OF%r1GARD Electrical Permit Application Plan Check 1i 13125 SW HALL BLVD. Recd By TIGARD OR 97223 Date Rec'd _ Date to P.E. Phone (5 03) 639-4171, x304 Print or Type Date to DST Inspection (503) 639-4175 Permit n� 07-7 O � Fax (503) 684-7297 Incomplete or i'legible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development - Number of Inspections per permit allowed Name(or name of business) .-1 (n� { Service included: Items Cost Sum Address_] I 05-, IW S S -1 J 4a. Residential-per unit r� 1000 sq.It.or less $110.00 _. _ 4 City/State/Zip I Gr C)<-" _ Each additional 500 sq.ft.or Commercial El c• Residential❑ portion f $25.00 1 Limited Energy i $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2a. Contractor installation on;j,: -- (Attach copy of all current ll%enses) 4b.Services or Fenders i Installation,alteration,or relocation Electrical Contractor_ ,Z L-_ i , c . j.�> c t> Address ��IJ �r� I hH 1• zoo amps or less _� $so.00 �_. z k ! 201 amps to 400 amps $80.00 2 City .cr. StateZip Ct Rcll 401 amps to 600 amps $120.00 2 Phone No. k, .3 IPSIa-5L-1J 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Elec.Cont. Lice. No._= CExp.Date 10 -1 - if Reconnect only $50.00 y. 2 OR State CCB Rey. No. Exp.Date •2--t-1. 9 4c.Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date,D- 1 -9� Installation,alteration,or relocation 200 amps or less $50.00 _ 2 Signature of Supr. Elec'n a, �✓, �6y3 A.4 a._-vim 201 amps to 400 amps $75.00 � ------,-•---- 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts, License bb. �'�'' ~ S Expp-D- ate �� see"b"above. Phone Nt �'S c - I i G 57 >5�� _ 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The foe for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 CfP State_ Zi -- b)The fee for branch circuits ty without purchase of Phone No. _ service or feeder fee. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 _ 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature u Each pump or Irrigation circle $40.00 _ Each sign or outline Ilghting $40.00 3. Plan Review section (if required):' Signal circuit(s)or a limited energy^ panel,alteration or extension $40.00 2 R Minor Labels(10) $100.00 ,r Please check appropr'Tile item and enter fee in section 5B. 4 or more residential units in one structure 4f.Each additional Inspection over 1- Service and feeder 225 amps or more the allowable In any of the above J System over 600 volts nominal Per Inspection _y $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described In N.E.C.Chapter 5 In Plant $55.00LL "Submit 2 sets of plans with application where any of the above apply. Jr. Fees: c c Not required for temporary construction services. 5s.Enter total of above fees $ a 1 591.Surcharge(.05 X total fees) $ �'!' NOTICE subtotal $ --- 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review L r9auIr (Sec.3) $ - ----NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK ..Subtotal $ ~-IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. Trust:account k Tota.'balance bus $ 10srMErcoe A"P Rav aae RECEIVED SEP 3 Q 1997 COMMUNITY OEVELOPMENI