11350 SW 95TH AVENUE f
11350 SW 95TH AVENUE-
TIGARD
ELECTRICAL P'E:RMIT
CITY OF
P'r.RMII" # : EI_C�3[�- ,ZIV14�i
DATE ISSUED• 011L,3/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 PARCEL- 1 31351)B-057504
SITE ADDRESS. . . : 11350 SW 95TH AVE
SUBDIVISION. . . . : THOMAS TERRACE ZONING.- R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5 .�
)Iro.�ect Description: Installing ser^vice feeder
_�._RESIIJk_N"i IAL UNIT•-----•- ----TEMP' SRVC/FEEDERS----- -----MISCELLANEOUS---
1000 SF= OR L.ESS. . . . : 11) 0 - 200 amp. . . . . . . : 0 PIUMPI/IRRIGATION. . . . : 0
EACH ADZ:!' L 500SF. . . : 0 201 - 4111111 amp. . . . . . . : 0 SIGN/OUT LINE: LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/P,ANCL. . . . . . . : Vi
'*ANF . 1-111/ SVC/F•DR. . : IZI 601+amps--1000 volt 0 MINOR LABEL- { 10> . . . : 0
_..___..-SERVICL:/F=E'EDER------ __.__BRANCH CIRCUITS- .___.._ __._ADD' L INSP'ECTIONS ____
0 - C:00 amp. . . . . . : 1 W/SERVICE OR FEEDER: 0 PIER INSPIECTION. . . . . : 0
400 amp. . . . . . : 0 1st W/O SRVC Ok FDF . : 0 P'1=R HOUR. . . . . . . . . . . : VI
401 _• 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 •----_._........______._._...__._.__ Pl_AN REVIEW SECTII:)N
11000-1- amp/volt. . . . . : 0 ) =4 RE,S UNITS. . . . . . , . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 aVC/FDR > = 225 AMPIS. . : CLASS AREA/GP'EC OCC. :
Owner-: _.__..__-_____.__.__..__.__._____.____-_____.__.__._._____._.__.-_ --_. ._._.__._.--.- FEES
LOUIS KREISBERG type amol-Int by date r,ecpt
11350 SW 95TH PRMT $ CIO. 00 B 01/: 3/96 96-275201
;PICT 11, 3. 00 B 01/23/96 96-275201
T IGARD OR 97223
Phone #:
Contrac:tor,,
AFB ELECTRIC I Nr, 63. 00 TOTAL_
P,O BOX .173
----- REQUIRED INSPECTIONS -_--
JE FLR1.3ON OR 97352 Elect' 1 Service
F='hone #F: Eler.t' 1 Final
Rey
This permit is issued subject to the regulations contained in the ;' TAt
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'e VIM t e e $!nn a �r^e
applicable laws. All work will be done in accordance with ,
approved plans, This permit wiil expire if work is not started
within 1% days of issuance or if work is suspended for sore
than 180 days. I s s 11 e d By
?N 1TA1_I_ATIOI'J
The installation is bezny made or; prOper•ty I own which is riot intended for-
sale, lease, or- rent .
OWNER' S SIGNATURE : DATE:
11:17R INSTALLA IfION ONLY- ------ -- -------__�____..._/._
S lGNP1UR1_: OF SUF='R. ELE:C' N: l�� �'t7 r«< _�_. DATE: ""G'�� `90
_...rte'`_.__ _._..__ ..___._._.. ..___.
t_ 1
CFNSE NO:
Call for inspection - 639--4175
Community Deveiopment 'ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # L' L �� GNA ----
Date Issued 1 -2L 'Q0 ----
Phone (503) 639-4171
FAX (503) 684-7297
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175 _
FName
Address: 4. Complete Fee Schedule Below:
( 1 5 {(��+ �1Jc=YNumber of Inspections per permit allowed
Development �.�ll I� Y> aService included Items I'ostiP,I um
//3C����, -- -
Cit /State/zip C-��'¢ 4a. ResidentIP: -per unit — T 4
Address--
City/State/zip P 1000 sq. It r less $11000
Each additional°00 so 1t or $2500
Name (or name of business) --- - portion chert of $25 00 1
Limited Energ)
Commercial ❑ Residential Each Manufd Home or Modular $6800 2
Dwelling Service or Feeder
2a. Contractor installation only: 4b. Services or Feeders
��pp installation,alteration of relocation $6000 2
Electrir,al Con�tracto FS f' kae.j1`'I c ---� --- 200 amps or less $ao 00 2
201 amps to 400 amps 2
Address n `� �-3 - $t2000
401 amps to 600 amps 2
State p 75 S� p $160 00
City "_ -i-F ���C Y L ZI l� 601 amps to 1000 amps �— $340 00 2
over 1000 amps or volts $50 00 2
Phone No. - Reconnect only
Job NO._
contractor's license NO._ - 4c. Temporary Services or Feeders
n Installation,alteration.or relocation 2
Contractor's Board Reg. No.— t t!� r� �. . �n0 amps or less 2
Signature of Su r. Elec'n __ $5000
201 amps l0 400 amps 2
Phone No.J��?`/_• 401 strips to 600 amps -__ s 000
Lir_ense No. $top 00
Aver 600 amps to 1000 volts
Bee°b°above
2b. For owner installations:
4d. Branch Circuits
Print Owner's Name _ New alteration or extension per pane
a)The fee for branch circuits with 2
Address reactor or service or rear fes. $500
City_ State Zip Each branch circuit
y b)The tee for branch circuits without 2
Phone No., purchase of service or reader tae. 2
The installation is being made on property I own which is First branch circuit $3500
not intended for sale, lease or rent
Each additional branch eVcult $500
4e. Miscellaneous 2
Owner's Signature, — (Service or feeder not included) 2
Each pump or irrigation circle _-- $40.00 _
3. Plan Review section (it required): Each sign or outline lighting $40002
Signal circum($)or a limited energy
Please check appropriate Item and enter fee In section 5B. panel alteration or extension $100 0000
Minor Labels(10)
4 or more residential units in one structure
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal the allowable In any of the above $3500
Classified area or structure containing special occupancy per Inspection $5500
as described in N E C Chapter 5 per hour $5500
In Plant
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: CC
6a. Enter total of above fees
NOTICE 5% Surcharge (05 X total fees) 5
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 6b. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED W11HIN 180 DAYS,OR IF Plan Review if required (Sec 3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal E
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS .m t—e.0"I"r Trust Account # $
COMMENCED.
""" Balance Due $ (e�
CITY OF TIGARD
August 6, 1996 OREGON
AFB Electric Inc.
P.O. Box 173
Jefferson, OR 97352
Gear Sir:
An inspection was conducted on January 26, 1996 at 11350 SW 95th, Tigard,
Oregon and corrections vere noted. Oregon Administrative Rule (OAR) 918-
260-270(2) requires corrections to be made within 15 days. To date, this office
has not received notice that these corrections have been completed. (A copy is
enclosed for your reference).
Please notify this office within 10 days as to the status of these correction::.
This office wishes to provide any assistance possible to aid you in getting your
inspection finalized
If you should have questions and/or concerns, please contact me at 639-4171,
ext. 356, before 9 a.m.
Thank you for your cooperation.
r
Michael Rudd
Electrical Inspector
Enclosure
i k:itywideWtbelec da:
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 - —
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 635 .175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach,
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Others
Date&2 A.M. __�_P.M. Entry:
Address: __ _ —__ L —
Tenant: �__.. — Ste:_- ___ MST:
BUP:
Con/Own:., _._. _._ MEC:
PLM: _
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
Inspectors -P. _ �LG7 Date F-2`-
APPROVED __DISAPPROVED/CALL FOR REINSP. CF CO
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