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13884 SSV MARCIA DR
CIT` OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., rl9ard,Off 97223(503)639-4171 ELECTRICAL PERMIT -
RESTRICTED ENERGY
PERMIT #: ELR98--0249
DATE ISSUED: 09/08/98
PARCEL: 29104BA-04700
SITE ADDRESS. . . : 13884 SW MARCIA DR
SUBDIVISION. . . . :CASTLE HILL #2 ZONING:R-12 PD
BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . :080 JURISDICTN: TIG
Project Description: Kirby
--------------------
A. RESIDENTIAL-------.--- B. COMMERCIAL-------------------
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTEPCCA & PraGING. . :
BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . : LANrsCAPE/IF,RIGAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . . NURSE CALLS. . . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR L.ANDSC LITE:
OTHER: . . HVAC. . . . . . . . . . . . . PROTECTIVE SIGNAL. . .
INSTRUMENTATION. : OTHER. . :
TOTAL # OF SYSTEMS: 0
Owner: -------------------- ------------------ -- FEES
MICHAEL KIRBY AND LORI KIRBY type amount by date recpt _ -
13884 SW MARCIA DR PRMT $ 40. 00 JSD 09/08/98 98-308935.
TIGARD OR 97223 5PCT $ 2. 00 JSD 09/08/98 98-308931
Phone #:
Contractor: ------------------------------------------------------- ------------------
AI_L'TEC SECURITY $ 42. 00 TOTAL
PO BOX 55310 ------ REDUIRED INSPECTIONS ---------
PORTLAND OR 9722238-5310 Ceiling Cover Low Voltage Tnsp
Phone #: 331.-2620 Wall Cover Elect' 1 Final
Reg #. . : 001188
This permit is issued subject to the regulations contained in the Tigard Plunicipal Code, State of Ore. Specialty Codrs and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if Mork is not started within IN
days of issuance, or if work is suspended for more than IN days. ATTENTION: Oregon law reAuires you to foil rule #dopted by the
Oregon Utility Notification Center. Tho 'rules are set forth in OAR 952-001-9018 through OAR 952-991-9981. Vou m obtai ies of
these rules or direct questions to it (503)246-1987. �r /o Tssued by � — 't� Permittee Si��
IL `
R --.-__- -__----------L-'------OWNER INSTALLATION ONLY------------------------------
I-- The installation is being made on property I own which is not intended for
sale, lyase, or rent.
� �
OWNER' S SIGNATURE: DAT'E;
J
F5 -------------------CONTRACTOR INSTALLATION ONLY------------------------------
5
J
SIGNATURE OF SUPR. ELEC' N: DATE
LICENSE NO:
+++++++++a-+++++++.,.%+.++++++++4.+++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-417` by 7:00 P. M. for an inspection needed the next business day
++++++++.++++•++++++++++++++++i•++++++++++++++++-1•++++++++++++++++-F+++++++++++++++++
7
Community Development RESTRICTED ENERGY E�TRICAL APPLICATION
13125 sw Hall Blvd. RECEIVED %-or
Tigard,OR 97223 PERMIT
Phone(50 639-4171c.t-D _ R 19980ATE ISSUED —
FAX (5016�4-2772 84 7297 u—-
TDD No.
CITY OF TIGARD Inspertion ) 6304775:1 TY mvri ow, IMUED 8Y
/ ? PLEASE COMPLETE ALL SECT/IONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
CL-- lir ► LIP,
Adtir s RESIDENTIAL—•Restricted Enemy Fee . . . . . . . 140.0
-2
� � � -2�-Z� (FOR ALL SYSTEMS)
7
City d Stale Zip check Tyne of Work limAys-d:
r'f RMIIS ARE NON IRANSI f RAfltt ANI:NON-REFUNDAIII1 AND ERPIRE If WORK ❑ Audio and Stereo Systems
IS Not STARIFI)WITIIIN Iflo DAYS Or ISSUANCE OR If WORK IS SUSPENDED FOR Burglar Alarm
190 I)AYS
❑ Garage Door Opener'
2. CON T RACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System'
Contractor ALLLCc SCCUi'.i:Ly--Type —.
❑ Vacuum Systems'
❑ Other --- — --
Address PO (lox 55310 — Portrlandt-OR 97238— 10
Date — �j- 1� (� COMMERCIAL— Fee for R O1 system . �44SlIl
'.Q--- ,,.�,/ (SEE OAR 918-260-160)
Property Owner > r b- Ohet k Tvoe of WorlE Involved:
El Audio and Stereo Systems
Contractor's Board Reg. No. _-` 118839 ❑ Boiler Controls
Phone Idf 331-2620 _ ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION ❑ fire Alarm Installation
O HVAC
Print Owner's Name Phone No ❑ Instrumentation
❑ Intercom and Paging Systems
Address ❑ Landscape Irrigation Control'
Slate Zip ❑ Medical
l_.tly ❑ Nurse Calls
This permil Is issue)undar OAR 918-120.170.lids applicanl agrees to make only El Outdoor Landscape Lighting'
restricted energy installations I I00vtslt amps at less)under this permit and to do the
folitnving ❑ Protective Signaling
CL 1. Only use electrical licensed persons to do installations where required.(Certain ❑ Other
R residential and niher transactions are exempt horn licensing These have
I— asterisks(').All others need licensing).
N 2. Call for an inspection when all of the installations under this permit are ready
lot inspeLoon at 501-639-4175. ❑ —Number, 'Systems
,,j 3. Purchase separate permits for all installations that are ready for inspection
when the inspector is out to inspect under this permit 'No licenses are requited. licenses are required for aA other Installatlons.
4. Assume responsibility for assuring that all cornctlons regdired by the inspector -
W are done,and
J
5. Assume responsibility for calling for a final inspection when all of the 5. FEE
coctinns are completed. $An
The person signing for Ihls permit n USE the applicant or a person a. Enter Fees (/(/
authorized to hind I f�
�— b. 5% Surcharge (.05 x total above) $ 'dy
Signature' JQTAL $ D
Aulhonly if other than .tppli<ant
crlERcAP.01r
• CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 PERMIT #: ELC96-0400
DATE_ ISSUED: 11/19/96
PARCEL: 2SI04BA-04700
SITE~ ADDRESS— : 1.3884 SW MARCIA DR
SUBDIVISION. . . . : CASTLE HILL #2 ZONINC.:R-12 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :O80
Project Description: Install two branch circuits
------------------
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- ------MISCELLANEOUS------
1000 SF OR LESS. . . . : 0 0 – 200 amp. . . . . . . . 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 – 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 – 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM! SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
_...-._.__SERVICE/FEEDER- . _- -_-.---BRANCH CIRCUITS----- ----ADD' L INSPECTIONS__._
0 – 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 – 400 amp. . . . . . : N 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 – 600 amp. . . . . . : 0 FA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
(3O1. - 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION------------.-- ..--
1000+ amp/volt. . . . . : 0 >-4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLAS, AREA/SPEC OCC. :
Owner: ------------------------------------------------------- FEES ------------------
KTRBY type amount by date recpt
11884 SW MARCIA PRMT $ 40. 00 .TMH O6/21/96 96-280849
5PCT $ 2. 00 JMH 06/21/96 96-228OB49
TIGARD OR
Phone #:
Contractor: -----------------_---------------------------------_---_---_----------
RED' S ELECTRIC CO INC $ 422. 00 TOTAL
2002 SE CLINTON ST
REQUIRED INSPECTIONS
PORTLAND OR 97202 Ceiling Cover Eler-t' l Final
Phone #: 503-233-6467 Wall Cover _
Reg #. . : 04443
This permit is issued subjea to the regulations contained in they _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signatuioe
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not starte "141w�ff
a within 180 days of issuance, or if work is suspended for more
than 10 days. I#ued Ry
--OWNER INSTALLATION ONLY------------ --•---------------.
} The installation is being made on property I own which is not intended for
J :ale, lease, or rent.
m OWNER' S SIGNATURE: DATE:
INSTALLATION ONLY-------------.--------------
W
SIGNATURE OF SUPR. ELEC' N: DATE s
LICENSE NO:
Call for inspection – 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SAN Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # ov
Phone (503) 639-4171 Date Issued
CITY Off TIOARD FAX (503) 684-7297 ISr-Udd uj
TDD No. k503) 684-2772 t,
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ i Numbw of Inspootione per permit allowed
Address].3 vcyS, SCS' It- �r_���� Service included: Items r.ost(ea) Sum
City/State/Zip_1 Sri, 2z Ar— �_3 Ie. Residential•per unit 4
1000 eq It or les@ $'10 OG
Name for name of business)_ kt(.,4 Each additional 500 aq 11 or 1
portion thereof $25
Commercial❑ Residential Limned $25 q 2
Each Manuf'd ul'd Nome or Modular
Dwelling Service or Feeder sm 00
29. Contractor Installation only:
4b.Services or Feeders
f Inalallatan,sMerMron or rotor nlroi — 2
Electrical Contractor a il� _ '200 amps or leas $6000
Address, j _ t7^� 201 amps to 400 ami W 00 _ 2
CI State Zi 401 amps l0 800 ampr (12000 2
tY X_ p 801 ampa to 1000 limps ___� (180 00 _ 2
Phone N0. Over 1000 amps or VON$ $34000 2
Contractor's License No. Aj(; / 4-- Reconnect only 15000
Contractor's Board Reg. No. A'1'-/t/ �� 4c.Temporary Services or Feeders
t InMallatron,aMeralion,or relocation 2
Signature of Supr. Elec' 200 amps or hes Iso no 2
_ 201 amps to 400 turps $7500 2
License N0. 5 j Phon O. " 401 amps to I=amps $10000 —
Over 800 amps to 1000 volts
2b. For owner Installations: see W above
4a.Branch Circuits
Print Owner's Name New,sMerMron or extsrmion per penal
Address a)The fee for branch circuits with
Purchase of svice or Aesda►be. 2
City_ State_ Zip Earl,hrarch clerrard 1500 _
Phone No. b)The Ise for branch circuits wlthoo
The installation is being made on property I own which is pumho a of e1 vko or beds Ase 2
Firs)branch sta $3500 2
not intended for sale, lease or rent. r —1—
Each add4ionat brars;h circuit $500
Owner's Signature! _ 4e. Miscellaneous
(Service or feeder not included) 2
.9. Plan Review section (i/required): Each pump or irrigation circle -- $4000 2
Each sign or outline lighting "o 00
Signal circuit(s)or it limited energy 2
Please check appropriate item end enter ire In section 5B. panel,allarMion or extension $4000
IL 4 o•more remdential units in one structure Minor Labels(11 0) $10000
Service and feeder 225 amps or more rc 41.Each additional inspection over
H __System over 600 volts nominal
1) Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E C. Chapter Per inspection —� $3500
Per hair $5500
In Plant �_ $5500
Submit 2 sets of giros with application where any of the above
mapply. Not required for temporary construction services.
5. Fees:
6
W NOTICE Be. Enter total of above fees $ yU
J --- 5%Surchnrge(.05 X total fees) S 2-47
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtofai $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b.Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS subtotel $
COMMENCED. R-Trust Account 0 $
D`
Balance Due $
CITY OF TIGARr)
13126 S.W. HALL BLVD. ,l�, i (f v Ca
TIGARD, OR 97.:23
I By
L
IMPORTANT f ERMIT NL-ICE
RED'S ELECTR"_t, CO INC
2002 SE CLINT01 ST
PORTLAND OR 9720.
EI&i,i:lludl Sigriatury Fuini
Permit # . . . . : ELC96-0400
Date Issued. : 11/19/96
Parcel . . . . . . : 2S104BA-04700
Site Address : 13884 SW MARCIA DR
Subdivision. : CASTLE BILI. #2
Block. . . . . . . . Lot : 080
Zoning. . . . . . . R-12 PD
Remarks :
Install two branch circuits
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
a OWNER: ELECTRICAL, CONTRACTOR:
KIRBY RED'S ELECTRIC CO INC
N 13884 SW MARCIA 2002 SE CLINTON ST
TIGARD OR PORTLAND OR 97202
Phone # : Phone # : 233-6457
Reg #. . : 04443
w
xe( #zo59s
S*Iu&r e o ervi g e�'f ctric an
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171, ext. #310