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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hoffer Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested /► �� AM PM BLD
Loc.-tionj_;�(l ` > IZ1Suite MEC
Contact Person ta-h ( Ph 5Zbf PLM
Contractor _ Ph _ SWR
BUILDING Tenant/Owner ELC �2MD 1A)jVjr�
�-R-ettaining Wall ELR _
Footing Access: r
Foundation PPS —
Ftg Drain z
Crawl Drain Inspection Notes: SGN
Slab _ _ SIT _
Post& Beam —
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —
Roof
Misc: ---- — -
Final
PASS PART FAIL ----- ----- --- -
PLUMBING
Post& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final -----^--
PASS PART FAIL
MECHANICAL
Post& Beam - - - --- - - ----- - _----- -- - ..
Rough In
GasLine -------- --- `_�_ —.� _ - -- --
Smoke Dampers
Final -
PASS P..RT FAIL
f,LECTRICAL _ � _ - ----- -------� --- - —_ _—
Service
Rough In
G UG/Slab
ct Low Voltage —
n Fire Alarm — �-
-------- ----------
�. Findf
PART FAIL -— --- --- ---- --- —
J
Backfill/Grading -
,;� Sanitary Sewer
J Storm Drain ( ) Reinspe^tion fee of$ required before next inspectio,i Pay at City Hall, 13125 SW Hai Blvd
Catch Basin ( ) Please call for reinspection RE I )Unable to inspect-no a;:cess
Fire Supply Line _
ADA
Approach/Sidewalk J/
vate Inspector
Other -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from tie job site.
CITY ®F T I G A R D ELECTRICAL PERMIT
PERMIT#: ELC2000-00162
DEVELOPMENT SERVICES DATE ISSUED: 04/07/2000
13125 SW Hall Blvd.,Tislard, OR 97223 (503) 639-4171 PARCEL: 2S103CC-05200
SITE ADDRESS: 13615 SW 121ST AVE
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: install five (5) branch circuits for an existing dwelling.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _MISCELLANEOUS
1000 S) OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'!- 500SF: 201 - 4'10 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601•i-amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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:
CHRIS OLENDER OREGON ELECTRIC CONST/GROUP
13615 SW 121 STAVE 1010 SE 11TH AVE
TIGARD, OR 07223 PORTLAND, OR 97214
Phone: Phone: 234-9900
Reg #: LIC 203
SUP 1302S
ELE 26-95C
FEES i _ _ Required_Inspections _
Type By D?te Amount Receipt _
_ Elect'I Service
PRMT GEO 04/07/200C $58.90 0001249 Elect'I Final
SPCT GEO 04/07/200C $4.71 9001249
Total $63.61 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR Specialty Cees and all other applicable laws.
All work will be done in accordance with approved plans This permit wil!expire if work is not started within 180 days of issuance,or 9 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 ordirect questions to OUNC at(503)
246-1987
' PERMITTEE'S SIGNATURE ISSUED BY: 77
OWNER INSTALLATION ONLY �
The installation is being made on property I awn which is not intended for sale, lease, or rent.
(23
OWNER'S SIGNATURE: — _ _ _ _�. DATE:
CONTRACTOR INSTALLATION ONLY —_
SIGNATURE OF SUPR. ELEC'N: _ DATE: --7/
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARDElectrical Permit Applicaj�' iv1-'0 Plan Check#
13125"6W HALL BLVD. Recd By
(\���
TIGARD OR 97223 Date Recd
p� �� j Date to P.E.
Phone (503)639-4171, x304 MSN
VE�O� Date to DST
Inspection (503)639-4175 Print of Type ��p��N\w�F'r{�� Permit# F-6
Fax (503) 598-1960 Incomplete or illegible will not be a�Ccepted v Called _
1.. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name(or name of business) Chris 01ender Service included: Items Cost Sum
Address_ja6 15 sw 121st Ave• _ 4a. Residential•per unit
City/State/Zip Tigard OR 9 7 2 2 3 1000 sq.ft.or less $ 117.75 Y 4
--- Each additional 500 sq.ft.or
Commercial ❑ Residential ❑ Limited Energy $ 60.00 _
Each Msnurd Home or Modular
2a. Contractor Installation only: Dwelling Service or Feeder S 72.75 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data base). Installation,alteration,or relocation
ElectricalContractcr Oregon Electric Group _ 200 amps or less - $ 64.25 2
Address 1010 SR 11 F h AyP_ 201 amps to 400 amps _ $ 85.50 2
--
City Portland State OR _Zip 97214 401 amps to 600 amps $ 128.50 2601 amps to 1000 amps -_ $ 192.50
Phone No. 234-9900 _ Over 1000 amps or volts _ $ 363.75 2
Job No. "i n 7.4 2 _ Reconnect only $ 53.50 2
Elec Cont. Lire. No._2 b-9 5C Exp.Date __ 4c.Temporary Services or Feeders
OR State CCB Reg. No. 203 Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. _ Exp.Da 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
f 1
Signature of Supr. Elec'n 401 amps to 600 amps $ 10700 2
r.� -
Over 600 amps to 1000 volts,
see"b"above.
License No _ ,AExp.Date ---- 4d.Branch circuits
2-3-4---5-9 Phone No. O O New,alteration or extension per panel
F0 The fee for branch circuits
2b. For owner installations: with put chase of service or
feeder lee.
Pant Owner's Name Each branch circuit _ $ 5.35 2
Addressb)The fee for branch circuits
---- without purchase of service
City _ - _-State _Zip�Y - or feeder fee.
Phone No _ _ First branch circuit 1 $ 37.50 37 . 50
Each additional branch circuit -4 _ $ 5.35 -.
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or rent. (Service or feeder not Included)
Each pump or Irrigation circle $ 42.75
Owner's Signature _ - Each sign or outline lighting _ $ 42.75
Signal circuit(s)or a limited energy
panel,alteration or extension $ 6000
3. Plan Review section (if required):* Miner Labels(10) $ 107.00 �-
Please check appropriate item and enter fee in section 58. 4f.Each additional Inspection over
4 or more resiuential units in one structure the allowable In any of the above
Cif Per inspection _ $ 50.00
Service and feeder 225 amps or more per hour $ 50.00
System over 600 volts nominal In Plant _ $ 5o 00
Classed area or structure containing special occupancy as
-r described in N E C Chapter 5 5. Fees:
t 5a.Enter total of above fees s 58. 90
Submit 2 sets of plans with application where any of the above pIVD $r/.Surcharge(05 X total fees) $ 1
''j Not required for temporary construction services. Subtotal $ �r-
5b.Enter 25%of line 5a for
NOTICE d Plan Review if re ug ired(Sec.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 GAY: ❑ Trust Account#_
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ __
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