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98-90,9870,9900 SW HREWING ST
CELECTRICAL PERMIT
CITY ®� T I G��D .__
PERMIT#: ELC2000-00640
DEVELOPMENT SERVICES DATE ISSUED: 11/20/00
13125 SW Hall Blvd.. Tiqard. OR 97223 (503) 639-4171 PARCEL: 2S102CB 03400
SITE ADDRESS: 09850 SW FREWING ST
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect only for unit#46.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ _MISCELLANEOUS_
1000 SF OR LESS 0 - 200 amp: PUMP/IRRIGATION:
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: MINL.R LABEL (10):
SERVICEIFEEDER _ _BRANCH CIRCUITS _ ADC'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: �J
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA AL)D'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+ anrp/volt: >=4 RES UNITS: —� > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS ARE /SPEC OCC: _
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
-ORTLAND, OR 97223
Phone: Phone
Rog #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTI2 11/20/00 $66.85 272000000 ( Elect'I Final
5PCT GTR 11/20/00 $5.34 2720000CJ01(
Total $72.19
This Permit is issued subject to the regulations contained in the Tigard Municipal Cede,State of OR. Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans. This permit v.ill expire if work is not started within 160 days of issuance,or if 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 slit forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to QUNC at(503)
246-1987
ISSUED BY:
PFRMITTEE'S SIGNATURE C Com• r ZC `z---
` OWNER INSTALLATION ONLY _ --
The installation is being made on propert`�w ' h isnot intended for sale, lease, or rent.
// \\ TE:
OWNER'S SIGNATURE: ----�---
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ ___ DATE:_
LICENSE NO: - - ---------�— _w
Call 639-417 ' ; 7:00prn for an inspection the next business day
Electrical Permit Application
Date received: i/12Permit no.: tieZ�Da
to City of Tigard Project/appl•no.:71 Expire date:
City of Tigard Address: 1.3125 SW Hall Blvd,Ti,;ard,OR 97221
Phone: (503) 639-4171 pate issued: By: Receiptno.:
—
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
U 1 2 lanuly dwelling or accessory U Commercial/industrial IJ Multi-fancily U Tenant improvement
U New construction U Addition/alteration/replacemert U Other: _ U Partial
INFORMATION
�( Job address: Cff U kj l- P` k)r tj CC Mg.no.: I Suite no.:!�! Tax n)ap/tax lot/account no.:
\ Lot: I Block: Subdivision: A AQ i A4c /_ _/
Project name: ascription and location of work on premises:
Wimated dote of :ompletion/inspection:
J�)h no:
hrr nt:e%
Business name: �!_'Al
Desc iptlon tp�. (ca.) rood no.insp
Address:
dd roa ss: c Nen resblential-single or multi-family per
dddNellingonto.Ine•4tdesataeleedgarage.
City: Slate: ZIP: Serviceincluded:
Phone: Fax: E-mail: IoW sq.ft.or less _ q
Hach additional 5W sq.ft.at.portion thereof
CCH no.: _ Elec.bus.Ile.no: l.imitedenergy,residentiel 2
City/metro IIC.no.: Limited energy,non-residential 2
Each manufactured home or modulydwelling
Signature of superv.sing electrician(requires) Date Service and/or feeder 2
Sup,elect.name(print): - — - - License no: Servvicesorfeeders-installation,
PROPERWOWNER 7— alteration or relocation:
200 amps or less 2
Name(print): x-01( G t eV /L--e 201 amps to 400 amps _ _ 2
Mailing address: , c �. - 401 amps to6Wantps —_ 2
Cll �: Stale: 601 amps to I OtA)amps ____ 2
/c' -� R r_)P ZIP: c2' oVNCjBflfl sbrvn 2
Phone:Sc 3- E-mail:
Owner installation:T e Installation is being made on property I own 7 Fe i ratysetwices or feeders-
which is not intende(Lf salese,rent,or exchange according to installation,alteration,or relocation:
ORS 447,455,479,67 ,7 l. 200 amps or less 2
201 amps to 4W amps 2
Owner's si na re: 4 �. Date: 11 Z�) 401 to 6tx)amps -- - — 2
7A.
ench circuits•newt,alteration,
r extension per panel:
Name: - Fee for branch circuits with purchase of
Address: service or feeder fer.,each branch jrcuil 2
City: Stale: ZI1' . Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: Fax: F-mail Each additional branch circuit:
I am I MITI Mhc.(Service or feeder not Included):
❑Service over 225 amps-commercial U Flealth-care facility Fach pump or initiation circle 2
O Service over 320 amps-rating of 1 k.2 U llu.ardous location Fach sign or outline lighting 2
family dwellings UBuilding over 10.000squarefeet fouror Signal circuit(s)or a limited energy panel.
❑System over Glx)volL%nomiiW more residential units in one structure alteration,or extension* 2
•Building over three stories U Feeders,400 amps or more *Description: _
IJ occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
U Fgress/lighthtgplan U Other _— Pe:inspection _-_E_ I
Submit^-sets of plans vAth any of the above. Investigation fee _
The above are not applicable to lempnrary construction service. Other
--I Not all juridicrions accept credit verde please L411)urlsdiction for more information.' Notice:This permit application Permit fee.....................$
U Visa U MasterCard expires if a permit is not obtained Plan review(al _ %) $
credit card number_ ispires within 180 days after it has been State surcharge(8%)....$
_- — � '/ .
Name of cardholder u shown on credit cry—
o accepted as complete. TOTAL ......... .............$ .� . l 9
'
S _
Cardholder signature Amount
_� __ 44046I S(6I1)IYC'OM
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: — —
p Restricted Energy Fee...................................................... $75.00
_ Number of Inspections per permit allowed (FOR AL1_SYSTEMS)
Service included: Items Cost Tota! y Check Type of Work Involved:
Residential-per unit
1000 sq it or less $145 15 4 [J Audio and Stereo Systems
F ach additional 500 sq It or
portion thereof $33.40 _ T__ 1 Burglar Alarm
Limited Energy __ $75.00
Each Manurd Humc r Modular [l Garage Door Ooener'
Dwelling Service or Feeder _ $9090
Services or Feeders I seating,Ventilation and Air Conditioning System"
Installation,alteration,or relocation
200 amps or less _ $80.30 ' Vacuum Systems'
201 amps to 400 amps $10685 z
401 amps to 600 amps $160.60 _ _
601 amps to 1000 amps $240,60 2 c)then
Over 1000 amps or volts _ $454.65 ?
Reconnect only $66.85
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation,aileration,or relocation
200 amps or less $66.85 7 Fee for ea.-h system.............................. ........................... $75,00
201 amps to 400 amps $100.30 _ 2 (SEE OAR X18-260-260)
401 amps to 600 amps — $133.75 _ 7.
Over 600 amps to 1000 volts, Check Type of Work Involved:
see"b"above.
Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel E] Boiler Controls
a)1 he fee for branch circuits
with purchase of service or
feeder fee. Clock Systems
Each hranch circuit $6 65 2
T
b) he fee for branch circuits _ Data Telecommunication Installation
without purchase of service
or feeder fee. F-1 Fire Alarm Installation
First branch circuit _ _ $4685
Each additional branch circuit $665 HVAC
Miscellaneous
(Service or feeder not included) F-1 Instrumentation
Each pump or irrigation circle _ $53.40_
Each sign or outline lighting $53.40 — F-� Intercom and Paging Systems
Signal circuil(s)or a limited energy
panel,alteration or extension $75.00
Minor Labels(10) _ $125.00 D Landscape Irrigation Control'
Each additional Inspection over F—] Medical
the allowable in any of the above
Per inspection $62.50 — F—] Nurse Calls
Per hour — $62.50
In Plant $73.75 ❑
Outdoor Landscape Lighting*
Fees:
�] Prolective Signaling
Enter total of above fees
�] Other
8%Stale Surcharge $_
Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ " No licenses are required. Licenses are required for all other Installations
front of application.
Total Balance Due $ Fees:
Enter total of above fees
Trust Account p _
8%Siate Surcharge $_
Total Balance Due =
i:\dsls\forms\etc-rees.doc 10709100
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour inspection Lina: 639.4175 Business Line: 639-4171 BUP
Date Requested-.//- L Z _---------.AM----PM .--- BLD _ _-4__--
Location �k57--.5 v " a _ Suite MEC
,.ontact Person -_ Ph _-� --- FLM __ --
Contractor Ph - _ SWR ----_—_---
- ---i c �G U
BUILDING TenELC Gel U
ant/Owner �-------------------
Retaining Wall ELR
Foc.ting Access: FPS
Foundation
Ftg C,rai i SGN
Crawl Drain Inspection
Slab C �� � � [- SIT
Post& Beanr
Ext Sheath/Shear (.J N I
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing 9 -
Firewpll
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- -- - ---
Roof N
Misc -
Final
PASS PART FAIL --
PLUMBING --�
Post & Beam -�-- -- ) 1
Under Slab -- -- --- �` -+-- - -_
Top Out
Water Service
Sanitary Sewer
Rain Drains - ------ - -- - - _ _ ._�
Final
PASS PART FAIL _
MECHANICAL
Inst g Ueanr — —--------- -..-._....- — --- — -- — _—._-- --- --
r,c,ugh In
nokF Dampers
F final ------ -- --------_---__ ---- -- —
PASS PART FAIL.
ervrce —
Rough In
UG/Slab --
Low Voltage
Fire Alarm -____-- _.- -------- -----
Fin
A1110AW PART FAIL --_ -- --- --..._. ------- - --... ---- -WE-
Backfill/Grading Backfill/Grading --- ---- -------- _------------------- —. —_._.__._
Sanitary Sewer
Storm Drain [ J Reinspection fee $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for r nspectlon RE:—_�- [ I Unable to inspect no access
ADA
Approach/Sidewalk
Other DateZ Inspector t f Ext
��-
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the yob site.
CITY OF TIGA,RD BUILDING INSPECTION DIVISION MST
24-Hour Inspection line: 639-4175 Business Line: F39-4171 -----
UP
^ B
Date — —
atc Requested_ --- A!UI PM
BLD
Location �
O >G✓ :1° ^*ZL` _ — Suite _�- MEC ,--
Contact Person _ CL /<_ Ph _ PLM
ContractorPh SWR
—
—_ -
BUILDING Tenant/owner ELC _� ��i✓O U,��
Retaining Wall - ELR
F ooting Access -----------
Foundation FPS —_-
Fog Drain -- - SIGN
SlabDrain Inspection Notes: -- --- —
Slab
-- SIT
----------- -----
Post& Beam ___------- — -----
Ext Sheath/Shear
Int Shr.ith/Shear �- 4
rAmog
Insulation - - --- -- ----------
Drywall (Jailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Rouf
Misc - -- - ---
Final
PASS PART FAIL -- - ---- -- - -- -- �=-L t - ---- --- -�
PLUMBING
- _ - - - - -
Post& Beam _.--�-------- --- --- --- --—
Under SlabCAL
Top Out - -----
Water Service
Sanitary Sewer --
Rain Drains
Final - _ -----------
PASS PART FAIL _
MECHANICAL -
Post&Bearn - - ----
Rough In
Gas Lire - --
Smoke Dampers
Final
P RT FAIL
TE-LECTRI --
Service 14Cs7loiecIC -
Rough In
UG/Slab
Low Voltage _. ._ - - - -- - ------ - -- ----
F'
PF' N'
PA. S ART FAIL __-- —
Backfill/Grading ---- -� —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$__-_ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin RE.ection Please call for ins
Fire Supply Line ( ] p [ ] Unable to inspect no access
ADA
Approach/Sidewalk Q�
Other Gate lJ _ Inspector _ Ext
Final
PASS PART FAIL DO NIT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inapection Line: 639-4175 Business Line: 639-4171
� BUP
Date Requested_ 5 P AMS PM BLD
Location_ �� t7 _�� b'+ �p MEC
Contact Person Al I Ph 2Zdi�—S e2— PLM
Contractor Ph SWR c
BUILDINU Tenant/Owner S,�Q{�f[1 �L�Q �_ ELC
Retaining Wall ELR
Footing ,Access: FPS
Foundation
Ftg Drain -- SGN
Crawl Drain Inspection Notes:
Slab SIT
Post&Beam n 9 S
Ext Si ieath/Shear —
Int Sheath/Shear
Framing __--
Insulation
Drywall Nailing —
Firewall
Firs Sprinkler —__
02
Fire Alarm
Susp'd Ceiling --- -- ---- — -— — --
Roof — —
Misc:
Final
PASS PART FAIL --- --- —— — �—
PLUMBING
Post& Beam —
Under Slab
Top Out
Water Service ---_..---_—__---__._ -- _-- ----— - --
Sanitary Sewer
Rain Drains ------ -- ___-- __ ----_--- I
Final
PASS PART FAIL `—_----------
MECHANICAL
Post& Beam -- — —
Rough In
Gas Line
Smoke Dampers
Final -- — —
PASS PART FAIL s
Re igh In
UG/Slab _ — —
Low Vol age
jiFg* EAIarm!'ART FAIL —
Backfill/Grading — — —
Sanitary Sewer
Storm Drain ( 1 Reinspection fee of$ required before nex 'nspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line i 1 Please call for reinspection RE - Unable to inspect-no access
ADA
IAoproach/Sidews!'c — _
Olhe, - Date Se—_ Inspector/:� � Ext
Final
PASS PART FAIL i DO HOT REMOVE this inspection record from the job site.
�►R D ---- ELECTRICAL PERMIT
CITY OF T I G
PERMIT#: ELC2000-00451
DEVELOPMENT SERVICES DATE ISSUED: 8/7/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S 102CB-03400
SITE ADDRESS: 09850 SW FREWiN(3 ST
SUBDIVISION: FREWING. ')RCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Reconnect u .1 for apartment #47.
__—
RESIDENTIAL UNIT _ TEMP_SRVC/FEEDEPSMISCELLANEOUS
1090 SF OR LESS- 0 - 200 amp: — PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 zmp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR I-ABEL (10):
_SERVICE/FEEDER — BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
10004 amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC-OCC:
Owner: Contractor:
ALEX FINKE OWNER
PO BOX 23562
TIGARD, OR 97281
Phone: 24,1-5824 Phone:
Reg #:
FEES r Required_ Inspections_ _
Type By _ Datn -- Amount Receipt I Elect'I Service —
PRMT BLD 8/7/00 $53.50 0001300
5PC'i BLD 8/7/00 $4.28 0004300
Total —^
$57.78
This Permit is issued sub,ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable Imus
All work will be done in accordance with approved plans This permit w1!1 expire if work is not started within 180 days of issuance,or if work is
suspended for more than 180 days AT ENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-00 1-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC ai(503)
246-1987
PERMITTEE'S SIGNATUREt { -t_ fit.__-�- ISSUED BY:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. `
OWNER'S SIGNATURE: _.. _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPIR. ELE(,'N: . �_ __—_ DATE:__
LICENSE NO: --_—
Call 539-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Rec'd By
Date Recd
TIGARD OR 9 223 Date to P.E.
Phone(503)639-4171, x304 /�' �/� Date to DST
Inspection (5r'_, 339-4175 Print of Type / Permit#.CC('e-7p-Da -.j2Q 5/
Fax (503) 598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 7� / ' r Number of Inspections per permit allowed
Name(or na eof business) A_ A L Service included: Items Cost Sum
r
Address Ld S yE/� Gj �� 4a. Residential-per unit
�' �� 1'900 sq fl or less $ 117.75 4
City/State/Zip / / -7 K_ --M Each additional 500 sq.ft.or
portion thereof $ 26.75 1
Commercial ❑ Residenti3iX, Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75
(Prior to permit Issuance,applicants must 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 gimps to 400 amps S 85.5n 2
401 amps to 600 amps $ 128.50 _ 2
City "State_ Zip 601 amps to 1000 amps $ 192.50 2
Phone No. _ Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only .� $ 53.50 .5_S,5D 2
Elec.Cont. Lice. No. _ Exp.Date 4c.Temporary Services or Feeders
OR State CCB Reg. No. Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. Exp.Date_J 200:�inps or less $ 53.50 2
201 amps to 400 amps $ 80.25
Signature of SU r. Elec n_ 401 amps to 600 amps $ 100.00 _ 2
g Supr. Over 600 amps to 1000 volts,
see"b"shove.
License No. Exp.Date
Phone No. 4d.Branch Circuits
----- - New,alteration or extension per panel
a)The fee fcr branch circuits
2b. For owner installations: with purchase of service or
n feeder fee.
Print Owner's Name F/
/AMZ� Each branch circuit Y $ 5.35 2
Address O 02 3 S-7o� b)The fee for branch circuits
without purchase of service
City. / I E>4 X State C • Zip / or feeder fee.
Phone No. vZvZ/f�} C,-,e First branch circuit $ 37.50
Each additional branch circuit S 5.35
The Installati,-n is being mad on pro which is not 4e.Miscellaneous
intended for sale, lease n (Sjrvice 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
if required):* panel, elsalteration or extension $ 80.00
3. Plan Review section
Minor Labels(10) $ 100.00
i
Please check appropriate item and enter fee In section 59. 4f.Each additional inspection over
4 or more residential units in one structure the allowable In any of the above
Service and feeder 225 amps or more Per inspection $ 50.00 _
- Per hour $ 50.00
System over 600 volts nominal In Plant $ 5900
Classified area or structure containing special occupancy as
described in N E.0 Chapter 5 5. Fees:
5a.Enter total of above fees S
* Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(08 X total fees) $
Nut required for temporary construction services. Subtotal $
5b.Enter 25%of line sa for
NOTICE Plan Review if re ug ired(Sec 3) S
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 $ 5�1.P
1.\dsls\forinodcotic doc
CITY OF TIGA►RD E' '"^.1RICALPERMIT
P' #: ELC1999-00462
DEVELOPMENT SERVICES NTE ftj-lL._D: 7/26199
13125 SW Hall Blvd..Tigard, OR 97223 (503) 6 IPA liss PARCEL: 2S102CB-03400
SITE ADDRESS: 09850 SW BREWING Sr
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect only.
RESIDENTIAL UNIT TEMP SRV_C/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:^
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601a•-imps - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER _- _BRANCH CIRCUITS ADD'L INSPECTIONS _
0 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L DRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION _ _ �-
1000+ amp/volt: �~ >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 — SVC/FDR >= 225 AMPS: _ CLA.:S AREA/SPEC OCC:
Owner: Contractor:
ALEX FINKE OWNER
PO BOX 23562
TIGARD, OR 97281
Phone: 244-5824 Phone:
Reg#:
FEES Required Inspections _
Type By Date Amount Receipt Elect'I Service `—
PRMT DEB 7/26/99 $53.50 99-317153 Elect'I Final
5PCT DEB 7/26/99 $3.75 99-317153
Total $57.25
This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR 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 180 days of issuance,or 4 work is
suspended fcr more than 130 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 oepres Of lh ae rules or direct questions to OUNC at(503)
246-1987
Permit Signature: / � / O Z'-`- Iss�ed Ey: /
OWNER INSTALLATION ONLY
Thr.;, installation iz:. being made on prop ty I own vMich is-nbt intended for sale, lease, or rent. /
_
OWNER'S SIGNATURE: � `' ` � DATE:---z/
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N: _—_-- �_ __ DATE:
LICENSE NO: —
Call 639-4175 by 7:C0pm for an inspection the next business day
a
CITY OF TIGARD Electrical Permit Application Plan Che —
13125 SW HALL BLVII. Recd B .I?
TIGARD OR 97223 Date Recd `7'A(47
_
Date to P.E. `-
Phone(503)639-4171, x304 Date to DST
hispection (503)639-4175 Print of Typie Permit 0 u2urq toy
Fax (503)598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: �, 4. Complete Fee Schedule Below:
Name of Development!>' X fes' X!!z4/ Number of Inspections r permit allowed
Name(or nam (o/f business) `, / Senrice included: items Cost Sum
Address O p T^���'/ 4a• Residential-oer unit
z 1000 sq.ft.or less $ 117.75 _ 4
City/State/Zip L1 r Z 3_— Each additional 500 sq.ft.or
portion thereof $ 26,25 _ 1
Commercial❑ Residential L Limited Energy _ $ 60.170
/ Fa(;h Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 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
Electrical Contractor 200 amps or less _ $ 64.25 2
Address — T 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.5C 2
City ----State ---Zip--. 601 amps to 1000 amps $ 192.50 2
Phone No._ _ _ Over 1000 amps or vnits $ 363.75 2
Job No.. _ Reconnect–only) $ 53.50 2
Elec. Cont. Lice. No. Exp.Date _ 4c.Temporary Services or Feeders
OR State CCB Reg. No. Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. _Exp.Date _ 200 amps or less S 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Su r. Elec'n 401 amps to 600 amps $ 107.00 — 2
9 p Over 600 amps to 1000 volts,
ses"b"above.
License No. Exp.Date_
4d.Branch Circuits
Phone No. – New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner Installations: with purchase of service or
feeder lee.
Print Owner's Name �=�C ' ��� Each branch circuit $ 535 2
Address vV 15 �-- b)The fee for branch circuits
without purchase of service
City State D j', Zip Ayl or feeder fee.
Phone No.'s A#O- k'W first branch circuit $ 37.50
Each additional branch circuit $ 535
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or ��� 1 (Service or feeder not Inclu,.ed) - --
/ Each pump or Irrigation circle $ 4275
Owner's Signature Each sign or outline lighting - $ 4275
Signal circuit(s)or a limited energy
if required):* MiPanel,alteration or extension $ 6000
3. Plan Review section
nor Labels(10) $ t07 00
Please check appropriatJ Item and enter fee In tiection 58. 4f.Each additional Inspection over
4 or i nora residential,nits in one structure the allowable In any of the above
Per Inspection $ 5000
Service and feeder 225 amps or more
Per hour $ 50 00
System over 600 volts nominal In Plant S 5900 _
_ Classified area or structure containing special occupancy as
described in N E C Chapter 5 S. Fees:
IM.Enver total of above fees $ J ,
Submit 2 sets of plans with application where any of the above apply. 111,9,154 Surcharge(05 X total fees) $ ��
Not required for temporary construction services. Subtotal
Ill Enter 25%of line 6s for
NOTICE Plan Review If required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONS i RUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 190 DAYS,OR IF CONSTRUCTION OR ClORK IS SUSPENDED OR ABANDONED FUR A PERIOD OF 180 DAPS ITrust Account'f _
0
AT ANY TIME AFTER WORK IS COMMENCED. Tote;balance Due $ l'
I:\dsts\forms',electric.doc
C __ ELECTRICAI PERMIT
CITY O� TIGARD
PERMIT#: EL( j0-00052
DEVELOPMENT SERVICES DATE ISSUED: 02/Gd/2000
13125 SW Hall Blvd..Tia3rd, OR 97223 (503) 639-4171 PARCEL: 2S102CA-00301
SITE ADDRESS: C9870 SW FREWING ST 060
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5
BLOCK: LOT : 018 JURISDICTION: TIG
Proiect Description: Reconnect service/feeder.
_ RESIDENTIAL UNIT TEM_ P SRVC/FEEDERSMISCELLANEOUS
1000 SF OR '-ESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 arnp: PLAN REVI,_W SECTION
j 1000+ amp/volt: >=4 RES UNi I S: > 600 VOLT NOMINAL:
L Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX TRUSTEE HURF ELECTRIC
JKE, LOTTE I TRUSTEE 17038 S. CLACKAMAS RIVER DIVE
PO BOX 23562 OREGON CITY, OR 97045
PORTLAND, OR 97281
Phone: Phone: 631-8700
Reg#: LIC 00038133 ORIGINAL
SUP 0001445S
El_E 003-103C
FEES Required Inspections
Type By Date Amount Receipt ^
__— Elect'I Service
PRMT KJP 02/08/200C $53.50 00-321626 Elect'I Final
5PCT KJP 02/08/200C $4.28 00-321626
Total $57,78
Th,s Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR 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 180 days of issuance,or if work is
suspen.fed 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 or ect questions to OUNC at(50"
246-1987 --
PERMITTEE'S SIGNATURE,X _ ISSUED BY:
_ OWNER !NSTAL LATION ONLY
The installation is being rn de on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE GF SUPR. EI_EC'N: _U�� "� " � DATE
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
1
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By
Date Recd
TIGARD OR 97223 Date to P.E.
Phone (503)639-4171, x304 Date to DST
Inspection (503)639-4175 Print of Type Permit#
Fax(503) 598-1960 Incomplete or illegible will not he accepted Called
1. Job Address: _1 /� 4. Complete Fee Schedule Below.
Name of Development (v /7 A' ? /_��__ Number of Inspections per permit allowed
Name(or narrip of business) J s . Service included: Items Cost Sum y
Address 61F 7 C) .5 Z - 4a. Residential-pev unit
Ci /State/Zi �/(�/¢ �� • 1000 sq ft,or lass _ $ 117.75 _ 4
City/State/Zip P - Each additional 500 sq it or
portion thereof $ 26.75 1
Commercial ❑ Residential �� Limited Energy _ $ 60.00 _
Each Manufd Home or Modular
2a. Contractor installation r7nly: Dwelling Service or Feeder $ 72.75
(Prior to permit issuance,applicants must provide contractor licimse 4b,Services or Feeders
Information for COT data e). Installation,alteration,or relocation
Electrical Contractor�_1Z 7�IL'7f)--►� 200 amps or less _ $ 64.25
AdAddress / ,L/F>�l/f/tr/f `� +l�d►- 201 amps to 400 amps _ $ 85.50 _ 2
dress _ Sate Zjp p - 401 amps to 600 amps $ 128.50 2
-�� 801 amps to 1000 amps S 192.50 2
Phone jt 6-3 "" Ob Over 1000 amps or volts i 363.75 2
Job NO. Reconnect only $ 63.50 .7 J-yy 2
Elec. Cont. Lice. No. Exp.Date -' 00 , 4c.Temporary Services or Feeders
OR State CCB Reg. No. � Exp.Date_.. - U Installation,alteration,or relocation
�
COT Business Tax or Metro No,, 40 1 ate 00 200 amps or less $ 53.50 2
201 amps to 400 amps $ 8025 2
_nature o` Elecr
S
. Supr. n {�J ^J('��`` 401 amps to 600 amps $ 100.00 2
�I
g p Over 600 amps to 1000 volts.
License No. -�+ Exp.Date /&- see"b"ebovs.
Phone No. (� y 7---e-- GO 4d.Branch Circuits
-- - 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
b)The fee for branch circuits
Address without purchase of service
City State___Zip_ or feeder fee.
Phone No. First branch circuit $ 37 50
-- Each additional branch circuit $ 5.35
The installation is tieing made on property I own which is not 4e.Miscellaneous
intended for safe, lease or rent. (Service or feeder not Included)
Each pump or irrigation circle +_ $ 42.75
Owner's Signature_ Each sign or outline lighting _ $ 4275
Signal circult(s)or a limited energy
if required):* Mipanel,alteration or extension $ 60.00
3. Plan Review section
nor Labels(10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f.Each additional inspection over
4 or more residential units in one structure the allowable In any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 5000 _
_Sys#eto over 600 volts nominal In Plant _ $ 5900
Classified area or structure containing special occupancy as
described in N E.C.Chapter 5 5. Fees:
5a.Enter total of above fees
* Submit 2 sets of plans with application where any of the above apps f. 8%Surcharge(.08 X total fees) $
Not required for temporary construction services. Subtotal $
5b.Entpr 25%of line 6a for
NOTICE Plan Review if required(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 DAYS LJ Trust Account#
AT ANY TIME AFTER WORK If COMMENCED Total balance Due $ �o
I adsts\fonnslelectrie.doc
CITY nF TIGARD BUILDING INSPECTION DIVISION MST
"i-eir Inspection Line: 639-4175 Business Line: 639-4171
BUP _
Date Requested--L Z cr AM PM __ BLD
Location fty6 - `�' rrP��r 5 Suite 61JI, MEC
Contact Person _ Ph Z z PLM —_—
Contractor — — _ Ph SWR —
BUILDING Tenant/Owner ELC ((O
Retaining Wall ELR - —
Fooling Access:
Foundation FPS —
Ftg Drain SGN
Crawl Drain Inspection Nofes:
Slab _—_-. SIT _
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing -----_ ------ - -
Insulation
Drywall Nailing --------__-- -- ----_-- _,�__� --
Firewall
Fire Sprinkler
u Alarm
Sw1 ce /
usp'd Ceiling ���.� _ �CD C- _.--
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
Gas Line -- -- -- - ----...-- --
Smoke Dampers
Finel ---- -- -- --- ---_PASS--PART FAIL
ELECTRIC_&I,) ----- -------- ----- __----- —
ervice - - ----- -- - ------- - —
Rough In
UG/Slab
I_ow Voltage
Fire Alarm - ----. ---- ---- ---- -- - -- --
F
PASS ART FAIL
Hackfill/Grading - - -� -- --
Sanitary Sewer
Storm Drain I ]Reinspection fee of$_ required before next inspection Pay at City Mall, 13125 SW Hall Blvd
hatch basin
Fire Supply Line ( ] Please call for reinspection RE: ____-- _ 1 ]Unable to inspect- no access
ADA /
Approach/Sidewa!k Datel-;,Z Inspector . Ext
Other
Final ---
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY �� �I'G A R D — ELECTRICAL PERMIT
PERMIfi#• ELC2001-00040
DEVELOPMENT SERVICES DATE ISSUED: 01/22/2001
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09900 SW FP'-WING ST 068
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect,
RESIDENTIAL UNIT _ TEMP SRV'C/FEEDERS MISCELLANEOUS _
- 1000 SF OR LESS: 0 • 200 amp: PUMP/IRRIGATION:
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: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
_ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 _ SVC/FDR >=225 AMPS: - CLASS AREA/SPEC OCC:_
Owner: Contractor:
FINKE, ALEX AND LOT TE I OWNER
Pc l BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg#:
FEES -
Reg6ired Inspections_
Type By Date Amount Receipt
Elt ct'I Service
PRMT CTR 01/2212001 $66.85 2720010000( Elect'I Final
5PCT CTR 01/22/2001 $5.35 2720010000(
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR 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 180 days of issuance,or I work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utilihj Notificatioii Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these ru!es or direct questions to OUNC at(503)
246-1987
PFRMITTEF_'S SIGNATURE ISSUED BY:
OWNER INSTALLATION ONLY
The installation is being made on proptert I o -is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ` � I��-" l DATE:
CONTRACI OR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: -�_ DATE:-
LICENSE NO: --- --- -- -- - --- - ---- -_ .._. -- --
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received: i `y / Permit no.:c ,- �S, ;
City Of Tigard Project/appl.no.: Expire date:
C•ityofTigard Address 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: eceiptno.: —
Phonc. 503) 639-4171
Fax (5(,3) 598-1960 :,ase Cilc no.: Payment type:
Land use approval:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenard improvement
U New construction U Addition/alteration/replacement U Other: U Partial
Job address: OCi 5 tn�t �' Bldg.no.: Suite no.: ITax map/(ax lot/account no.:
Lot: Block: Su)division:
Project name: AP+-Pr-RoAJr Description and location of work on prep isese /4R!/,OTTr r t(= x�'>`
Estimated date of completion/inspection: #-
Job no: Al,AFee Max
Drscri lion Qly. (ea.) Total no.bis
Business name: New residential-.back or mullf-famlly per
Address: dwelling unit.Includes attached garage.
City: State: ZIP: _ Servlcehrcloded:
E-mail: 1000 sq.ft.or less
Phone: =Fa X _
"ch additional 5(x)sq.R.or portion thereof-
CCB no.: Elec.bus.tic•no: Limited energy,residential _
City/metro lic.no.: Limited energy_non-residential
Each manufactured home or modular dwelling
Signature of—supervising electrician(requited) Date Service and/or feeder
Su elect,name(print): tcop,,.e. Services or feeders-installation,
Palteration or relocation:
r-� 21x)amps or less 2
Name(print): A-.L x. /� N k. 201 amps to 4W amps _ _ 2
401 amps to 6(x1 amps _ __ 2
Mailing address: 0• w 3,y L � fiU1 amps to 1000 amps — '-
('ily; r (�. State:UZJtS;/ Over I000 amps or volts — - 2
Phone: - Fax: I E-mail: Reconnect only I
Owner installation:The installation is being made on property I own Temporaryservieesorfeeden-
which is not intended rvr ale rent,or exchange according to Installation,alteratlon,orrelocatfon: 2
t 2(10 amps or less _
ORS 447,455,479, 201 amps Iu 400 amps _ _ -'
Owner's si natu Date: 401 to 600 Props 2
Branch circuits-new,alteration,
or extension per panel:
Nance- A. Fee for branch circuits with purchnsc of
Address_ service or feeder fee,each branch circuit -'
Cily; State: ZIP: B. Feefor branch circuits without purchase
-- of `
service or feeder fee,first branch circuit:
Phone:
Fax: E mIIl1: Euch additional branch circuit.
my I alk-11 0 Misc.(service or feeder not Included):
Lach pump or irrigation circle _2
U Service over 225 amps-contntercial U I lealth-care facility — -- -
U Service over 320 amps-rating of l&2 U liazardousinration mach sign or outline lighting 2 -
familydwellings U Building over 10,(.X)square feet four or S!gnnel cocuins)or a limited energy panel.
USystem over 600volts nominal more residential units in one structure _dteration,orextension' 2
U Building over three stories U Feeders,4W arrips or more •IA•scri tion: —
U Occupant load over 99 persons U Manufactured structures or RV park FAch additional Inspection over the allowable In any of the above:
U EgressAightingplar, U Other , -_—�--- pennspection r -
Submit _sets of plans with any of the above. Investigation fee
The above are not applicable to tempomry construction service (Other
----�— — —
PCrti)Il fee........ ............
No,all Judrdicau naccept credit cards,please call Juduktiror lotwm
mr inGnatioa Noticethis permit application
U Visa U MasterCard expires if a permit is not obtained Plan review(at 9f) $
Credit card number: within 190(lays after it It& been State surcharge(Rab)....$
r.xpims accepted as complete, TOTAL .......................$ �e .
Name of u —on credit c
S _
Cadiolder dpuaurc ----- - Amount .t•t1W6I I rm I,om
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: Restricted
OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee
.......................................... $75.00
Number of Inspections per permit allowed) (FOR ALL.SYSTEMS)
Service Included: Items Cast Total t Check.Type of Work Involved:
Residential-per unit.
1000 sq.ft or less _ —� $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq it or
portion thereof _ $3340 1 I F3urglar Alarm
Limited Energy — -_ $75.00
Each Manufd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $9090 ?
Services or Feeders ❑ Heating,Ventilation and Air Conditioning Syst(.m'
Installation,alteration,or relocation
200 amps or less $8030 _ 2
201 amps to 400 amps _ _ $10685 _ 2 ❑ Vacuum Systems*
401 amps to 600 amrs _ $160.60 — 2 ❑
601 amps to 1000 amps — $24060 2 L Other
Over 1000 amps or volts $45465_ _ 2
Reconnect only _ $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,altoralion,or relocation Fee for each system.......................... ............................... $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-267)
201 amps to 401)amps _ __ $100.30 2
401 amps F00 amps _ $13375 2 Check hype of Work Involved
Over 60C-,mDs to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits
New,alteration or exlensio^per panel C, Lloiler control-
Now,
The fee for branch circuits
with purchase of service or ❑ Clock Systems
fender fee.
Each branch circuit $665 2 �� Data Telecom nunicalion Installation
b)the fee for branch circuits
without purchase of service �] Fire Alarm Installation
or feeder fee.
First branch circuit _ $46.85
Each additional branch circuit $6 65 — F-] HVAC
Miscellaneous U instrumental on
(Service or fee Jer not Included)
Each pump or irrigation circle __ $53 40 Intercom an Paging Systems
_ r—� I
Each sign or outline lighting $5340 i
Signal circutt(s)or a limited energy
panel,alteration or extension $7500 _ Landscape Irriaalion Control'
Minor Labels(10) $125.00
Each additional inspection over — ❑ Medical
the allowable In any of the abrve ❑
Per inspection — $6250
Nurse Calls
i
Per how $6250
In Plant $73 75 Outdoor Landscape Lighting'
Fees: Protective ,naling
Enter total of above fees $ ❑ Other
8%Stale Surcharge $ ._ Number of Systems
25%Plan Review Fee
See"Plan Review"seclior,el, $ No licenses we required Licenses are required for all other installations
front of application --------
Fees:
Total Balance Vue $
-�� Enter total of above fees =
Trust Account# _ -- 8%State Surcharge $
Total Balance Due =
.lercti,nn�,a•Ir Ices duIn nor ixi
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP
--— -
_ ----Date Requested .S-/ AM PM _ BLD
Lo(.ation.V ) 5; ✓ ► /� i" Suite'1S3 MEC
Contact Person _ — Ph Gay 7< q PLM
Contractor _ _ — Ph — SWR
I�,Aaininq
Tenant/Owner ELCWall ELR
Footing Acress: FPS
Foundation -
F-i g Drain SGN
Crawl Drain Inspection Notes: --
Siab _—_ — --- --- SIT _
P)st& Beam
EA Sheath/Shear -- ----
In Sheath/Shear
Framing -- --_-- -- -----
Int,ulation
Drywall Nailing _---. -___---- --.—- - --
Firmall
Firo Sprinkler -
Fim Alarm j��� 1-
Surp'd Ceiling
Roof
Misc: —__-
Final
PASS PART FAIL --- - --
PLUMBING —^
Post& Beam — —
Uricer Slab
Top Out
Water Service -
Saritary Sewer
Rain Drains -
Final
PASS PART FAIL. ------
MECHANICAL f
Post& Bearn -- -� _ -- ---------- - -
Rough In
Gas Line ---- _ -- --------- - - -
Smoke Dampers
Final ------__----------- --- --- --------____------- -
PASS PART FAIL
1,o ryice --- ------- --- - -- --------- --
Rough In
ll( /Slab _— -- ------ --- -- — --- -— - -_-
I ow Voltage
F iie Alarm
?ASS ART FAIL ------ ----- ---_ — ----_ -- _-SITE _
Backfill/Grading ----------_--- ------- --------------- _ --------
Sanitary Sewer
Sanitary
Storm Drain I Reinspection fee of$ required before next inspection Pay at City yail, 13125 SW Hall Blvd
Catch Basin Unatle to inspect no access
Fire Supply line I ]
Please call for reinspection RE: -__-- __ [ 1 P
Approach/Sidewalk Date ' (� Inspector — / Ext
Other -
Final
PASS PART FAIL 00 NOT REMOVE this inspection rocord from the job site.
CITY OF TIGARV BUILDING INSPECTION DIVISION MST
24-'lour Inspection Line: 639-4175 Business Line: 639-4171 -- --
BLIP
---Date Requested Sr --AM __PM _ BLD
Location_ VSZ �F—✓mow ~5 S _ Suite �� MEC
Contact Person _ —C k ae- — Ph PLM _
Contractor _ Ph _ SWR
BUILDING — Tenant/Owner ELC .320
Retaining Walllr ELR
Footing Access
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: — —
Slab — - -- -- ---- SIT
Post& Beam -
Ext Sheath/Shear
Int Sheath/Shear —
Framing —
Ir sulation
Prywall Nailing --- ------- ------ -------- —
Hrewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof A __ �
Misc: 'ter Q 1111_ / ✓ _--�
Final —
PASS PART FAIL - - --- --------.
PLUMBING
Post& Beam --
Under Slab
I op Out —
Water Service -
Sanitary Sewer
r
Rain Drains
Final - -- —�- -- � --
PASS PART FAIL
MECHANICAL
Post& Beam ------
Rough In
Gas Line --- - --
Smoke Campus �-
Final - - - — +0 --
PASS PART FAIL r
Service
Rough In
UG/Slab
Low Voitage -- - -- --
Fire_Alarrit.-
Ff��1-
PASS VART FAIL
SITE
Backfill/Grading --- ----- -- -_-- -
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( J Please call for reinspection RE: J Unable to inspect-no access
Fire Supply Line
ADA �
v
Approach/Sidewai; a �`
Other Date rJ 'G —Inspector—L�dL L� /� _%�L_ Ext
Final —
PASS PART FAIL_ DO NOT REMOVE this inspection record from the job site.
CITY O� ������ _ ELECTRICAL PERMIT _
PERMIT#: ELC2001-00220
DEVELOPMENT SERVICES DATE ISSUED: 5/1;0
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S102C6 03400
SITE ADDRESS: 09850 SW FREWING ST 48
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Prosect Description: Electrical reconnect of unit#48.
_ RESID_ENT!AL UNIT TEMP 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: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _ _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW Si=CTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: _
Owner: Contractor:
FINKS, FLEX AND LOTTE I OWNER
PO BOX 2.3562
PORI LAND, OR 97223
Phone: Phone.
Reg#:
FEES _ Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 5/1/01 $66.85 2720010000(
5PCT CTR 5/1/01 $5.33 272.0010000(
Total $72.18
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable lags
All work will be done in accordance with approved plans This permit will expire it work is not started within 180 days of issuance,or 0 work is
suspended for more than 180 nays ATTENTION Oregon law requires you to follow ndes adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 thro h OAR 951-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
2466699 or 1 800-332-2344. , -�
Permit Signature: Z c Issue By:
_ OWNER INSTALLATION ONLY
I hf, installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: y ___ — DATE:_;Lla
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ _ �_______.____ �__ DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
i
Electrical Permit Application
\ Datereceived: Permit no.:
City of Tigard Projeet/oppl.no.: Expire date:
Cirvof Fsgard Address: 13125 SW Hall Illvd,'1'igard,OR 97223 Date issued: B Receiptno.:
Phone: (503) 639-4171 =--
Fax: (503) 598-1960 Case file no.: Piynienl type:
Land use approval:
❑ I &2 family dwelling or accessory ❑Commercial/indust,ial i1multi-I�iily_ J Tenant improvement
❑New construction ❑Addition/alteration/replacement Other:rv;" t''N Zl i'I$rt2l
Job address: �n ��u-.t G,f?`a 1�� 1/i 4n c '� Bldg.no.: Suite no.:�� Tax map/tax I (/account no.:
Lot: 5B 11-01
Subdivision: A-1V O —7_ --Cr I d
Project name: I Description and location of work on premises:
Estimated date of com letion/ins ection: w ,✓'
LINE IFANKIIIGLIIMNE
MMM
Job no: Pee Max
Business nan417 k0 TZ 9W A r1r-5 Description "Y. (ea.) Total no.Ins
ew rrsidential•single or multi-family per
Address: 1i Q SP 77V W ik /ti S dP:welling mril.Uicludesatlachedgaiage.
city: Stale:p ZIP: ,� 3 ServimincludiA:
Phone:Z, 1jLZ kax: I E-mail: 1000 sq.ft.or less _ 4
—T'�-- Each additional 500 sq.ft.or portion thereof
CCB no.: E)ec,bus.lie,no: aJ Limited energy,residential — 2
City/metro Ilc.no,: Limitedeuergy,nou-residential 2
_ Each manufactured home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder 2
Sup elect,name(110110: --- License no: Services or feeders-Installation, --
aileratlon or relocation:
200 at or Tess 2
Name(print): At-k- /N iCt 201 antpi to 400 amps��— � 2
401 snips to 6(10 snips 2
Malkin ddress: �7, .v 601 amps to I(Kx)amps --!- _ - - - 2 -
City: / State: 0C ZIP: Over IIxx1 amps or volts - 2
Phone A#4 Fax: E-mail: Recomiectonly / I
Owner installation:The installation is being made on property I own Tempmrryservlce+orfeeden-
t�
which is not intended fo lc kae-,irff Ztr exchange according to lnstaValion,alteration,orrelocation:
ORS 447,455,479,/ ), 1 t)tt
' _nips or less
A_ c 201 amps to 4W amps 2
Owners si malar'. Dale: J 41(1 ut61x)antps 2
Bench circuits-new,alteration,
or extension per panel:
Name: A Fee for branch circuits with purchase of
Address: !service or feeder fee,each branch circuit
City: Stale: ZIP: N. Fee for branch circuits without purchase
l -- of service or feeder fee,first branch circuit:
Phone—: E-mail: Fach additional branch circuit:
PLAN Ri N 11 1% (Please check all that rippl.$) Mi+c.(Service or feeder not Included):
U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Halnrdous location Fach sign or outline lighting �— - 2
familydwelling-i U Building over 10,000 square feet four or Signal circuits)or a limited energy panel.
U System over 6(x1 volts nominal nmre residential units in one structure alteration,or extension' 2
U Building over three stories J Feeders,401 amps or mote •1?escri tion:
U Occupant load over 99 persons U Manufactured structures or RV pad; Each additional Im"lon over the allowirhle in any of the above:
U Egressnightingpltm U Other: _
- Per inspection �--�'�-
Submit_sets of plans with any of the above. Investigation fce -- _
_I•he above are not applicable to temporary construction service. Other -- —
Not all jurisdictiau secepl credit cards,please call jurisdiction for more information. Notice:This permit application Permit fee.....................$
U visa U Mastercard expires if a permit is not obtained Plan review(at -- %) $ ---
rtedit card number within 180 d rys atter it has been State surcharge(8%)....$
F"lrlfes accepted as complete. TOTAI, . $
Name of:nnfholrkr s'shown on credit cud - ---
- ---_--Vardholdei dptature Amount 44(}4615(MinwOM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF F WORK INVOLVED -RESIDENTIAL ONLY _
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Invulved:
Residential-per unit
1000 sq If or less $145 15 4 ❑ Audio and Stereo Systems
Eads additional 500 sq it of
portion thereof _ $3340 _ ❑ Burglar Alarm
limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $9090 _ 2
Services or Fenders ] t-seating,Ventilation and Air Conditioning System'
In.-talialion,alteration,or relocation
200 amps or less _ $80.30 2 ❑ Vacuum Systems'
2.01 amps to 400 amps _ $106.85 2
401 amps to 600 amps $160,60 2 ❑ Other
601 amps to 1000 amps _ $240.60 2
Over 1000 amps or volts $454,65 2
Reconnect only $66.85 ,j- 2
Temporary Services or Feeders TYPE OF WORK INVOLVED •COMMERCIAL ONLY
Fee for each system.......................................................... $75.00
Installation,alteration,or reior.alion
200 amps or less $66,85 2 (SEE OAR 918-260.260)
201 amps to 400 amps _ $100.30 _ 2
401 amps to 600 amps $1:+3.75 !_ 2 Check Type of Work Involved
Over 600 amps to 1000 volts,
see"b"above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Each branch circuit _ $665 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm installation
or feeder fee.
First branch circuit _ $4685 n HVAC
Each additional branch circuit $665 _
Miscellaneous ❑ Instrumentation
(Service or feeder rpt included)
Each pump or irrigation circle _ $5340 _Y s_ ❑ Intercom and Paging Systems
Each sign or oubine lighting $53,40
Signal circuit(s)or a limited energy El Landscape Irrigation Control'
panel,alteration o•extension $75.00 v
Minor Labels(10) __ $12500 ❑
Medical
Each additional inspection over
the allowable In Any of the above ❑ Nurse Calls
Per inspection _J $62.50 _
Per hour $62,50
In Plant _ $73 75 El Outdoor Landscape Lighting'
Fees: �. ❑ Prolective Signaling
Cl -- - --- -
Enter total of above fees $ t��� Other --
8%State Surcharge $ 5 ' _Number of Systems
25%Plan Review Fee W licenses a,e required Licenses are required for all other Installations
l See"Plan Review"section on $ _
front of application _
/011 Fees:
Total Balance Due 3f
Enter total of above fees
❑ Trust Account p 8%State Surcharge ;
Total Balance Due $•—
r uists\liomuklc-fees doc 101090)
/ CITY C)F" T I GA R D ELECTRICAL PERMIT
PERMIT#: ELC2001-00245
DEVELOPMENT SERVICES DATE ISSUED: 5/14/01
13125 SW Hall Blvd., Ticlard, OR 9722:, (503) 639-4171 PARCEL: 2S102CB 1)3400
SITE ADDRESS: 09850 SW FREWING ST 53
SUBDIVISION: FREWINGS ORCHARD TRACT'S ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Prolect Description: Reconnect only.
RESIDENTIAL UNIT! _ TEMP SRVCIFEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
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: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN_REVIEW SECTION _
1000;amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only 1 SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
11NKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt E lect'I Service
PRMT CTR 5/14/01 $66.35 2720010000(
5PCI CTR 5/14/01 $5.35 2720010000(
Total $72,20
This Permit is issued subject to the regulations contained in the 1igard Municipal Code,State of OR 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 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rales adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 1"ou may obtain copies of these rules ordirect questions to OUNC at(503)
246-6699 or 1-800-332-2344.
Permit Signature: �`n'yk �' � �-���--L _ Issued By:
OWNER INSTALLATION_ONLY
The installation is being made on prco(ty I owtr *hich is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: Y—/- L ��——. DATE:
CONTRA07OR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _� —. DATE:_ _
LICENSE NO: -- ------
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received: Permit no.:&e.7Q4 �d0,2
a. City of Tigard Project/appl.no,: Expire date:
Cirvo/Pitiard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:� eccipfno,:
Phone: (503) 639-4171 --
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U I &2 family dwelling or accessory U Commercial/industrial Multi-family U Tenant improvement
U New construction U Add ilion/al terat ion/replace mefit U Other: U Partial
1.1011 SITE INFORMATION
Joh address: / 4 .t/ r,! �' �� Bldg. no.: Suite nu.: 'i fax map/tax lot/account no.:
Lol: — IJluck_ Subdivision: CT rp:/(i 4 t f S
Project nantr. I Description and location of work on premises: _ / 5)
Estimated date of con letion/inspection:
Job no: Fee Max
Business name: A71Descri tion Qty. (ca) Tatal no.Ins
--- —-- New residential-single or multi-family per
Address: doellinQunit.InclndesottacherlgmWe.
City: State: ZIP: Service included:
Phone: Fux: Email - I(M aq.n.or less
---
CCB no.: Elec.bus.tic.no: Each additional 500 sq.ft.or portion thereof
-
Limited energy,residential
TCity/metro Iic.no.: Limited energy,non-residential _
Fach manufactured home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder ___
Sup.elect.name(print) License no: Services or feeders—installation,
alteration or relocation:
2(x1 amps or less 2
Name(print): �4�r r/N Ke 201 amps to 4lx)amps 2
Mallin address: C.1' 401 amps to 600 smog 2
B C7Z 't J`T r✓� g-} 601 amps to I(1(x)amps 2
City: / (' ' eu":/ Slate: D ZIP: 77 -- t Over 1000 amps or volts 2
Phone: N//- S 'Pax: F-mail: Reconnect only
Owner installation:'the installation is being made on property I own Temporary services or feeders-
which is not intended fbr sglir..Jr ,,rent,or exchange according to Installation,alteration,or relocation:
ORS 447,455,479,617( ,70t> 200 amps or less --_ 2
�4 201 amps to 4(x)amps 2
Owner's SI nfl re: r Dfllec ,7 �7 D` 401 to 611(1 amps 2
BrAnch circuits-new,alteration,
or exle-Won per panel:
Name: 4A Icc for branch circuits with purchase of
Address: ' service or feeds fee,each branch circuit 2
City: Stale: ZIP: B. Fee for branch circuits without purchase
--- of service or feeder fee,first branch circuit: 2
Phone: l;tr.: F mail:
fsach additional branch circuit
Misc.(service or feeder not Included):
U service over 225 amps-commercial U I Icai(h unr utciltlN Each pump or irrigation circle 2
UService over 320amps-rating of 1&2 UIla,ardou,locatwo Each signor outline fighting 2
family dwellings U Budding Derr 10 otm)square feel four or Signal circuit(s)or a limited energy panel,
U System over 6W volts norninal more nstdenual touts in one structure alteration,orextension• _2
U Building over three stories U Icedcrs.40xl amps or more •Dcscri tion:
U Occupant load over 99 persons U Manul actuted suucnm•s m Rk'pauk Each ad111lonal Inspection over the allowable in any of the above: -- — —
UI*ress/lighlingpinn U(hher Perinspection —
Submit __ _ sets of plans with any of the above. Investigation feeThe above are not applicable to temporary construction service. Other
Nni all jurisdiclion•i sccoor creclit carate,please call junutictiorr for more information Notice:this permit application Pfee.......... ) $ tO
J�'isa U Mastert'ard expires if a permit is not obtained Pllanan r review(a( — 96) $ ^
t lcdo anal numlreo _ within 180 days after it has been State surcharge(89f) ....$
Expires accepted as complete. TOI 11u $ J a aZ 0
Name of catc1holder as shown on credit cud
('udholder signature --Amount 4404615(6R O COM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
Number of Inspections perpermit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total ► Check Type of Work Involved:
Residential-per unit
1000 sq it or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq (I or
portion thereof _ $3340 1 ❑ Burglar Alarm
I imited Energy _ $75.00
Fach Manufd Home or Modular E] Garage Door Opener'
Dwelling Service or Feeder 390.90 2
Services or Feeders Heating,Ventilation and Air Conditioning System'
installation,alteration,or,elocation
200 amps or less $80.30_ u Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $150.60 2
601 amps to 1000 amps _ $240.60 2 ❑ OtherOver 1000 amps or volts $454.65_ 2
Reconnect only _ $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
!nstallation,alteration,or relocaticn Fee for each system.......................................................... $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps _ $100.30 _ 2
401 amps to 600 amps $133 75_ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. Audio and Stereo Systems
Branch Circuits Boiler Controls
New,alteration or ext( ;ion per panel
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit _ $665 _ — 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fir'Alarm 1• dalletion
or feeder fee.
First branch circuit $46.85 ❑
Eau',additional branch circuit _ $665
HVA(;
Miscellaneous ❑ Instrumentation
(Service or fear,3r not included)
Uiwi pump or irrigation circle __ $53.40 _ _ Intercom and Paging Systems
Each sign or outline lighting — $53.40_
Sigral circuit(s)or a limited energy
panel,alteration or extension _ $76.00 ❑ Landscape Irrigation Control'
Minor Labers(10) $12!100
Medical
Each additional Inspection over ❑
the allowable In any of the above ❑ Nurse Calls
Per inspection _ $6;:50
Per hour $61'50 _
In Plant $73.75_ El
Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $ --------Number of Systems
25%Plan RevI9%Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all olhsr installations
front of application — ---
Fees:
Total Balance Due $
----- Enter total of above fees $_ _
❑ Trust Account M 8%State Surcharge $_
-- -��--- Total Balance Due $
i Vises\fonmsAelc-fees do( 10Yr��'00
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P 15/02 00089
DATE ISSUED: 3!15/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2 S 102CB-03400
SITE ADDRESS: 09850 SW FREWING ST BUILDING
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT: 009 _ JURISDICTION: TIG
CLASS OF WORK: AI T GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 5 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Sewer line repaired, approx. 5 ft. _ _-
--_—_--- FEES _
Owner: _ Type By Date Amount Receipt
FINKS, ALEX AND LOTTE I PRMT CTR 3/15/02 $72.50 27200200000
PO BOX 23562 5PCT CTR 3/15i02 $5.80 27200200000
PORTLAND, OR 97223 — —.- __
Total $78.30
Phone 1:
Contractor: —
ROTO ROOTER - WEST OFFICE
25599 SW 95TH B
WILSONVILLE, OR 97223 REQUIRED INSPECTIONS
Sewer Inspection
Phone 1: 503-227-3330 Final Inspection
Reg#: LIC 13989
PLM 37-76PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. Alt work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION- Oregon law requires you to `ollow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-000 1-00 10 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1937
N B Permittee Signature: —
Issued y 1 . 1—.
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbing Permit Application _
— Date received: 1`� y Permit no:
City Of 'Tigard Sewer permit no.: Building permit no.:
Address: 1.1125 SW Hall Blvd,'rigard,OR 97223
('irvn/'1'igurd Phone: (503) 611-4171 1'm,lecUappLno.: Expire date: -�
Fax: (503) 598-1960 Date Issued: By: -(�j Receipt no.:
Land use approval:
Case file no. Payment type:
_. �_—_
U I &2 family dwelling or accessory U Comntrrcial/indusU al Multi-family U Tenant improvement
U New construction U Addition/alteration/n- lacement U Food service ❑Other:
Job address: Q LM �ure l 0 Description Fce(ea.) Tota!
Suite no. _ — New I-and 2-family dwellings only:
Bldg.no.: -- (includes too ft.forenchutilityconnection)
Tax nlarctax lot/account no.: SFR(1)bath --- --__ i---
Iot:_ Block: Subdivision: SFR(2)bath
— �---��
Project name: __ SFR(3)bath
City/county: —'t `qCt _ LIP: 12 3 Each additional bath/kitchcn
Description and loca4iion of work on premises:_� Siteutilhies:
tr p p r Calrh basin/area drain
60
Drywells/leach line/irench drain
Est.date of completion/inspection: — Faring drain(no.lin. t1.)
_ Manufactured home utilities
Y' Business name: '� t� pt�� -i�— _ Manholes
Address: S(/V Rain drain connector _
City: (�� 5(jJV Ut �_
State:(� 7.IP: �O 7 O Sanitary sewer(no.lin.It
Phone: 3 3O Ftix: E-mail Storm sewer(no.lin.ft.) —
7 ---•� V�'atrr service(no.lin.ft.)
CCB no.: \�j�Q�� Plumb.bus.reg.no: 3_7 ?G�'`� Fixture or item:
1 Cityimetro lic.no.: Absorption valve
p b
Contractor's representative signature: ,_ l,
��__—_— Back flow preventcr
Print name: :57T +\ �\ mate: 0� Backwater valve
Basins/lavatory
Clothes washer
Name. —_ Dishwasher
Address: Prinking fountain(s)
LIP:
Ejcctors/sump
Phone:50 z '7S _ 4pFax: E-niail: ` Expansion tank
Fixture/sewer cap —_
Floor drainefloor sinks/hub
Namc(print): _ — — Garbage dis sal
Mailing address: Huse bibb
City: State: LIPS Ice maker
Phone: Fax: E-mail: Interceptor/grease trap _
Owner installation/residential maintenance only: The actt,al installation Primer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sump
Tubs/shower/shower pan
Urinal _ _
Name: _ Water closet
Address:_— ------- __ Wuter heater, — —
City� _, State: 7_IP: — Other.
Phone — Fax: E-mail: Irotrl
Minimum fee................$ —12 _
Nd all juritdicooru occepl credit,oda pleax cell Juri+dtcaon rx more infantar`m. Notice:This permit application Plan reV lew(at — %) $
u visa U MasterCard expires if a permit is not obtained
p State surcharge(896) ....$ � c C�
Credit card number_—_----------_----- -- -- within 180 days after it has been
r accepted as complete. TOTAL .......................$ 7 S
-- Nam of cardhnldrr v rhown on it card s
--- - C'ardMAder ai6ruturr - Atncwnt 440-4616(6/00KTMI
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES Individual QTY ea AMOUNT (Includes all plumbing fixtures Lt PRICE TOTAL
Sink 1660 the dwelling and the flrst100 ft. QTY (ea) AMOUNT
16.x0 for each utility connection)
Lavatory _ One(1bath _ $249.20
Tub or Tub/Shower Comb 16.60 Two 2 bath __ _ $350.00
Shower Only 1660 ThrepA3Zbath -_^ $399.00
Water Closel 16.60 --�--` SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Garbage Disposal 16.60
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor5ink 2" 16.60 - --� PLEASE COMPLETE:
3" 16 60
q" 16.60 _
Water Heater O conversion O like kind 16.60 Quantity b Work Performed
Gas oiping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
per it Ca ed
, _ --- -
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavato
_ Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains — — 16.60 Shower On_ly_
Drinking Fountain 16.60 Water Closet _
Urinal
Other Fixtures(Specify) 16,60 _ Dishwasher
— Garbage Disposal
-- — Laundry Room Tray -
- WashincLMachine
_ Floor Drain/Sink: 2"
Sewer-1 sl 100' 55.00 — 3^
Sewer-aach additional 100 v _ 46.40 _ 4" _
Waler Service-1s1 100 55.00 Water Heale; _-
46 40 Other Fixt,•es
Water Service-each additional 200'_ _ _ S eci _
Storm 8 Rain Drain-1st 100' 55.00
Storm&Rain Drain-each addiliona 100' 4F,40 -
Commercial Back Flow Prevention Device
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially —6250
Requested Inspections er/hr __ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 —
Grease Traps -- - 1660 - --- -
QUANI'ITY
Isometric or riser diagram is required if i
Uuantlt:Total is >9 _ ------ _
'SUBTOTAL ---- --
8%STATE SURCHARGE
'"PLAN REVIEW 25%OF SUBTOTAL
Required only if fixture gly total Is>9
TOTAL $
*Mlnlinum permit fee Is$72 50+B%state surcharge,except Residential Backflow
Pr@N^Tion Device.which is$36 25+e%state surcharge
' All New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
i:\dsts\forms\plm-fees.doc 12/26/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Busines: Line: (503)639-4171
BUP ---
Received _ _Date Regtiested_�
02
Received _ ASA___.-.____ PM SUP
Location 70!. ij_ w m", (L'�Suite--._ -____-- MEC
Contact Person —--- — - — -- Ph( -) —-- _ PLM
Contractor __ , Ph
BUILDING1 Tenant/Ownor _ _ �_ ELC
Footing 1 ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain _
Slab Inspection Notes 7s- _ 1:1"1p(fI-? SIT
Post&Beam
Shear Anchors QTS -- -- ------------- ---
Ext Sheath/Shear
Int Sheath/Sheer
Framing -- -- - - - -- -
Insulation
Drywall%fling ---- --
Firewall
Fire Sprinkler - --- -- ---- --
Fire Alarm
Susp'd Ceiling — , --- �--
Root
Other -- --T.
Final
P 'rPAFMFAIL
�--- - - -- - --- -- — --------
- - -
('PLUMBING
Undor SlaIL
Hough-In I
Water Sery?ce"IT -- - --
ain DrainE _—
Cat,,h Basin/Iu:anhole
Storm Drain - ---- ---- i ---�-- -- ��.
Shower Pan
PAP'T FAIT_ - — -----�- -
MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers -- -- - - -- - — - �.
Final
PASS PAPT FAIL --
ELECTRICAL
Service
Rough-In
I1G/Slab - - - - -
Low Voltage
Fire Alarm
Final [� Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: -__— �� Unabie to inspect- no arc^ss
Fire Supply Line
ADA Date /d �" Inspector l ��, Ext
Approach/Sidewalk -
Other:_
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY ELECTRICAL PERMIT
OF TIGAR
PERMIT#. ELC2002-00447
DEVELOPMENT SERVIC!=S DATE ISSUED: 9/5/02
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL: 2S102CA-00301
SITE ADDRESS- 09870 SW FREWING ST 055
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5
BLOCK: LOT : 018 JURISDICTION: TIG
Proiect Description: Reconnect.
'RESIDENTIAL UNIT _ i TEMP SRVC/FEEDER_SMISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ ERANGH CIRCUITS ADD'L INSPECTIONS___
0 - 200 amp: 1'V/SERVICE OR FEEDER: PER INSPECTION:
201 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: ` 600 VOLT NOMINAL:
Reconnect ons: I _SVC/FDR >= 225 AMPS: _.� CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX TRUSTF-E OWNER
FINKE, LOTTE I TRUSTEE
PO BOX 23562
PORTLAND, OR 972.81
Phone: Phone:
Rep #:
— FEES Required Inspections
Type By Date Amount Receipt Elect'I f=inal
iPRMT CTR 9/5/02 $66.85 2720020000(
5PCT CTR 9/5/02 $5.35 2720020000(
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipgl Code.State of OR Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or I work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Not'rficaticn Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
246-6699 or 1 4100-332-2344.
Permit Signature: ��..�- _ Issued By:
OWNER INSTALLATION ONLY _ -The installation is being made on propei4y4Mn Which is not intended for sale, lease, or rent. j I
OWNER'S SIGNATURE: y �'�-�' DATE: / -
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: __.--LLLL DATE:
LICENSE NO: �.----- -- -- - -
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application _
Date received: I �,,.'j Permit no.:
7 ma City of Tigard Project/appl.no.: Expite date:
City of Tigan/ Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: H
Phone: (503) 639-4171 , Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
a
INUI 8c 2 family dwelling or accessory U Commercial/industrial k$Millii-G;miIV U Tenant improvement
U New construction U A(I(lition/alteration/replacement U Other: _ U Partial
JOB SITE,INFORMATION
Job address: C %lei I— �;.'6 rv')ti. f, Bldg. no.: Suite no.:.,55 Tax map/tax lot/accouni no.:
Lot: Block: uhalivision:
Project name.-TAU )tion and location of work on premises: r —
Estimated date of completion/inspeplion:
APPLICATION FEE SCHE-911
Job no: Fee MAC
Business name: -- - -- r - - - IMscriplion Qly. (ea.) Total no.Imp
New residential-single or multi-famny per
Address: _ doellingutdt.Incluricsattached garage.
City: V State: GIP: tiwrvicelncluded:
Phone: Fax: E-mail: I(N)0 sq.ft.or Icss a
Each additional 500 sq.ft.or portion thereof' _
CCB n0.: Elec.bus.IiC.n0: - _ I,innitedenergy,residential Cit /metro IiC.n0.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(req,fired) Date Service and/or feeder 2
Sup.elect.name(print): I.iccn c no: Services or feeder-installation,
alteration or relocation:
200 amps or less 2
Name(print): f} `�'tj�/ lie= V401
to 400 amps to 600 ampsMailing address: �j!y� .iz 3 STi ��� ax to 1000 ampsCity: / l1.74 P_ T) State:0 . 'LIP: 0 amps or volasPhone: 2Ny--5V 9+ Fax: E-mail: tonl Owner installation:The installation is being made on property I ownrywrvicesorfeeder- -
which is not intended for rent,or exchange accordin to Installation,alteration,or relocation:
2(A)omps or less 2
ORS 447,455,479,6 -- -
C
201 amps to 400 amps 2
Owner's si nature t _- F Date: _ C aoI n 600 am s -- ---� — —
Branch circuits-new,alteration,
or extenclon per panel:
Name:
-- A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit _
City; date' 711'; B. Fee for branch circuits without purchase
-_ - - �-- of service or feeder fee,first branch circuit: 2
Phone: I ax: �1:-mail: —----EachPW additional branch circuit:
Misc.(Service or feeder not Included):
U Service over 225 amps-conunercial U Ileaith-carefacility Each pump or irrigation circle 2
UServiceover320amps•ratingofl&2 ULiazardouslocation Each sign oroudineligMing _ _ _ 2
family dwellings U Building over 10,000 square feet fouror Signal circuit(s)or a limited energy panel,
v System over 600 volts nominal more residential units in one structure alteration,or extension* 2
U Building over three stories U Feeders,400 amps or more •Lkscri tion:_
U Occupant load over 91)perAm'. U Man-factured Structures or RV part( Each additional inspection over the allowable In any of the above:
U F.gressllightingplan U thfnrr Per inspection
-�T-
Submit cels of plan%with:inti of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all Jurisdictions accept cmht cards,please call Jurisdiction for more Informatinn Notice:This permit application Permit fee.....................$ ^_
U Visa U MasterCard expires if a pennit is not obtained Plan review(at _ %) $ _--
Credit card numher-__ / / within 180 days atter it has been Slate surcharge(8%)....$ _
Expires accepted as complete. TOTAL .$
Naar of cerdhnldtr u shown on credit card ���������������� � �-
S
- Cadholder signature Amount 440-1615(&MCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
_'TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee............... ............. $75.00
.....................
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Involved-
Residential-per unit
1000 sq.R or less _—� $145 15 4 ❑ Audio and Stereo Systems'
Each additional 500 sqft.or
portion thereof $33.40 1 ❑ Burglar Aldrm
Limited Energy _ $75.00 �—
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 _ 2 ❑ Garage Door Opener'
Services or Feeders ❑ Healing,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps _ $106,85 2 Vacuum Systems'
401 amps to 600 amps $160.60 2 ❑
601 amps to 1000 amps $24060 2 Other
Over 1000 amps or volts _ $454.65 /12
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system.......................................................... $75.00
200 amps or less _—v $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $10030 2
401 amps to 600 amps — $133 75 _ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits ❑
New,alteration or extension per panel Boiler Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Fach branch circuit $665 _ 2 ❑ Data Telscommunicalion Installation
b)'I he fee for branch circuits
without purchase of service �❑ Fire Alain Installation
or feeder fee.
First branch circuit _ $4685
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not Included)
Erich pump or Irrigation circle $5340 ❑
Each sign or outline lighting _ $53.40 — Intercom and Paging Systems
Signal circuit(s)or a limited energy
panel,alteration or extension $75.00 _ ❑ Landscape Irrigation Control'
Minor Labels(10) _ $125.00
Each additional Inspection over ❑ Medical
the allowable In any of the above ❑
Per inspection $6250 _ Nurse Calls
Per hour $6250
In Plant $73.75 j Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ Other
8%State Surcharge $ Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required tAcenses are required for all other installations
front of application. ----
Fees:
Total Balance Due $
—"- Enter total of above fees $
❑ Trust Account# _ _ 8%State Surcharge S
__---- --�-�^--__----�_ Total Balance Due s
All New Commercial Buildings require 2 sets of plans.
i:\dsts\forrns\elofees.dnc 08/30/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)ra94171 �r
BUP
Raceived Gtr Date Requested — AM ...�PM— BLIP
Location Ph PLM
�'7l MEC61
--- --
Contact Person _ �L��1 _
( ) — .Q —
Contractor — -- -- _-- Ph(- ) SWR
BUILDING ---- --�1 Te►tant/Owner _ ELC c:;:t_
Footing ELC
Foundation Access: -
Ftg Drain ELR
Crawl Drain -`
Slab Inspection Notes: _ SIT —
Post& Beam
Shear Anchors - - ----
Ext Sheath/Sheer
Int Sheath/Shear -
Framing ---
Insulation ( /
Drywall Nailing --- � ----- -
FI re Sp
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- ---- -----
Roof
Other: — ---- --- --- --- - -
Fn.al _
PASS PART FA0.
PLUMBING
Post&Beam —
Under Slab
Rough-In
Water Service ----- - -- ----- ---- --- ---- —
Sanitary Sewer
Rain Drains - -- ---- - -
Catch Baein/Manhole -�-
Storm Drain - - ---- _ _- - --- - --- - -
Shower Pan
Other: - ----- ----- - - - - - _ - -- -- ---
Final
PASS PART FAIL - - - - -- ---- - ---- -
14 CHANICAL
Post& Beam
Rough-In -- -- - - --- �__
Gas Line
Smoke Dampers
Final
PASS PART FAIL ---- - - - - ---
ELECTRICAL
Service - ------ - -- - - _ ---
Rough-In
Ur/Slab � ,�•� " - -- - ------- -- - - — -- ----- -
Low Voltage -
Fire. Alarm
t '%I J Reinspection fee of$ _-_ required before next inspection. Flay at City Hall, 13125 SW Hall Blvd,
PART FAIL
SIT - — Please call for reinspectio RE: __. [-] Unable to inspect -no access
Fire Supply Line
ADA
Approach/Sidewalk Data _ Inspectors L'h � 1'"'""'` Ext _
Other --- ----
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL
V l��`i OF TIGARD ELECTRICAL PERMIT
PERMIT#: ELC2002-00443
DEVELOPMENT SERVICES DATE ISSUED: 9/4/02
13125 SW Hall Blvd..Ticiard. OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09850 SW FREWING ST 47
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect only.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+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 W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >=225 AMPS:_ _ CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 9/4/02 $66.85 2720020000(
5PCT CTR 9/4/02 $5.35 2720020000(
Total $72.20
T his Permit is issued subject to the regulations contained in the Tigard Municipal Code State of OR 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 180 days of issuance,or if work is
suspended foi more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notificatior.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 a'(503)
246-6699 or 1-800-332-2344 �-
d B
Permit Signature: r�! � IssueY'
OWNER INSTALLATION ONLY
The installation is being made on property I ovvn_ icf, §n6f intended for sale, lease, or rent.
A zo
L'` :_
DATE
OWNER'S SIGNATURE: �. 4 —
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:--
LICENSE NO: `—_— ---- —�
Call 639-4175 by 7:00pm for an inspection the next business day
r
1' ONLY
Eletl, lsLgl Perinit AwliCatioli x111VCd f I lcctncal n G
D WEl : O _ Permit No.:E �y�✓
COf� T
Tigard Planning Approval Sign
City > est form Da� _y Permit No.:
13125 SW Hall Blvd, Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:Post-Rev
Phone: 503-639-4171 Fax: 503-598-1960 Da(c/Hy: Land Use
efe Case No.:
Internet: www.ci.tigard.or.us Contact Juris•: LJ See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: I Supplemental Information.
TYPE OF WORK_ PLAN REVIEW Please check all that apply)
❑Ncw construction - Demolition 0 Service over 225 amps- lieallh-care facility
commercial ❑Hazardous location
—
Addition/alteration/replacement r�]Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION 1 &2 family dwellings four or mote residential units in
i & 2-Family dwelling Commercial/industrial ❑:;ystcm over 600 volts nominal one structure
❑Building over three stories ❑Feeders,400 amps or more
Accessory Building Multi-Farnily ❑Occupant load over 99 persons ❑Manufactured structures or RV park
Master Builder Other: i]I'.gress/lighting plan ❑Other:__
JOB SITE INFORMATION and LOCATION Submit!sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: VfYC9 1 f? / 0 FEF*SCHEDULE
Suite#: Bldg,, t.#: Number of ins r'ections per 1) mit allowed
Pro'ect Name: Description Qty Fee(ea.) Total
New roldentlal-single or multi-family per
Cross strcet/Dlrections to Job site: dwelling unit.Includes attached garage.
%'� Service Included:
1000 sq.fl.or less 145.15 4
Each additional 500 sq.R.or porion thereof _ 33.40 I
LOt#: Limited ener residential 75.00 2
Subdivision: Limited enerity,non residential 7500 2
Tax map/parcel #: Y Each manufactured home or modular dwelling
DESCRIPTION OF WORK Services
and/or feeder 90.90 2
Services or feeders-Installation,
alteration or relocation:
IV / L 200 snips or less 80.30 2
6 201 amps to 400 ams 106.85 2
401 snips to 600 ams 160.60 2
PROPERTY OWNER TENANT 601 amps to 10010 amps _ _ 240.60 2
/ Over 1000 amps or volts 454.65 2
Name: /A h Reconnect only — _ 66.85 2
Address: �Lir "ice 3��� Temporary services or feeders-Installation,
7 7� dleretion,m relocation:
City/State/Zip: C7,A1'K.0 200 amps or less -_ __ 66 HS I
1'hOile:Z/f '✓ Fax: 201 amps to400!mEs __ ._— 100.3;) 2
APPLICANT CONTACT PERSON 401 to 600 ams 133.75 2
Branch circuits-new,alteration,or
Name: extension per panel:
A.Fee for branch circuits with purchase of
Address: _ service or feeder fee,each branch circuit t'0 2
City/State/Zip: I3 Fee for branch circuits without purchase of
service or feeder fee,first branch circuit 035 2
Phone: Fax'. Each additional branch circuit 6.65 2
E-mail: Misc.(Service or feeder not included):
CONTRACTOR Each pump or irrigation circle $3.40 2
Each sir or outline lighting 53.40 2
.lob No: Signal circuit(s)or a limited energy panel,
Business Name: alteration,or extension' :E75.00 _ 2
*Description:
Address:
City/State/Zip:/State/ZI Path additional inspection over the allowable in an of the above:
Per inspection r hour-min. I hour 62.50
Phone: Fax: insesti !tion f"-.-
CCB
ee:CCB Lie.M Lic.#: Other.
Electrical Permit Fees* _
Super%ising electrician Subtotal S
si nature re ulred- Plan Review 25%of Permit Fee) S —
Print Name:/R L //j r Lica #: State Surcharge(8%of Permit Fce) S ?
TOTAL PERMIT FEE S 20
Authorized C Notice: This permit application expires If a permit Is not obtained within
Signature:(� L' _ Date: 'A 190 day,after it has been accepted ac complete.
*Fee rncthodolog� set by Tri-County Building Industry Service Board.
(Please print nate)
CITY OF TI.GARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received _ Date Requested AM_-__ PM BUP
Location _ _. . eS �'' _
----- ��-� MEC
Contact Person -_ --- � _-� Ph( -) _- ------L.1- PLM
Contractor . -__ ---_-. - _ Ph(--,-) ---__ --__--- SWR
BUILDING Tenant/Ownet _- _-- ___. _�_______� ELC y 3
Footing ELC _
Foundation Access:
Ftg Drain ELR
Crawl Drain _-
Slab Inspection Note:• SIT
Post&Beam ---.-------_--
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - --- -_ - --- --
Insulation /
Drywall Nailing ---- - - - dl
Firewall ( ( ��I�N ��1�S
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -�--- ---
Roof
Other:
Final - - - -----
_PASS PART_ FAIL _Post&Beam
Under Slab -- -.-- — - -
Rough-In
Water Service - ------ — -
Sanitary Sewer
Rain Drains -- -----
Catch Basin/Manhole
Storm Drain -� --- -
Shower Pan
Other: - --
Final
PASS_PART _FAIL _
MECHANICAL
Post&Bearn
Rough-In -- ------_--___,__--- -
Gas Line
Smoke Dampers --- ----- --- —-
Final
PASS PART_ FAIL
ELECTRICAL
Service
Rough-In —
UG/Slab N
Low Voltage -
Fire Alarm Sl
Fina ART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SV'i x1311 Blvd.
S Please calf for reinspection RF __-_ - Unable to inspect-no access
Fire Supply Line
ADA Dots Inspector ___ Ext___
Approach/Sidewalk ----
Other:
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL
CITY OF T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM20"13-00617
13125 SW Hat; Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/10/03
PARCEL: 2S 102CA-00301
SITE ADDRESS: 09870 SW FREWING ST 056
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5
BLOCK: LOT: 018 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASH;NG MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXT'1RES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 25 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace approx. 25ft. water line.
FEES
Owner:
Description Date Amount
FINKE, ALEX TRUSTEE JI'LLIN1111 Permit I-ce 12/10/03 $72.50
FINKE, LOTTE I TRUSTEE
PO BOX 23562 l"1'A\I t State tiurcharl 12/10/03 $5.80
PORTLAND, OR 97281 Total $78.30
Phone :
Contractor: _
FIFTY & TWO THOUSAND PLUMBING
16133 SWAN AVE
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Water Line Insp
Phone : 0511-1407 Final Inspection
Reg #: LIC 134805
I'1,h1 3-4241113
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR.
Specialty Codes and all other applicable Ia'Ns. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Permittee Si naturi: f f k C
Issued By: g — — --
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Buildini. Fixtures
PlumainL; Permit Application
Recerveu Plumbing `7 q
DateiB i 't Pertnit No.
City of Tigard
Planning Approval Sewer
y Date/By: _ Permit No.
13125 SW Ball Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.: —
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use
Internet: www.ci.tigard.or.us ` Datc/B : Case No
Contact iuris., See Page 2 for
24-hour Inspection Request: 503-639-4175 Narne/Method Supplement 11 Information
TYPE OF WORK _ FEE'SCHEDULE for special Information use checklist
New constniction Demolition Description Idt�. I-Fee(ea.) Total
F Addition/alteration/replacementI I— Other: New t-&2-fandly dwellings
CATEGORY OF CONSTRUCTIONIncludes 100 R.for each u 111ty connection)
SFR(I)bath 249.20
1 & 2-Family dwelling Commercial/Industrial
SFR(2)bath 350.00
AccessoryBuilding k Multi-Family _ SFR(? bath 399.00
Master Builder Other: _ Each additional bath/kitchen 45.00
JOB SITE INFORMA'T'ION an LOCATION Firesprinkler-sq. ft.: Page 2
Job site address: U rQ40 I 11110'C3 ST- Site Utilities _
Suite#: I31d ./ lA 5`Z Catch basin/arra drain 16.60
-- Footing
ell/leach line trench drain age 2
Project Name: / - -'% Footin drain no.linear R. Pae 2
Cross street/Directions to job site: Manufactured home utilities I la(x)
./,
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no. linear ft.) Pae 2
Subdivision: Lot#: Storm sewer no. linear R.) Pae 2
Tax map/parcel
Water service(no. linear R.) Paee 2
#: —
DESCRIP TION OF WORK Fixture or Item
Absorption valve _ 16.60
" ri k A-- -_ Etackflow prevcntcr Page 2
Backwater valve - 16.60
T �-Z Ooihes washer 16.60
Dishwasher 16.60
PROPERTY OWNER TENANT Drinking fountain 16.61"
Ejectors/sum 16.F0 _
Name:rf'OKC Expansion tank MA
Address: ,t)� 13 6M o'✓ Fixture/sewer cap 16.60
City/State/Zip: _77t(-,AM3 4A• „2Floor drain/floor sink,'hub 16.60
- --�- ---
Garbage disposal 16.60
Phone:,Z4*- Fax: Hose bib 16.60
APPLICANT CONTACT PERSON Ice maker 16.60
Name: _ — Interceptor'grease trap 16.60
Address: Medical gas-value: S Pae 2
City/State/Zip: Primer 16.60
Roof drain(commercial) 16.60
Phone: � Fax: _ Sink'basin,,lavatory _ 16.60
E-mail: Tub sho%vershower pan 16.60
CONTRACTOR Urinal 16.60
Water closet 16.60
Business Name: JVF Lr.-�-�' P/Y M� r F� Water heater Ifi.60
Address: /t., 3 3 s S". a.•, Aur —
Other:
City/StateL �r a ao», e,, ey wR, 174;y ' Other:
Phon„ Sz- ,S $IL-0171 Fax: Sti S &S2 7yel cPlumbing Permit Fees"
CCB Lic. #: 1 3 g i Plumb. Lic.#:i If 2 y!j3 Subtotal S
--
Authorized Minimum Permit Fee S'2 50 S
.1� n a / Residential Backflow Minimum Fee S36 25 91, t� _
Signature: [!t/ta r""-+' 1/ti•"^�y`1 a Date _��. p8 �,3 Plan Review(25%of Permit Fee) S
State Surcharge 810 of Permit Fee) S _
(Please print name) TOTAL PERMIT FEE I S 1 . )
Notice: Thi%permit application expires if a permit is not obtained%s irhio All new commercial buildings require 2%ets of plans%Ith isornetric or
180 da.s after It has been accepted a%complete. riser diagram for plan res less.
*Fee rnethodolog� set t.% Tri-( iu,ti Building Industry Ser%ice Board.
i Dsts Perm,Formu PlmPernuV pp.doc 01 us
l
Plumbing Permit_ApOication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: _ Residential Fire Suppression Systems:_ _
Site Utilities Qty. Fee(ea) Total Square footage: Permit Fee: v
Footing drain- I" IM' "iii; 0to2,(xH) _ $115.00 —_
Footing drain-each additional 100' — 4640 2 001 to 3,W) — $160.00
3,601 to 7.200 $220.00
Sewer- I st 100' 7,201 and greater $309.00
Sewer-each additional 100' 46.40 —
Water service- Ist 100' 55.00 Medical Cas Systems:_
Water Service-each additional 100' 46 411 Valuation: Permit Fee: _
Storm&Rain Drain- I st 100' 55 00 SHY)to$5,000.00 Mnumam[cc$72.50
Storm&Rain Drain-each additional 100' 4(,411 $5,001.00 to$10,000.00 $72.50"or the first$5,000.00 and$1.52 for each
Fixture or Item Qty. Fee(ea) Total additional$100.00 or fraction thereof,to and
___ includingS10,000.00.
Commercial Hack Flow Prevention Device 46.40 $10,00 1.00 to 325.000.00 si Z 5o for the first$10,000.00and$1.54 for
Residential Heckflow Prevention Device each additional$100,00 or fraction thereof,to
(mtmmum permit tee$36.25) 1 27.15 and mclu_d pj $25,(100.00 _
Rain Drain,single family dwelling 65 25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 51.45 for
Inspection ol'exisung plumbing or — — each additional S100.00 or fraction thereof,w
s spial re nested nis plumbing
ions- cr hour 72.50 and including$50,000.00.
—1'- $50,001 00 and up $742.00 for the first$50.000.00 and$1.20 for
Subtotal' each additional$100,00 or fraction thereof.
Fixture Work:
Are fou capping,moving or replacing existing fixtures" If
yes please indicate work performed h� fixture. failure to
accurateh report fixtures could result in increased sewer fees*.
— ( usnilt by Fixture Work Performed Comments regarding fixture work:
Fixture Type: Replace
New Moved E[lstln Capped ---- —— -- --
Ha lislr /Font
Hath Jub'Shower
-Jacuzzi.Whirlpool -- --- -- ----- —
C'ar WaAi -Each Stall
-Drive 1 hru --- __ -----� _�
Cuspidor Water Aspirator ---
DishHasher -Commercial -
-Domestic _
Drinking Fountain — -- --
e Wash — --- -- — --
Hoor Dram,Birk 2•'
C at %d ash Drum — *Vote: If the fixture work under this permit results in an
Garbage -Dumcioc -- —
Disposal -Commercial — _ increase of sewer EM's,a seer permit will he issued and
-Ind,istrial fees+ assessed for the sewer increase must he paid before the
Ice Mach.Refn Drams J— plumbing permit can he issued.
Oil Separator(Gas Stalwn 1
Rec Vehicle Dunip Station _
Shower -t fang
-Stall
Sink -Har I_a%atorN
-Bradley
-Commercial
-Service i—
Swimming P(x)l Filler _
Washer-Clothes
Water Extractor
Water Closet-Toilet _
Urinal
Other Fixtures. J
ODstOermo Forms%PlmPcrmitAppPg2 doc 01 03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST --
INSPECTION DIVISION Business Line: (503)639-4171
BUP _
Received _ _G� --�_`__ Date Requested - I --- AM__ PM BUP
Location - ------ 1�1-- - - .. --- S - ---- MEC _-----
Contact Person _--__ _ Ph (.___—) - __— PLM
Contractor - ----- --- - Ph (-- ) -----.____-- SWR
BUILDING TenanVOwner _ ELC _
ELC --------- -_
Foundation Access:
Ftg Dram ELR -
Crawl Drain —
Slab Inspection Notes: S!T
Post& Beam - — ...- — -�: �= "J�- -_--
Shear Anchors .
Ext Sheath/Shea. - --- ----
Int Sheath/Shear
Framirq
Insulation
Drywall Nailing
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling
Roof
Other: --
Final
PASS PART FAIL
PLUMBihG
Post& Beam
Under Slab --- ---- --- -
Rou,; -in
Water Service -- ------ -- -
Sanitary Sewer _
Rain Drains --
Catch Basin/ividnhole
Storm Drain
Shower Pan � _-
Other:
Final
i ----
PART FAIL
E _AN_ICAL - - - -
Post& Beam
hough-In ---- -
Gas Line
Smoke Dampers -
Final
PASS PART FAIL _ —
ELECTRICAL
Service
Rough-In ------ -
UG/Slab ---- - ----
Low Voltage ---
Fire Alarm
Final L_.J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
TE __ ❑ Please call for reinspection RE: -___ r� Unable to inspect- no access
SI
-- E ---
Fire Supply Line _`��j„^/
ADA Data. l - - --- Inspector - ,r/ - - Ext ---
Approach/Sidewalk
Other:
Final DO iOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
Vie,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP _
_— —Date Requested - Z AMPllrl —�_ BLD
Location_��� Sw r''�`''�~� —__ LL Site _ MEC
Contact Person —_— _ _ Ph 7a —_ PLM
Contractnr _ Ph SWR —_
BUILDING Tenant/Owner -- ELC
Retaining Wall ELR
Footing Access: —
f-oundation FPS
F-tg Drain SGN
crawl Drain Inspection Notes: --- —
Slab ------ -- --__----- -- --- SIT
Post& Beam - --- -
Fxt Sheath/Shear _
Int Sheath/Shear
I ramin9 r_ ----- --- _ --_-__-.-___---
Insulation
Drywall Nailing -- -- ---.-_-.-.__--
F irewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
PASS PART FAIL - ----
PLUMBING �¢ rr 42
Post& Beam y _
Under Slab
Top Out -_-_-_ -_-- -
Water Service
Sanitary Sewer - ^- --- - —
Rain Drains
Final ---- - --- - ----
PASS PART FAIL
MECHANICAL
Post& Ream -- - -- - - -
Rough In
Gas Line - -- --- -----
Smoke Dampers
Final --- - ------ -- —
PA FART FAIT_
Service
RoughIn _._.__._�----- --- --- - ---- - —
UG/Slab
Low Voltage —
Fire Alarm
Final---
ASS -PART FAIL
SITE
Backfill/Grading ___�.. -- --------- -_---_—
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ -_ required befor nex inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE:--_ ( J Unabie to inspect no access
ADA
Approach/Sidewalk r-
Other Date _� ! �, _-_ Inspector _ 7 i Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/ CITY C�F T I G A R D ELECTRICAL PERMIT
PERMIT#: ELC2001-00163
DEVELOPMENT SERVICES DATE ISSUED: 3/23/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09820 SW FREWING ST 26
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect only.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS___
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADU'L 5(10SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _BRANCH CIRCUITS _ _ ADD'L INSPECTIONS
0 200 arnp: W/SERVICE OR FEEDER: PER INSPECTION:
201 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L. BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+ amnlvolt: — >=4 RES UNITS: >600 VOLT NOMINAL:
_ Reconnect only: 1 _SVCIFDR >=225 AMPS: —__ CLASS AREA/SPEC OCC:__l
Owner: Contractor:
FINKE, ALEX ,',,ND LOTTE I OWNER
PO BOX 23561
PORTLAND, OR 97223
Phone: Phone:
Reg #:
FEES _ Required Inspections
Typu By Date Amount Receipt Elect'I Final
PRMT _ CTR 3/23/01 $66.85 2720010000(
5PCT CTR 3/23/01 $5.35 2720010000(
— Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plays This permit will expire if work is not started wdtun 180 days of issuance,or if 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 ropies of these rules ordirect que1ions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURE-,/ �: .� ISSUED BY: %
—OWNER INSTALLATION ONLY
own whic/fy is not intended for sale, lease, or rent.
The installation is being made on prtif5e ty 7
Z -< l t
OWNER'S SIGIJATURE: L DATE- — —�
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N __ __ — _�� DATE:—_ _
LICENSE NO. —
Call 639-4175 by 7:00pm for an inspection the next business clay
1 Electrical Permit Application
\� Date received: i t 2 p Permit no.:rte 200 I
l� . tri
City Of Tigard Project/appl.no.: Expire date:
City(of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Recetptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval-
I's U Nil 00
U I &[ lamely dwe'lltnE(ir acccti:,uly U Commercial midutitnal Multi-family U Tenant improvement
U New construction U Addition/aheratittrt/rrplacement U Otlmer:— _ U Partial
Joh address: ,C PE / Bldg.no.: Suite no.: Tax in lot/account no.:
Lot: Block:_ Subdivision: �1=]�/ * r.
Project name: Description and location of work)n premises:
Estimated date of com letion/inspection:
Job no: Fee Mat
Business name: At.-F- ,P L �- I)escri lion QI). (ea.) Total no.h,.
Address: , G"r 3 `1 -" Newmsidential-,ftleormulti-family per
dwelling unit.Includes attached garage.
City: / e77 I State:C1' ZIP: - Service Included:
Phone: - E-mail: IOW sq.ft.or less 4
— `— - - Each additional 5W sq.ft.or portion thereof
CCB no.: Elec.bus.lic.no: _ _ Limited energy,residential 2
City/metro lic.no.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) Dal, Service an(Vor feeder 2
Sup.elect.name(print) I tn•nse lit,
Services or feeders-Installation,
alteration or relocation:
161111111110 200 amps or leas _
Name(printy L= r '/'/N CG: 201 amps to 400 amps Y 2
- 401 amps to 600 amps 2
Mailing address: �S 04r;I vit 4 ft 60I amps to IOW amps 2
City: / State:t� ( ZIP: ) Over I(xx)ampsorvolts __ _ 2
Phont I E-mail: Reconnect only
Owner installation:The installation is being made on property 1 own Temporary services or feeders-
which is not intended for e,rent,or exchange according to installation,alteration,orrclocation
ORS 447,455,479,6 v 7W trope or less 2
i ? h 201 amps to 4W amps 2
Owner's si nature• t-{= Dale: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name:T _ A. Fee for branch circuits with purchase of
Address: r service or feeder fee,each branch circuit
('ily: — Stale: IIP: - B Fee for branch circuits without purchase
--- of service or feeder fee,first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit.
Mlsc.(.service or f roder not Included):
O Service over 225 amps-commercial U Health-care facility Each pump of irrigation circle 2
U Service over 320 amps-rating of 1&2 U Harardouslocadon Each sign or outline lighting 2
familydwellings U Building over 10,000 square feet four or Signal circuil(s)or a limited energy panel.
U System over 600 volts nominal more residential units in one structure alteration.orextension• 2
U Building over three stories U feeders,40x)amps or nitre •Descri tion:
U Occupant load over 99 persons U Manufactured structures or RV park Each addMloml Inspection over the allowable In any of the above:
U EgressAightingplmt U thher: . Per inspection
Submit__sets of plant with any of the above. I Investigation fee
The above are not applicable to temporary convtrurtion service. Other
- Permit fee.....................$ c G
Not all jtaisdictir as wrept ctedil cart,,Please call jurisdiction for more inf,xmation. Notice:This permit application -
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
(-re(ht catd aaatxr: _L� within 180 days alter it has been State surcharge(8%) ....$
a( der u shown urs credit:aid
Expires accepted as complete. TOTAL .......................$ _ ?�._aK Q
---
S
Cardholderii`aitrae - Amoual 4404615(600170M)
Electrical Permit Fees: Limited (Energy Fees:
----"— ----- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: -— -�
Restricted Energy Fee...................................................... 175.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total ,heck Type of Work Involved:
Residential-per unit
1000 sq ft or less $145 15 4 Audio and Stereo Systems
Each additional 500 sq,ft,or
portion thereof _ $3340 1 Ll B,ngiw Alarm
Limited Energy $75.00 _
Each Manufd Home or Modular C] Garage Door Opener'
Dwelling Service or Feeder _ $9090 _ 2
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relncation
200 amps or less $8030 2 f—'1
Vacuum Systems
201 amps to 400 amps _ $10685 2
l_J
401 amps to 600 amps _ $160 rn 2
G01 amps to 1000 amps $24060 __ _ 2 ❑ other
Over 1000 amps or volts $45465_ 2
Reconnect only _�_ $66 8.5 :; 2
Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or FeeFee for each system.............. .............................. ............ $75.00
Installation,alteration,or relocation
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2 ({deck Type of Work Involved:
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems
see"b"above.
Branch Circuits fioiler Controls
New,alteration or extension per panel
a)The fee k-r branch circuits r 1
with purchase of service or Clock Syslerns
feeder fee.
Each branch circuit $665 2 Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ❑� HVAC
Each additional branch circuit __ $6.65
Miscellaneous D Instrumentation
,,Service or feeder not Includer)
Each pump or irrigation ci,cle $5340 ❑ Intercom and Paging Systems
Each sign or outline lighting $5340
Signal circuit(&)or a limited energy r�
panel,alteration or extension $75.00 J� L Landscape Irrigation Control'
Minor Labels(10) $125.00 ❑
Medical
Each additional inspection over
the allowable In any of the above ❑ Nurse Calls
Per inspection $62.50 _
Per hour $62.50 ____ ❑
In Plant $73.75 Outdoor landscape Lighting'
Fees: ❑ Protective Signaling
Eoter total of above tees $ ❑ Other ----
", State Surcharge $ _----------Number of Systems
25%Plan Review Fee ' No licenses are requimd Licenses are required for all other Installations
See"Plan Review'section on $ _-
front of application _
Fees:
Total Balance Due
------ Enter total of above fees $_ _
❑ Trust Account p _ _ 8%State Surcharge $�
Total Balance Due
i\fists\fomu\elc-fees.doc 10/09/00
1�D � ELECTRICAL PERMIT
CITY OF TIGA
PERMIT#: ELC2001-00297
DEVELOPMENT SERVICES )ATE ISSUED: 6/6/01
13125 SW Hall Blvd., Tipard, OR 97223 (503) 639-4171 PARCEL 2S102CB-03400
SITE ADDRESS: 09820 SW FREWING ST 29
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Prolect Description: Service reconnect.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALWANEL:
MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
-- -- ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDI-R: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX AND LOTTE I
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg#:
FEES Required Inspections _
Type By Date Amount Receipt Elf-ct'I Service
PRMT CTR 6/6/01 $66.85 2720010000( Elect'I Final
5PCT CTR 6/6/01 $5.35 2720010000(
Total $72.20
his Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws
All work will be sone in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if 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 OU14C at(503)
246-6699 or 1.800-332-2344 --
Permit Signature: h �� Z.� Issued By:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
_CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: -_ _. __— DATE-:-----
LICENSE
ATE:_____LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received G D Permit no.• a)
City of Tigard) Project/appl.too.: Expire date:
CiryofTigard Address: 13125 SW Ball Blvd,Tigard.OR 972 3 Date issued: Hy Receiptno.:
Phone: (503) 639-4171 --- _.
Fax: (503)598-1960 (/1 `(�/) Case file no.: _- I'avmcnt type:
Land use approval: 1 \
U 1 &2 family dwelling or accessory U Commercial/industrial Multi-family U'fenant improvement
U New construction U Addition/alter�ation/replacentent U Other: U Partial
Joh.address: ' •S t iQoa Int N Bldg. no.: Suite no.:Tax map/tax lot/account no.:
1A 5 Block:_ Subdivision:
Project name: —Description and location of work on premises: AL4c_ d-4-� - i
Estimated date of completion/ins ction: 41
Ii
Job no: nee Max
-Business name: -- _—�- --- - Description Qty- (ea) Total no.Ins
-- --- --- New residential-single or muhl-family per
Address: _ dwelling unit.lnclodesattached gorage.
City: r S1alC: ZIP: Seri icefncluded:
Phone: _ Fax: E-mail: Itx>v sq.ft.or It.% _ .t
CCB no.: I Elec.bus.lie.no: Each additional 500 sq.ft.or portion thereof
fIcy/IlelrtIle.no.: mited ngynial 2
Iiitedeergy non-residential
2
Each manufactured home or modular dwelling
Signature of supervising eleculclen(requited) I tai,. Service and/or feeder 2
Sup.elect.name(printj: -- 1,ii,.,, ,.,,,, Services or reeden-Installation,
alteration or relocation:
200 amps or less 2
Nance(print): G.'k l` l 6'� i. r, - 201 amps to 400 amps 2
D 7 i, 401 amps in 600 amps 2
Mailing address: 7rr 601 amps to 1(Xx)amps _ — — 2
City: •I IC Stale: C ZIP: Over I(x>u amps or volts
Phone: .2.4 -, E_-mail: Reconnectonly 1
Owner installation:The installation is being made on property I own Temporary services orfeeden-
which is not intended e,lea,e,rent,or exchange accordin r to Installation,alterstIon,orreloation:
200 amps or less 2
ORS 447,455,47 -20 I amps to 400 amps - 2
Owner's si na e: (�. /t ' Date:
atc 401 a ps t 4 s
2
Branch circuits-new,alteration,
Nance, j or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit
city: Stale: ZIP: B. Fee for branch circuits without purchase
- "-� —' --- of service ur feeder fee,first branch circuit:
1111011c: I ax 1'; mail
Each additional branch circuit:
I'll N� RIA-11 1% (Please check all that Hppli) Mlsc (Ser lceorfeedernotincluded):
UService over 225amps-commercial Uerdth-care facility Each pump oiimigationcircle
U Service over 320 amps-ruting of I&2 U Harardous location Each sign or outline lighting ?
familydwellings U Building over MOM square feet four or Signal circuit(s)oralimited encigs palwl. -'
O System over 600 volts nominal more residential units in one structure nheration,or extension' _ _ 2 _
O Building over three stories U Feeders.400 amps or more •DLscri tion:
U occupant load over 99 persons U Manufactured structures or RV park pa,It additlonal Inspection ow r the silos-able In any of the above:
U 13gressAightingplan U Other: --�•- -_----_- Per inspection
,Submit—sets of plans with any of the abi ve. Investigation fee -�-
The above are not applicable to temporary construction service. Other — -- -
Not at;jurisdictions accept credit catdr,please call jurisdictirn fur more Information Notice:*Mis permit application Permit fee.....................$
U Visa U MasterCard expires if a permit is not obtained Platt review(at — %) $
Credit card number: _ -__--L-�-- ssilhin 180 days ager it has been State surcharge(8%)....$ -
r'l1fe` accepted as complete 'TOTAL . $
Name of cardholder as shown on credit cart) •�••••••��•���•�••••••
_ S
Cardholder dpsnure ___ Arnounn 110461116HxyCOM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee.................. ................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Involved:
Residential-per unit f�
1000 sq it or lass $145 15 4 l l Audio and Stereo Systems
I-ach additional 500 sq It or
portion thereof — _ $33 40 1 Burglar Alarm
Limited Energy $15.00
F:ach Manufd Home or Modular El Garage Door Opener'
Dwelling Service or Feeder _ $90.90 _ 2
Services or Feeders [� Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less _ $8030 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
El 401 amps to 600 amps $16060 2 I�
601 amus to 1000 amps _ $240.60 _ _ 2 LJ Other
Over 1000 amps or volts $454.65 2
Reconnect only _ $6685 _ 2
Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary services or FeeFee for each system.......................................................... $75.00
Installation,alteration,or relocationder
200 amps or less $66.85 _ 2 (SEE OAR 918-26(1-260)
201 amps to 400 amps _ $100.30 2
401 amps to 600 amps $13375 _ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, 11
see"b"above. C—J Audio and Stereo Systems
Branch Circuits C I Boiler Controls
New,alteration or nxlension per panel
a)The fee for branch circuits �I
with purchase of service or L J Clock Systems
leader lee.
Each branch circuit _ — $665 _ 2 Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service L Fire Alar Installation
or feeder/be.
First branch circuit _ $4685 _
Each additional branch circuit $6.65 HVAC
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or irrigation circle _ $5340 __- Intercom and Paging Systems
Each sign or outline lighting $5340
Signal circult(s)or a limited energy ❑
panel,alteration or extension — $75.00 Landscape Irrigation Control'
Minor Labels(10) $125.00
Medical
Each additional Inspection over
the allowable In any of the above ❑ Nurse Calls
Per Inspection _ $62.50
Per hour _ $62-50
In Plant _ T_ $73 75 _ Outdoor Landscape Lighting"
,Fees: ❑ ProtecL.e Signaling
Enter total of above fees $ _ n Other
8%State Surcharge $ Number of Systems
25%Plan Review Fee No licenses are required Licenses are required for all other installations
See"Plan Review"section on $
front of application — -- — — -
Fees:
Total Balance Due $
— - Enter total of above fees $
❑ Trust Account# ___ 8%State Surcharge $
— ------------- ------- � Total Balance Due $
i Asts\forms\elc-Fees rine il)'091(NI
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Flour Inspection Line: 639-4175 Busines- Line: 639-4171 — —
BUP
-Date Requested Cl- 7 AM PM BLD —
I_oc.ation �, �t' l Fti✓'�,t Suite MEC —
PLM J �� </�
Contact Person Ph --- --
C;ontractor Ph — SWR
BUILDING Tenant/Owner
ELCw/--�L' `yL
Retaining Wall ELR
Footing Access: PPS
Foundation
Ftg Drain SGN _
Crawl Dram Inspection Notes
Slab er l < a r1 r SIT
Post& Beam
Ext Sheath/Shear `" Cin tie -
---- ---
Int Sheath/Shear
Framing ---
Insulation
Drywall Nailing --_-- -- -
Firewall
Fire Sprinkler _- ---- ---
Fire Alarm _
Susp'd Ceiling ---- --- -
Roof
Misc -- - -
PASS PART FAIL
PLUMBING _
Post& Beern - -
Under Slab --
Top Out
Water Service --
Sanitary Sewer
Rain Drains -
Final
PASS PART FAIL -- -'-
MECHANICAL
F'r_x,t& Beam -
Rough In - _ __-_--
Gas Line --� -
Smoke Dampers _ - _-
F inal -
PASS PART FAIL
ervice -
� Retrgf'i In
UG/Slab - ------ ----- .------.- --
Lilw Voltage
Fire Alarm _ -- - _--_----- -- -
PASS �"PART FAIL _- ---------- -- - - ---- --- -
SIT — �^ — -- — — —
Backfill/Grading ----
Sanitary Sewer
Storm Drain [ J Reinspection fee of$__. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE' _ J Unable to inspect-no access
Fire Supply Line
ADA
Approach/SidewalkEXt
Other Inspector- Date -__._�._ L -_-- p -
Final
PASS PART FAIL 00 NOT REMOVE this inspection rer:ord from the job site.
BUP - Building Permit ELC - Electrical Permit__
Ins ection Descri tion nate Passed By Inspection Description Date Passed B�
Footing/Setback Underground cover
Foundation walls Wall cover_
Footing drain Ceilm cover
Waterproof b_smt walls Electrical rough-in
Slab _ Electrical service
Crawl drain _ Electrical final
Underfloor insulation
Post/beam structuralV
Shear walls/anchors ELR - Restricted Ener y_Permit
Roof nailing Inspection Description Date Passed B
Firewall_ Low voltage
Tilt-up panel _ Electrical final
Masonry/Reinforcetnent
Framing
MFG-Structure set-up.__ MEC - Mechanical Mechanical Permit _
Insulation Inspection Description Date Passed By
Drywall nailing Post/beam mechanical
Sus ndedceili� _ Gas line
Engineered soils Mechanical rough-in +_
Welding Lab Final Fire damper
Concrete Lab Final _ Duct work_ _
v
Bolting Lab Final _ Smoke detector
Structural observation Mechanical final�
Fireproofing Lab Final
Final inspection
PLM - Plumbing Permit _
4 Inspection Description Date Passed By
BUP — Fire Protection-System Permit
Plumbing underslab —
_ Inspection Description Date Passed By
Crawl drain
S rinkler underfloor/slab Post/beam plumbing _
Sprinkler rough-in Plumbingtop-out
op-out
Sprinkler final _ RP/backflow preventer_ _
Fire alarm final Rain drain
Storm drain _
Water service
SIT - Site_Permit _ Sanita sewer
4Ins ctiion Description Date Passed By Culvert/catch basin
Footing Pum /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor/slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils Inspection Description Date Passed By
Engineering acceptance _ Sanitary sewer _
Final ins ection _ Final inspection _
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
i:Qsts\forna\InspRecordBUP.doc 04/17/01
ELECTRICALPEIj�MT
CITY OF TIGARD
DEVELOPMENT SERVICES DATE ISSUIED: 6/6 01001 00297
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09820 SW FREWING ST 29
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Prosect Description: Service reconnect.
RESIDENTIAL UNIT TEMP SR_VC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
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: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp- 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IM PLANT:
601 - 1000 amp: PLAN REVIEW_ SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: _
Owner: Contractor:
FINKE, ALEX AND LOTTE I
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg#:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 6/6/01 $66.85 2720010000( Elect'I Final
5PCT CTR 6/6/01 $5.35 272.0010000(
Total $72,20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Spedalty 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 0 days of issuance.or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted ty 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)
246-66699 or 1-800-332-2344
Permit Signature: �_ : �� — Issued By:
OWNER INSTALLATION ONLY
The installation is being made c i property I own which is riot intended for sale, lease, or rent. `
OWNER'S SIGNATURE: DATE: _
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ —� DATE: _-
LICENSE NO:
Call 639.4175 by 7:00pm for an inspection the next business day
CELECTRICAL PERMIT
CITY O� TIGARD —
PERMIT#: ELC2002-00330
DEVELOPMENT SERVICES DATE ISSUED: 7/1;/02
13125 SW Hall Blvd., Tiqard. OR 97223 (503)639-4171 PARCEL• 2S102CB-03400
SITE ADDRESS: 09820 SW FREWING ST 24
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Reconnect.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
_ _
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amu: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+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 W/O SRVC OR FDR: PER HOUR:
401 - 600 arnp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
I INKE, ALEX AND LOTTE I OWNER
P() BOX 23562
PURI LAND. OR 97223
Phone: Phone:
Reg#:
FEES Required Inspections
Type By Date Amount Receipt Elecl'I Final
PRMT CTR 7/18/02 $66.85 2720020000(
5PCT CTR 7/18/02 $5.35 272.0020000(
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. 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 180 days of issuance, or if
work is suspended for more than 180 days ATTENTION: Oregon lav,requires you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAF,952-001-0080. You may obta n copies of these rules or direct ^,uestions to
Permit Signature: Issued By:
OWNER INSTALLATION ONLY _
1 he installation is being made on prop n which is t intended for sale, lease, or rent.
DATE:
OWNER'S SIGNATURE: - —
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: -- - -- -
Call 639-4175 by 7:00pm for an Inspection the next business day
Flee t sical Permit Application
—� Date received:' -/`6 G 1 Permit
City of Tigard Projecl/appl.no.: F.xpiredate:
City u('figard Address: 131.'5 S IlaII Blvd,"Tigard,OR 97223 Date issued: 13yf"(" Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U I &2 family dwelling or accessory U Commercial/industrial hlulti-family U Tenant improvement
U New construction U Addition/altt•tation/replacement U(glu•t U Partial
Job address: C- d' C-Y Bldg.no.: suite no.: "Y I Tax map/tax lotlaccount no.:
IAW Block: Subdivision: �Z,Lci T F A T S.__-.�
Project name_ Description and location of work on premises:
Estimated date of com letion/ins ction:
Job no: Feeel Max
Business name: t r Description of . (ea) Total no.Ins
Nen reddential-single or muhi-family per
Address: d welling unit.Includes attached¢arage.
City: state. ZIP:- - — Servicr!ncluded: l
Phone: I E-mail: IOW sq It.or les: _ -- 4
CCB no.: Elec.bus.lic.no: Each additional 500 sq.ft.or portion thereof
Limited energy,residential _2
City/metro lie.no.: Limited energy,non-residential '-
Each manufactured home or modular dwelling
signature of supeivising electrician(required) Date Service and/or feeder
Sup.elect name(print): License no: Serviceaorfeeders-Installation,
alteration or relocation:
200 t mps or less 2
Name(print): A Lk--_X 201 amps to 400 amps 2
401 amps to 60(1 amps 2
Mailing address: 7? C•/r 7t +� Z 3 – 601 amps to 10()(1 amps '-
City: State:L)C ZIP: over Itx10 amps or volts _ 2
Phone: /F//—/a Fax: I E-mail: teconnectonfly I X
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,I ge,rent,or exchange according to Installation,alteration,or relocation:
200 amps or less
ORS 447,455,479,6 201 amps to 400 amps J 2
Owner's si rnature: �-e�G Date: /T"�t'2` 401 to 600 ams — 2
Branch rlrcul's-new,alteration,
or extension per panel:
Nainc' A. Fee for hraach circuits with purchase of
Address: r service or feeder fee,each branch circuit
lily: State: ZIP: It Fee for branch circuits without purchase
_of service or feeder fee,first branch circuit: -
Phone: Fax: E-mail:
Each additional breluh circuit:
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Henhh-care facility Iinch pump or imgation circle _ 2
U Service over 320 amps-rating of 1 R2 U Harnrdous location Each sign or outline lighting _ 2
familydwellings U Building over 10,000square feet four or Signal circuit(s)oralimited ercrgypancl.
U System over60(1 volts nominal more residential units in one structure alteration,or extension* V '-
U Building over three stories U Feeders,40()amps or more •Deaeri tion:._. —
•Occupant load over 99 persons U Manufactured structures or RV park FAch additional Inspectlon over the allowable In any of the above:
J Egress/hg`rtingpien U other . --- -_---- Perinspecuonf--T_�–�-
Sublsit__sets of plans with any of the above. Investigation fee _
The above erre not applicable to temporary construction service. Othet
Na all jurisdictions accept c,.:it cmde,pteue call jurisdiction for more Information Noticehots permit application
Perot fee.....................$
U Visa U MasterCard expires it:,permit is not obtained Plan review(at —_ %) $
credit card number within 1 R( bays nRer it has been state surcharge(91T) ....$
Lxpirer
_ ;,,,.pp�,_i Its armplete. TOTAL. .......................$ _.
Name of cardholder as shown on credit card
�" Cardholder signature Amount 4"15(6/001COM)
Electrical Permit Fees: Limited Energy Fees:
-- —' — TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: --
Restricted Energy Fee...................................................... $75.00
Number of Ins cticns per "mit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Tota' Check Type of Work Involved
Residential-per unit
1000 sq ft or less $145 15 4 ❑ Audio and Stereo systems
Each additional 500 sq.It or
portion thereof $3340 _ 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $9090 2
Services or Feeders U Heating,Ventilation and Air Conditioning System'
Installation,alleraticn,or relocation
200 amps or less __ $80 30 _ 2 El
Systems'
201 amps to 400 amps $10685 2
401 amps to 600 amps $16060 2
601 amps to 1000 amps $240.60 2 E] Other
Over 1000 amps or volts $45465 2
Reconnect only 4 $66 85
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Instaporar,alteration,or Feeders
relocation Fee for each system.......................................................... $75.00
200 amps w less $66.85 2 (SEE OAR 916-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved
over 600 amps to 1000 volts,
sue"b"above.
Au Jin and Stereo Systems
Branch Cim0ts ❑ Boiler Controls
New,alteration or extension per panol
a)The lee for branch circuits
with purchase of service or L� Clock Systems
feeder fee. 1
Each branch circuit _ $665 2 �J Data retecomrnunication Installation
b)1he fee for branch circuits
without purchase of ser vice L__1 Fire Alarm Installation f
or feeder lee. 4
First branch circuit $4685 C� HVAC
Each additional branch circuit $665
Miscellaneous L-� Instrumentation
(Service or feeder not Included)
Eich pump or irrigation circle _ $5340 _ _ ❑ Intercom and Paging Systems
Fach sign or outline lighting _ $5340
Signal circuit(s)or a limited energy ❑ Landscape Irrigation Control'
panel,alteration or extension $75.00 _
Minor Labels(10) $12500 _ ❑
Medical
Each additional inspection over
the allowable in any of the above ❑ Nurse Calls
Per Inspection $62.50 _
Per hour $62.50 ❑
In Plant $73.75 — Outdoor Landscane Lighting*
Fees: ❑ Protective Signaling
Enter total of above fees $ l Other
8;e State Surcharge $ -_ --.------Number of Systems
25%Plan Review Fee No licenr-,are required Lice,ises are required for all other installations
See"Plan Review"section on $ –
front of application _,
Fees:
Total Balance Due $
------- Enter total of above fees $
C� Trust Account p.___ 8%State Surcharge !+
Total Balance Due $
lAdWVbmtsvdC fees do 10/001N,
1
'1 eV o
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received __ _ ____– Date Requested I_1 AM_ PM___ BUP
Location Z �'�� Suite MEC
Contact Person . �___-- Ph(._-- ) _;2 41 -wa T PLM ------ --
Contractor -- __-- Ph ( --) .—
SWR
BUILDING Tenant/Owner _- -_ .0 1�U , ELC
Footing ELC -----___ _--
Foundation Access-
Fig Drain L _ 0 F piELR —�---------
Crawl Drain _
Slab Inspection Notes: S -- -----
Post&Beam _— -- - 0
Shear Anchors - -- -
Ext Sheath/Shear _ --.__--
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall _ - )
Fire Sprinkler % —
Fire Alarm
I Susp'd Ceding -
Roof
Other: --
Final
PASS PART FAIL
Post& Beam
Under Slab - - - -- _ ---- -- --- -__---
Rough-In
Water Service - --- -- — ----
Sanitary Sewer
ANN—
Rain Brains -�-�'- ---._--_._.- - - -- ------ --- ---
Catch Basin i Manhole _
Storm Drain ---- - ---- -- ---
Shower Pan
Other: ---------------- -- - --Final
PASS
PASS PART FAIL
------------ -
MECHANICAL — -- - - - - - - --- - -
Post$Beam ----
Rough-In ----
Gas Line
Smoke Dampers -- - --- - ---- - ---- --- ---
Final
PASS PART FAIL
ELECTRICAL—
.
Service
Rough-In
UG/Slag
lt
--
LowVo
l_ow Voltage _
Fire Alarm J'
F:*� RT FAIL Reinspection fee of$ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd.
Srrk� Ploase call for reinspection RE: _-- - � Unable to inspect--no access
Fire Supply Line
ADA ct�6�
Approach/Sidewalk Date /-f---- - Inspe r Ext --- ----.
Other.
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CELECTRICAL PERMIT
CITY OF T9GARD
PERMIT#: ELC2001-00058
DEVELOPMENT SERVICES DATE ISSUED: 1/26/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09800 SW FREWING ST 32
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIC;
Proiect Description: Reconnection of electrical service tc apartment#32.
___RESIDENTIAL UNIT TEMP S_RVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: OR LABEL (1 ):
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (101:
--SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRN CH CIRC: IN PLANT:
601 - 1000 amp: _ _ NITPLAN REVIEW SECTION
— _
L— 1000+ amp/volt: — >=4 RES US: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: .
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg #:
FEES Required Insr ections –
Type By Date Amount Receipt _ Elect'I Service
PRMT CTR 1/26/01 $66.85 2720010000( Elect'I Final
5PCT CTR 'I/26/01 $5.35 2720010000(
Total $72.20
Tnis Permit is issued subject to the regulations contained m the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws
P II work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if 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 -� I
�f f , ISSUED BY:
PERMITTEE'S SIGNATURE �� J �'_ if✓�� �/,%
RE INSTALLAI IUN ONLY
The installation is being made on proper owf►which is not intended for sale, lease, or rent.
j
OWNER'S SIGNATURE: _ DATE: ��
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N- — — DATE:
LICENSE NO: ---- --- --- _ ------- ----
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Datereceived: /-16'-G/ Permitno.: ,f4ZAy -�jp5'T
City of Tigard Projoct/appl.no.: Expire date:
City uJTigard Address: 13125 SW [fall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 6394171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval
U 1 dir 2 family dwelling or accessory U Conmteicial/industrial Multi-Ianlily _1"l'enant itnhn,ct•mcnt
U New construction U Addition/alteration/replacement U Other: U Partial
Job address: [It `i ,mac la/r N(-� _ �2_0 __ uite no.: ZITax map/tax lot/account no.:
Lot: I Block: Subdivision:
Project name('1,4 ; t( 4 i5V, I Description and location of work on premises: _eNI
L-
Estimated date of completion/inspection:
Job no: ree Mar
Business name: r Description _ Qtv. tea► Total no.Ins
L N --- Neh trsidential-single or multi-family per
Address: _ d„ellinp unit.lnrluelm attached garage.
City: J State: ZIP: SeniceIncIudrd:
Phone: x I E-mail: l(Hx)sq.ft.or less 4
CCB no.: Elec.bus.tic.no: Each additional 500 sq.ft.or portion thereof
Limited energy,residential 2
City/metro lic.no.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) Irut Service and/or feeder _
Sup.elect name(print): License no: Services or feeders-Instsllation.
alteration or relocation:
1 2a)amps or less
Name(print): /�f_I=-k. 1: f!v kt: 201 amps ro 4(10 amps ' —
t_ -- 401 amps to 600 amps '
Mailingaddress: -
601 amps to 1000 amps _—
Clly: / ir._T Stale: r @ ZIP: ,2g Overlax)ampsorvolts �_ 2
Phone: '2._t///••:a el Fax: E-mail: Reconnectmrly
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lei,rent,or exchange according to Instauation.alteration,orrelocaliun:
ORS 447,455,479,67tT, 200 amps to Ic,s — --- 2
�.. 201 amps b,400 mops 2
Owner's si nature _ J Z( ( /_ Datc: G� ' r r 40l ro 600:111111,— -- - — -
Branch
circuits new,alteration,
or extension per panel:
Name: K Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit
City: Stale: ZIP: B. Fee for branch circuits without purchase
— of service or feeder fee,first branch circuit: 2
Phone: Fax: G mail:
Each additional branch circuit.
Misc.(Service or feeder not included):
❑Servitt over 225 amps-commercial U Health-care facility Each pump or irrigation circle — 2
U Service over 320 amps-rating of I fit U Hazardous Incation Each sign or outline lighting — 2 _
family dwellings U Building over 100110 square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal noir residential units in one structure alteration,orextension' - 2
U Budding over three stories U Feeders,4a)amps or more •I)escri tion:
U Occupant load over 91 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
U Fgress/lightingplan U(thee ___,-_ _ _ Per inspection
Submit___sets of plans with any of the above. Investigation fee
The above are not applicable to temporary constrnetlon service. Other
Permit fee.....................$ -�—
Nm all junulicti,xn accept credit cads,please call jurisdiction Sex m(ne mfoonarnn Notice:This permit applientiun
J Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _._
•rdii card number: -___ -___ .L._.1 within 180 days atter it has been State surcharge(8%)....$ 1
Expires accepted as complete. TOTAL .......................$ 7 '
Name of cardhol r u shown an credit card
S _
Cardholder signature _ Amount 410.4615 MO VOM)
Elect-ical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL CNLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total I Check Type of Work Involved,
Residential-per unit r ,
1000 sci it or less $145 15 4 lj Audio and Stereo Systems
Each additional 500 sq ft or
portion thereof _ $3340 1 ❑ Burglar Alarm
Limited Energy $7500
Fach Manufd Home or Ntodu ar Garage Door Opener'
Dwelling Service or reedei $9090 2
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,altoralion,or relor ation
200 amps o-less $80.302 Vacuum Systems'
201 amps to 400 amps $106.85
401 amps to 600 amps _ $16060 2 ❑
601 amps l01001)amps $24060 — 2 Other
Over 1000 a mps or volts $45465 _ _ 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Fee for each system.......................................................... $75.00
Installation,alteration,or relo:alion
200 amps cr less $6685 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 _
401 amps to 600 amps $13375 2 Check Type of Work Involved.
Over 600 amps to 1000 volts, E]see"b"above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New,alt�ralion or extension per panel
P', The fee for branch circuits
with purch,ise of service or ❑ Clock Systems
feeder lee.
Ei.h h-,ch circuit $665 M 2 ❑ Data Telecommunication Installation
b)The fee fur branch circuits
wtfhoo t purchase of scervice ❑ Fire Alarm Installation
or feeder fee.
First bunch circuit _ _ $4685 HVAC
Fach additional branch circuit $665
Miscellaneous C] Instrumentation
(Service or feeder not inclu, .1
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy
panel,alteration or extension $7500 _ ❑ Landscape Irrigation Control
"Inor 1._abels IT 0) $12500 _
Medical
Each additional Inspection over ❑
the allowable In any of the above ❑ Nurce Calls
Per inspection _ $6250 !__
Per hour $62 50
In Plant — $73 75 Outdoor Landscape Light)rg'
Fees: [] Protective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $ - ----.--Number of Systems
2.5%Plan Review Fee No licenses ate required Licenses are required for all other installations
Sae"Plan Re\,iew'section on $
front of applica"ion -- v'
Fees:
Total Balance Due $
----- — Enter total of above fees $� �-
❑ Trust Account tt - ___ _ 8%State Surcharge
---- -— - - - -- --— Total Balance Due $.
r\dsLs,IR,nnskic4ces dt c I la)q IN1
CITY OF TIGARD BUILDINU '6 ION DIVISION
MST
24-Hour Inspection Line: 639-4175 Sesiness Line 639-4171 —_
SUP —
_ Date Requested _._.._ —.. m_ PM _ BLD _
Location- G S wY�w�' __— — Suite MEC
Contact Person __ ________,-^_ Ph 1 V PLM _
Contractor_ _ .__ ._r— .._.. Ph _ _ SWR —_
BUILDING^ Tenant/Owns r ELC v - /�c��3
-�.5�_-_ 3
Retaining Wall ELR
Footing Access:
Foundation FPS - -- ---
Ftg Drain _ SGN
Crawl Drain Inspecticrt Notes: --------
Slab -.----------- SIT _
Post&Beam
Ext
_A —
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- — - _- -
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling _ - ---- ----------
Roof
Misc: - -- -- ---- -- _
Final (/
PASS PART FAIL - �- - — T
PLUMBING
Post& Beam
Under Slab ^_
Top Out
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Past& Beam --- ---_-- -
Rough In
Gas Line ---- ---
Smoke Dampers
Final - - ---
PASS PART FAIL
Rough In ------_-------
UG/Slab —
low Voltage
Fire Alarm --- ---- --at
PASS ART FAIL - -- - -- ----- -- ---
Backfill/Grading -- __.— ---- _.-
Sanitary Sewer
Storm Drain I (Reinspection fee of$-_.-_T_-required be inspection. ay at City Hall, 13125 SW Hall Blvd
Catch llasin
Fire Su PP Y I Line I 1 Please call for reinspection RE'_ ( (Unable to inspect-no access
ADA
Approach/Sidewalk Date 61 - Inspector _ �_'� Ext
Other - -- — ——
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CELECTRICAL PERMIT
CITY O F T I G A R D
PERMIT#: ELC2001-00039
DEVELOPMENT SERVICES DATE ISSUED: 01/22/2001
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S102CB-03400
SITE ADDRESS: 09800 SW FREWING ST 040
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
prolect Description: R;t;unnect.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS_
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGWOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL:
MANF HMI SVC/ FDR: 601+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 W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L 3RNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL.
Reconnect enly: 1 SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:_
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
Reg#:
C _ FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 01/22/2001 X66.85 7.720010000( Elect'I Final
5PCT CTR 0112212001 $5.35 2720010000(
Total $72.2.0
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State Y OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if'Norte is not staried within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to'ollow 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 or direct questions to OUNC at(503)
246-1387
PERMITTEE'S SIGNATURE ISSUED BY;
r
OWNER INSTALLATION ONLY
The installation is being made on pre�perty I ovvrTw ICh isnot irJ ended for sale, lease, or rent.
_
OWNER'S SIGNATURE: DATE:--
Ir -
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SIIPR. ELEC'IJ: _ DATE:,--.–
LICENSE
ATE:. —.–LICENSE NO:
Cal! 639-4175 by 7:00pm for an inspection the next business day
Eleddcal PerndtAppUcation
FEEF//e received: / Permit no.: L C' -00
City of Tigard Projecl/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: 40 Receipt no.;
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U I 72family dwelling or accessory U Commercial/industrial Multi-family U Tenant improvement
U Nuction U Addition/alteration/reel icemr nt U 0Iher ❑Partial
OHL81
Joh address: �' UCJ 5 f%�y / C� lildg.no.: Swlc nu.: �-t 'litx map/tax lot/account no.:
Lo(: Block: Subdivision: _ —
Project name: A A -A?7-'� T Description and location of work on premises: L 44R�u G N/k
Estimated date of coo Iction/ins ction:
gum
Job no: \- i) . Fee Max
- ----
Description (r (ea.) 'notal no.lns
Business name: NewreaMemial-shwleormulu-famllyPei
Address: dwellintunit.Includes anachedglsrage.
City: State: ZIP: ServiceirKluded:
4
1000 sq ft.or less
Phone: _ I )x: _ F.-mail:
Each additional 500 sq.ft.or portion(hereof
CCB no.: Elec.bus.lic.no: Limited energy,residential 2
City/metro Iic.no.: Limited energy,non-residential _ 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) pale Service and/or feeder '
Services or feeders-Installation,
Sup elect nnnar(print) License no: alter:tlon or relocation:
200 amps or less _ 2
/ �: 201 amps to 400 amps 2
Name(print): �� 401 amps to 600 amps 2
Mailing address: r, C",� z 3��� 60I amps to IOOOrmps 2
Cily, -G Stale: G>� ZIP: �fl/ over 1000 amps or volts _ 2
Phone:�2_$,AFj-S Fax: E-mail: Reconnectonly __ l
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for Ie,1eB_se,rent,or exchange according to Imtallation,alteration,orrelocation:
t amps or less _ _ 2
ORS 447,455,479,6 2ll I amp,to 4(X)amf•s — 2
()\tner's si mature: Zt•1 Date: `` �G� -401 to(A)amps 2
Branch circuits-c.ew,alteration,
or extension per panel:
Marne: A Fee for branch circuits with purchase of
Address' service or feeder fee,each branch circuit 2
B
--"' Mate: III — Fee for branch circuits without purchase
City: -- of or feeder fee,fiat branch circus-- - — � Z ---- 2
Phone: lax fi m:fit: EachaddiUonalbranch circuit. —~- —
Mise.(Service or feeder not Included)-
Each pump or irrigation circle 2
•Service over 225 amps-commercial U Health-care fac I h IN — 2
U Seryice over 320 amps-rating of 1&2 U Hazardcius location Each signor outline lighting —
farmlydwellings U Building over 10.000 square feel four or Signal circuit(s)or a limited energy panel.
U System over C00 volts nominal more residential units in nne strurture alteration,or extension* 1 1
7
U Building civet three stones U Fe-Aers.400 amps or more •lkscnption:_ -
U Occupant load over 99 persons U Manufactured strucotres or RV park Each additional Inspection over the allowable In any of the above:
U Egress/lightingplan U Other Per inspection f—T
Submit____sets of Plans with any of the above. Investigation fee _
The above are not applicable to temporary construction service. other
--
Permit fee l .Q
-- - ................... .$
�.
Na all jurisd-mions wcej>t credit cants,pease call jurisdiction for more informotion. Notice:This permit application
U Visa U Mastert•ard expires if a permit is not obtained Pian review(at ___ %1
credn card number _—.— / / within 180 days after it has been State surcharge(8%) .. .$ -_
txplrea ace.ptedascomplete. TOTAL .......................$
Name of cardholder u shown on c it card s
440.4615(6WCOM)
Cardholder aijputme Amount
Electrical Permit Fees: Limited Energy Fees:
-- — — --- I TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee................�......................••••••.•• $75.00
Number of Inspections iter permit allowed /FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential•per unit g 14 15 4 Audio and Stereo Systems
1000 bq f1 or less --_- _--_ --Each additional 500 sq ft or $38 40
_ 1 Burglar Alarm
portion thereof
Limited Energy $75.00 _
Each Manufd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder S90 90 —
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or rebcalion
200 amps or less ___ 1,8030 _ 2 Vacuum Systems'
201 amps to 400 amps $10685 2
401 amps to 600 amps _ $16060 -- 2 Other
601 amps to 1000 amps $24060 2
Over 1000 amps or volts $45465 _ 2
Reconnect only $66.85 _11��_-= 1
TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or Feeders Fee for each system.......................................................... $75.00
Installation,alteration,or relocation 2 (SEE OAR 918 260-260)
200.imps or less _ $66 85
201 amps to 400 amps $100 30 2 Check Type of Work Involved
401 amps',o 600 amps $1:13 75 _. 2
()ver 600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits �_, Clock Systems
with purchase of service or
feeder fee.
Fad)branch circuit $6 65 2 Data Telecommunication Installation
b)T he fee for branch circuits
without purchase of service U Fire Alarm Installation
or feeder fee. $46.85 r
j First branch circuit _�_____ HVAC
F
Each additional branch circuit $665 —
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 Ej Intercom and Paging Systems
Each sign or outline lighting $5340 (-.--
Signal circult(s)or a limited energyLandscape Irrigation Control'
panel,alteration or extension _ $75.00
Minor I Abels(10) -- $12500 ❑
Medical
Each additional inspection over
the allowable In any of the above ❑ Nurse Calls
Per inspection $6250 _
Per hour _,_ $6250r— t
__ Outdoor Landscape lighting'
In Plant $73 75 u
Fees: Protective Signaling
Enter total of above fees $ - Other
8%State Surcharge $ ___ __Number of Systems
25%Plan Review Fee $ " No licenses are required Licenses are required for all other installations
See"Plan Review"section on —
front of application Fees:
Total Balance Due $ __ — --
Enter total of above tees $____
❑ Trust Account N ___ 8%State Surcharge $--- -
-----� Total Balance Due $----
i41stsMorsAetc.fecsdoc I0/09'(9)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIP
Date Requested —AM- PM eLD — _—
Location Gv S�1 lwl ------- Suite �L_L MEC --
Contact Person __ Ph PLM
Contractor _ --- Ph IC `' v a o o �J
BUILDING E
Tenant/Owner — —_ --L- 0
Retaining Wall ELR -__—
F ooting Access: FPS
Foundation --� --
Fog Drain SGN
Crawl Drain Inspection Notes.
Slab — ---- --- ----- ----------— -- SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- - --- -
insulation
Drywall Nailing ----_ - --...-- - --- -- ------------
Firewall
Fire Sprinkler _-----_-_--- �[ -�= - -" - — ----- ----- —
moire Alarm
Susp'd Ceiling -------- ---- - -- - -----
Roof
Final
PASS PART FAIL -- --- - ---
PLUMBING - —
Post& Beam — --- (�
Under Slab - ----- --- ------ — -- --
Top Out
Wate. ,ervice -- ---- -
Sanitary Sewer
Rain Drains ---
Final
PASS PART FAIL _ --- -
MECHANICAL
Post& Beam - ---------..--------- -- - — -- -�
Rough In
Gas Line -- -- --- —
Smoke Dampers
Final --
PART FAIL -_—__— -
Servicej.nn f --_— --_----- --- - — ------ --
Rough In
LIG/Slab - -- �.. — — - - ----- - _-
Low Voltage
Fire Alarm ---- - ------
Fi
P SS ART FAIL -'—�---
Backfill/Grading ---- ---_— —--- ---- -- -�----
Sanitary Sewer
Storm Drain ( Reinspection fee of$ _-_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basinable to inspect- no access
Fire Supply Line ( ) F lease call for reinspection RE' -7 able C �
ADA /
Approach/Sidewalk Date �� f "Inspector
_ t Ext
Other
Other --- --�
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.