13385 SW 110TH AVENUE �r
ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 6.5 '-4171
Inspection:_
Footing Suso. Coiling Sprink. Rough-in nppr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg, Top C..,t Elec. Pough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underfir. Insul. Shear Wal Gyp. Bd. lect.
Date Requested: � I S /y S Time: AM .,Z_PM
Address: /3 7 0 S 11C
Builderl��x w /,,s 3(no Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: 7 ,
1�S(pector'tee:,-37-Dat -g
.ZPROVED DISAPPROVED APPROVEL SUBJECT TO ABOVE
_Call For Reinsp.
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CITY I-IF T I GUARD RFC.:F:I GT' OF P'AYME'NT RECF'I r''-C NO. r 95-2681 9r
CHECK AMOUN'l' a 36. 7�5
rJAMF ` i PHOENIX E'LF CT��I C CA91A AMOUNT : rL►. NN
PDDRU:131a, ! 7379 9W TECH CE.N'TER DR. ,PAYMFW' MATE 07/1E1/Ar
T WARD, OR SUBD I V 17I ON s
97c'23-
PURI OCA iE Ol PAYMENT AMOUNT PAI D PLIk 'DOSE. OF PAYMENT AMOUNT GAIL)
H RLFLfiRICAL 'PERMIT 35. Oel RT'. HUIL.D GFR 1. 7
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11385 SW 110TH AOE. - EL_C 95-017,13
T'DI AL AMOUNT PAID s - _ > 36. 75
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• Community Devefonment ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # [L�, 6I -O N
PhonF (503) 639-4171 Dete Issued 1-19 -`i�-
CITY OF'TiGARD FAX (503) 684-7297 Issued by • M- 11��_trh-
TDD No. (503) 684-2772
Inspection 1,503) 639-4175
1. Job Address: { `Y` y c-jq -S l D 4. Complete Fee Schedule Below:
Name of rfeve anmc-nt \� 4 11 C r h Number of Inspections per permit allowed
Addiess. �DW\ Service included: items Cost(ea) Sum
City/State/Zip_ �j _ 1 a �� 4a. Residential-per unit -- — 4
1000 sq it or less $11000
Name (or name of business) portion Ihereo_ Fach addsif s, n ,r $?5 00 1
re - _
Commercial❑ Residengal Limiter)Energy $2500
Each Manut'd Home or Modutar 2
Dwelling Service or Fneder —`– $6800 -_
2a. Contractor installation only:
4b.Services or Feeders
Installation,allsration,or relocation 2
Electrica! Contracto.0/710.r iV I -0 - C 200 amps or loss $sc 00 2
Y 201 amps lu 400 amps $80 00 _ 2
Addres.1 5 �7 -- ---
401 amps to 800 amps $12000
_ 2
aty� ! Stated_ ip � 801 amps to 1000 amps � $18000 r– 2
Phone Ni-" -1,L( aver 1000 amps or volts $54000 2
Contractor s License No. Q, Reconnect only $5000
Contractor's Poard Reg. No. 4c.Temporary Services or Feeders
Irotallation,alteration,or relocation 2
Signature of Suer. Elec'n_&5 • 200 arnps or lana $50 00 _ 2
License No. ' rune No. �-s 201 amps to 400 amps $71100 2
401 amps to 800 amps $10000
(Nor 800 amps to 1000 volts
2b. For owner installations. see•b•above
4d. Branch Circuits
Print Owner's Name _ New,alteration or extension per panel
Address a)The lee for branch circuits with
CityState ,Zip —! purchase of eavke or A.eer 1".
Each branch nrcurt _ $500
Phone No. h)The IPA for branch circuits without
The installation is being made on property I own which is purchase of s+rvke or feeder fee, 2
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not intended for sale, lease Or rent First branch circuit $3500 2Each additional branch circuit 1.500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): ^Pdl pump or inigabon aide S4000 2
Etch sign or outline lighting $4000
Signal cirrus(s)or a limited energy 2
Please check appropriate item and enter fee in section 58. pane; alteration or extension $4000
4 or more residential units in one structure Minor Lapels(10) $10000
_ Service and feedor 225 amps or more
System over 600 volts nominal Af. Each ,addilfonai inspection over
i'lassitied area or structure containing special occupPer inspancy the allection in any of the above
as described in N E C. Chapter 5 Per hour
on $35 no
$55 no
In Plant $55 00
Sul•,nit 2 sets of plans with application where any of ilia uv:e --
e�,ply. Not required for temporary construction services. 5. Fees:
NOTICE 5u. Enter total of above fees $ 4=
51".Surcharge(OS X fetal fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORI7ED IS NOT COMMFNCED WITHIN 180 DAI: OR IF 5b.Enter 2 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 Subrenal $ —
COMMENCED. ❑ Tru.-,t Account# $
Balance Due
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