13360 SW HALL BLVD-2 j
• o
ADDRESS:
3 3SI
�+ •
r..
r
i
r'.
1
a
S
ti
i`
i:\records\microflm\ta rgets\huilding.doc
CITv OF TIGARD BUILDING INSPECTION NOTICE
Inspectior Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam St,uct. Plbg. Top Out Elec. Rough-in FINAL:
Po�I/Beam M)ch. San. Sewer
Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line insulation
-Mach.
Underflr. Insul. Shear Wall Gyp. Bd.
Date Requested: Time: _AM `_PM w
Address:_
Builder � PermitTHc DL'_ RRECTIONS ARE REQUIRED:
Ce
,i
Inspector.
Date
ZXPPROVi D _DISAPPROVED _APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
a
0
4k +ap6aN,vr� lE't:
r t'^ � ref '�' ' � '•�' � a� J i{ y
1
s TEhII'ORARY - 10/ 31 /95 - 11 /6/95 V"
Community Development ELECTRICAL PERMIT APPLICATSON
13125 SW Hall Blvd.
00
Tigard, OR 97223 Planck/Rec. #
Permit # r=/�VS OSD9 —_
Phone (503) 639-4171 Date Issued lo . 3l - 95
FAX (503) 684-7297 Issued b
CITY OF TIGARD TDD No. (503) 684-2772 Y
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Bcl;edule Below:
Name of Development Numb- of Inspections per permit allowed —
Address 1 3 3 6 0 SW HALL BLVD . Service included: Items Cc,-t(ea) Sum
City/State/zip T I G A R D , O R E G O N 9 7 2 2 3 4a. Residential-per unit 4
' 1000 sq it or lase 511'.10
". IJan-.e (or name of business)_t3 R I A N M U C H M O R E Each additional sou sq it or 1
- portion thereof $2500
Commer,,ial❑ Residential® Limited En"rgy $2500 �!
W 0 55334 Each Manul'd Home or Modular 2
Dwelling Service or Feeder $6800
2a. Contractor ►nstaliation only:
4b.Services or Feeders
Installation,alterrhon or relocation 2
Electrical Contractor F_R f^ILLERRE L����_— 200 amps or lass $151000 2
Address 1 1 8 6 0 SW G R TF N_13 U R G ROAD 201 amps to 400 amps $8000
Ci f State 0 R Zi 91 2 2 3 401 amt&to 600 amps —� $12000 2
`7 p 801 amps to 1000 an.ps $16000 2
Phone No. 6a9-4Over 1000 amps or volts }'340 00 2
Contractor's License No. 34- 13 Reconnect only T $50oo T�1T�TT
Contractor's Board Reg. No. 3 1 4 10 4c. Temporary Services or Feeders
/J, limstallation,alteration,or re oc:ation 2
Signature of Supr. Elec'n_ /C 41 �✓ 200 amps or lens $50 00 2
License No. 18 16 Phone No. 639-462 7 201 ar'ps to 400 amps $7500 _ 2
401 emts to 600 ampe S10000
Over 600 am as to 1000 Volta
2b. For owner installations: nee•b-rtr�ve
4d. stanch Circuits
Print Owner's Name_— N".alteration or extension per panel
Address n)The fee for branch circuits with
Ditty State Zip purchase of urvics or leerier fee. 2
Phone No. -- Each branch arc'.' $500
_ b)The trip.for branch circuits without
The installation is b3ing made oii�t,. �p purchase of service or feeder tae. 2
not intended for sale, lease or r First branch circuit $3500 2
/0 13 s
Each add4lonal branch circuit $500
Owner's Signature4e. Miscellaneous
(Service or feeder not included) 2
3. Pian Review section (if required): Fach pump or angation circle — $4000 2
Fach sign or outline fighting $4000
S g eel amut(s)or a limited energy 2
Please check appropriate item and meek fee in section 58. panel,alteration or extensicn $4000
4 or more fesldonfial units in one structure Minor 1,abals(10) $10000 —_—
__Service and feeder 225 amps or more
System over 600 v.11ts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E.0 Chapter 5 Per inspection $3500
Per hour $5500
Submit 2 sets of plans with application where any of the above In Plant $55 00-- ---
pply. Not required for temporary construction services. 5• Fee S: t
NOTICE 5p.. Enter total of above foes $ 50 , 00
-- 5%Surcharge(05 X total fees) $ —
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ --
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WCRK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY l IME AFTER WORK IS Subtotal $ `
COMMENCED ryl_J Trust Accounts $ 52 , 50
Balance Due $
—1-1.W 4..pm sm
I
i
It
If
i U
, A
i
I
II�
F ■
fL- 1 I Y t�F 1 l hi�lk)l _ C;! l'k !F' I LIF k'i�e'1�1F f�i f E7F t f:l�•'f hli+. ;`I'^ � '� '�•• i
I
j I)r11*11. C Ctl l: F:►l r ! ;.! I Ct1 f !.;I'J
fel�1 Fel ".�.• ; 1 t f F 4 4't",i I .1 ! I I�ttlltt ►:La I.I Yh'If'.'N'1' DWI k. � I Q
ON
i,.tl! i .;t.l w'i I F1ML�l.Ifl! I �J.is 11...11{F4;F, Ill I.+i-Iy11f,NI
i it
i.!
"05-0509
5--0 509
it
I
I
f