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CITY 'TIGARD BUILDING INSPECTION NOTICE t
Inspection Line: 639-4175 Business Phone: 639-4171 `
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mech. I w "' `r'+M
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PIbg.Und/Flr/Slab Plbg.Top Out Insulation
Post/Beam Struct. Mech. Rough-In Gyp. Bd. -Bldg.
t f4flfA Sgt �� f
San. Sower Gas Line Appr/Sdwlk Reins.
Other:
Date: L ` A.M._P.M. Entry:
Address:
Tenant: Ste:--- MST: ,w' ,Y; '
BLIP: _ �" �•p'
Con/Own: r..l'(-.f1 L C,�L'/1'1.��-e_ MEC: q "
PLM: lw
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ELC:
THS FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: � �" v�- _--- Data:
APPROVED _DISAPPROVED/CALL FOR REINSP. CF CO
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg,
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm ' •
Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect, f
Date Requested:___ [ U6(o q Time: AM PM
Address:
P@fmlt #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: Y
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PPROVED rDISAPPROVED APPROVED SUBJECT TO ABOVE
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_Call For Reinsp.
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 95
Permit # LLQ 9.S-- C>
Phone (503) 639-4171 Date Issued /0 i,1 - 95-
FAX (503) 684-7297 Issued b
CITY OF TIGARD► TDD No. (503) 684 1772 y Ch,,,
Inspection (503) 639-4175 ti
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development �. Number of Inspections per permit allowed r'
•Y
Address-2Z (� ;��� r4'i 4, X41 Sbrvice included Items Cost(ea) Sum
City/State/Zip '1 r ,fin� 4a. Residential- per unit 4
T_ - 1n00 art II or less $11000
I?t4,�„1 f ♦ t1l_ �rv)41 K' Ir
Each additional 500 sq It 3r
Name (or name of business) � f , � �.� � portion thereof $25 00 1
i Commercial Pj_ Residential o Limited Energy $2500 —�
., Each Manul'd Home or Modular 2
�. Dwelling Servnaa or Feeder $6800
2a. Contractor installation only: t”`3 (
4b.Services or Feeders
Irxalallalion.altorntion m relocnlion 2
Electrical Contractor lrJ,tl A M• t1 S("Az- 2;c_ l�� 200 amps or less, $8000 2
Address 1"(j xi', y 201 amps l0 400 amps -- $80 OL 2 g
401 amps to 600 amps E120 00
f City 1 i,�t�Z�� ` State L_ Zips L _._ 2
Phone No. 601 amps 10 l000 amps $le000
r �iG Y �' 3'I A $340.00 _—
Over 1000 amps or volts 2
Contractor's License No. -71 - ?.S'S C' Reconnect only $5000 _ _^
Contractor's Board Reg. No. 7cpS S 4c.Temporary Services or Feeders
Installation,altaraticn,or relocation
Signature of Supr. Elec'n 200 amps or lase $5000 2
License No. LfjG S hone Nc. ry 201 amps to 400 amps --- $7500 i_
401 amps to 600 amps $10000 _
Over 600 amps to 1000 volts
2b. For owner installations: see V above
4d. Branch Circuits
Print Owner's Name Now,afleration or extension per panel
Address a)The lee lot branch circuits wlth
City State_--— Zlp_ purchase of oorvlco or Arodor Ara, 2
Each branch circuit $5 00
Phone No. b)The tea for branch circuits without
The installation is being made on property I own which is purchsso or service or boder Aro. � 2
not intended for sale, lease Or rent. Fret hranch circuit $3500 S
Each additional branch circuit $500 aiQ7
Owner's Signature 4e. Miscellaneous
(Service or leader not included) 2
3. Plan Review section (if required): Fnch pump or irrigation circle $4000 2
la,b sign ur outline lighting $4000 _
Signal cimwt(s)or a limited onargy 2
Please check appropriate Item and enter fee in section 513. panel,alteration or extension $4000
4 or more residential units in one structure Minor I abals(10) $10000
Service and feeder 225 amps or more
System over 600 volts 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.C. Chapter 5 Per inspection $'Ir,on _
Per hour
$5500
Submit 2 sale of plans with application where any of the above In Plant $5500 l
apply. Not required for temporary construction services 5. Fees:
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NOTICE 59. Enter total of above foes $ 5 (J
5%Surcharge(.05 X total fees) $ Z a
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 190 DAYS,OR IF 5b. Enter 25%of line 4 ;.rt
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 190 DAYS AT ANY TIME AFTER WORK IS Subtotal $ —
COMMENCED. ❑ Trust Accountlit
$
Balance Due $
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