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16640 SW MONTEREY LANE NI I13a31NOW MS 09% z J W ad W H z 0 IL c m 16640 SW MONTEREY LN CITY OF TIGARD BUILDING INSPECTION DIVISION" MST 24 Hour Inspection Line: 639-4176 Business Line: 639-4171 SUP Daae Requested —AM—// PM BLD Location �OY�� f1,� Ln Suite MEC rte_ Contact Person 1n� -�� O(An Ph 401&'VX11 PLM Contractor _ Ph SWR BUILDING Tenant/OwnerELC ,?,06V0031 Retaining Wall ELR Footing Access: Foundation / FPS Ftg Drain `' L9 e-le Crawl Drain Inspection Notes: SGN Slab 31T Post& Beam Ext Sheath/Shear f 1 � Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarr,i Susp'd Ceiling AL, _ 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 R Beam Rough In Gas Line — — Smoke Dampers Final — — -- PASS PART FAIL LEC RI - — — a' Sery p: ou U(U/Slab Low Voltage J Fire Alarm � rn ASS PART FAIL W .J Backfill/Grading -- Sanitgry Sswer Storm urain [ ] Reinsp,:-tion fe-of$ —_ required before next inspection. Pay at City Hal!, 13125 SW Halt Blvd Catch Basin Fire Supply Line [ j Please call f reinspe 'on RE: ��— [ j Unable to Inspect no access ADA Approach/Sidewalk Date Inspector Ext Other _ — Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. ELECTRICAL PERMIT • C IT O F T I C A R D PERMIT#: ELC2000-00311 ^ DEVELOPMENT SERVICES DATE ISSUED: 06/08/2000 13125 SW Hall Blvd..Tigard,OR 97223 (503)6394171 PARCEL: 2S116AD-05900 SITE ADDRESS: 15640 SW MONTEREY LN SUBDIVISION: KING CITY NO. 12 ZONINC•: BLOCK: 17 LOT : 002 JURISDICTION: KIN Prosect Description: Install a frist branch circuit. _ RESIDENTIAL UNIT _ TEMP SRV'CIFEEDERS _ MISCELLANEOUS 1000 SF OR LESS: I - 200 amp: PUMPIIRRIGATION: 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 FOR: 1 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: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: WRIGHT, ELMA E TR FOSE CITY ELECTRIC CO INC 16640 SW MONTEREY LN 4012 NE CULLY BLVD KING CITY, OR 67224 PORTLAND, OR 97213 Phone: Phone: 287-6164 Reg#: SUP 2127S LIC 00003567 ELE 26-113C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT GEO 06/08/2.00C :$37.50 0002765 Elect'I Final 5PCT GEO 06/08/2000 $3.00 0002785 ORIGINAL Total $40.50 _J f his Permit is issued subject tc the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws. d FJl work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of Issuance,of if won is suspended fo,more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cente Those Fa- rules are set for`,h in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordirect questions to OUNC at'503) fn 2461987. %� PERMITTEE'S SIGNATURE G71 ISSUED BY: ( L /y" // m �j 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: .l DATE: LICENSE NO: — Call 639-4175 by 7:00pm for an Inspection the next business day CITY OF TIGARD Electrical Permit Application Plan RCheck 1ecd Be 31,26 SW HALL BLVD. R�C��yE Date Recd TIGARD OR 97223 �1 Date to P.E. shone(503)639-4171, x304 Ma's 3 ZO�u.Vd��Date to DST Inspection (503)639-4175 Print of Type WillaPermit 0� _ , rte" Fax (503) 598-1960 Incomplete or illegible will not be A alled ---- �- - - - - f 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name(or name of business) -� 0 VX le* rvice included: Items Cost Sum Address 4a. Residential-pe:unit 1000 sq ft or less S 117.75 4 City/State/Zip_ Ltvl a Lk _ Each additional 500 sq.R.or portion thereof $ 26.25 1 Commercial ❑ esidential Limited Energy S 60.00 Each Manufd Home or Modular 2a. Contractor installation only. Dwelling Service or Feeder f 72.75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders Information for COT data PYe�se). Installation,alteration,or relocation Electrical Contractor 1 " S eJ '_ 200 amps or less $ 64.25 2 Address 201 amps to 400 amps $ 65.50 2 city ►�, tt) State r�`,�� -7 a 401 amps to 600 amps $ 128.50 2 y---t-� J 801 amps to 1000 amps $ 192.50 _ _ 2 Phon'.No _ ]_ � Over 1000 amps or volts S 363.75 _ 2. Job No. � L. Reconnect only S 53.50 2 Elec. Cont. Lice. No. Exp.Date c)1:) 4c.Temporary Services or Feeders OR St?[e CCB Reg. No. �- _Exp.Date U L-70 Installation,alteration,or relocation 2110 amps or less _ $ 53.50 2 COT Business Tax or Metro No lU L Exp.Date v` ?01 amps l0 400 amps _ $ 60.25 - 2 Signature of Supr. F_lec'n_/I X I 401 amps to 600 amps - S 107.00 2 - Over 800 amps to 1000 vo;ts, L icense No. a2 I .Zis Exp.Date ( U� see"b"above. Phone No b l lu M 4d.Branch Circuits New,aderation or extension per panel a)The fee for branch circuits 2b. For owner installations: with p•rrchsse of service or feeder fee. Print Owner's Name EE^.h branch circuit - $ 5.35 2 Address b)Thk fee for branch circuits --- without purchase of service City _State Zip or feeder fee. I Phone No First branch circuit l $ 37.50 Each additional branch circuit S 5.35 _ The installation is tieing made on property I own which is not 4e.Miscellaneous intended for sale, lease or rent. (Service or feeder not Included) I - Each pump or irrigation circle - - $ 42.75 - Owner's Signature Eads sign or outline lighting S 42.75 Signal circutt(s)or a limited energy aRiIf required):** panel,alteration or extension _ _ $ 80.00 3. Plan Review section : Mi � �• Q � nor Labels(10) - $ 107.00 U) Please check appropriate iters and enter fee In section 5B. 4f.Each additional Inspection ower _ 4 or more residential units in one structure the all twable In any of the abovrt Service anh(pe d feeder 225 amps or more ction S 50.00 �! I Per- - Per he ur _ S 50.00 - m System over 600 volts nominal In P'.mt S 5900 Classified area or structure containing special occupancy as WI described in N E C Chapter 5 5. Fees: 6o.Enter total of above fees S _ * Submit 2 sets of plans with application where any of the above apply. t'r#A Surcharge(.05 X total fees) S Not required for temporary construction services. Subtotal $ 5b.Enter 25%of line 8a for NOTICE Plan Review H required,(Ser, 3) S PERMITS BECOME VOID IF WORK OR CONSTRUCTInN AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRI IL T YEN OR - WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF.W DAYS ❑ Trust Account# AT ANY TIME AFTER WORK IS COMMENCED Total balance Dtte $ i�dsls\form%\elcctric.doc 1111N-07-00 WED 11 :4F AM City of King City FAX:503 639 3771 PAGE 1 KING CIZ`Y" 15300 FM 116th Avenue,King City,�Jregnn 97824-2893 r Phone;(608)639-4082•FAX(008)689.9771 4 Notice To Contractors Working In Ding City Due to an intergovernmental agreement with the City of Tigard, many building related permits forprojects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT RE )UIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff«•ill then create the permit, issue the permit, and perforin inspections. Please indicate on the permit application whether you would like the Tigard staf'to call you when the permit is ready foi issuance or whether you prefer it to be mailed withaut any notification. Any incompiete or illegible application will be returned to King Ci.y staff for correction and no processing will o.cur until a complete. legible application is received. If your permit application DOES REQUIRE PLAN REVIEW,this form must be signed by a King City staff person. King City staff will simply sign this form indicating land use approval.. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are available at 639-4171 Ext. 304 should you have any questions concerning submitral requirements, All permit fees will be assessed and collected at the City of Tigard. a The City of King City hereby authorizes applicant to pursue permits at the City of Tigard OC cc Building Department for the following project. _ ct�L MJ located at: 13W L King City Representative (c- -7-- CXR I DSTS19MAr Doe