7113 SW MAPLELEAF STREET i
A'
..1
W
IV
1V
a
r
mmrl
rD
r
I
-- 7113 S.W. Mapleleaf Street -
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 —--- --
__ — Date Requested_— —_— AM —PM BLD
Location , Suite MEC
Contact Person - -� ) _ Ph ' U 7�' /� _ PLM _
Contractor Ah---r G t [-- �c l y—, Ph — __. SWR -----------
BUILDING Tenant/Owner C /� v , E:LC _� y (�
Retaining Wall EL.R
F,oting Access
l ,)undation 1 FPS
Ft Drain l j �J _)J l__-
g SGN
Crawl Drain Inspection Notes �----�--�-
Slab SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Freming
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -- --- — -- -- - -- - ----- —
Fire Alarm
Susp'd Ceiling
Roof v?
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
GasLine ---_ -- ------• ---------__---.---------- ---___.__
Smoke Dampers
Final.-- -- ---- - --_---®----_�._—_------_.�_�_
AS9 RT, FAIL
(
ELECTRICAL
UG/Slab _ — --- _------------ --- --- ---
Low Voltage
FireAlarm ---- — --------- --_—_ -- ------ ----__. .__..__.. -- ._.—--
PASS PART FAIL ---- — ------ ---- — ---------—
Backtlll/(iradlllg --- -- _ —'--- — ----'—`--- ---
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _required before next ispection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I ]Please call for reinspection RF —__— __— _ ( )Unable to inspect-no access
ADA
Approach/Sidewalk
Date Z) Inspector 11/ =-� �,Ext
Other _ -- _ _.
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TI�ARD ELECTRICAL PERMIT
PERMIT#: ELC2001-00420
DEVELOPMENT SERVICES DATE ISSUED: 8/16/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136AB-01900
SITE ADDRESS: 07113 SW MAPLELEAF ST
SUBDIVISION: METZGER ACRE TRACTS ZONING: R-4.5
BLOCK: LOT : 005 JURISDICTION: TIG
Proiect Description: Replace 200 amp or less service panel.
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 _ AD_D'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION: —
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA AD7'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLANREVIEW SECTION
1000+ amplvolt: >=4 RES UNITS: — —i Y> 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS CLASS AREA/SPEC OCC:
Owner: Contractor:
STAFFORDSHIRE INVESTMENTS INC AARON EASTSIDE ELECTRIC
7353 SW GORDON LANE 302 7 NE 10 FH
WILSONVILL.E, OR 97010 PORTLAND, OR 97212
Phone: 503-709-1460 Phone:
Reg #: ELE 26-1065C
LIC 138474
SUP 2958S
FEES — Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 8/16/01 $80.30 2720010000( Elect'I Final
SPCT CTR 8/16/01 $6.42 2720010000(
—� Total $86.72
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 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)
246.6699 or 1-800-332-2344
Permit Signature: Issued By: '
r
OWNER_INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ---��--� _-- _-- HATE: ----_—•----_
CONTRACYOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N
LICENSE NO: — --- --- --- -- -- ------
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received: .-,
/, , G/ Permit no.:
City of Tigard Wojcct/appl.no.: Expire date.
Cavo./Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97221 Date issued: By: Recciptno.: _-
Phone: (503) 639-4171 Pa rnent t
Fax: (503) 598-1960 Casr fife no.: Y YPc
Land use approval:
1 I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addiutin/alb ralirm/nplaccnu•nt U Other: ----- __ J Partial
JORSITEINFORMATION a;-
Joh addres�s:: /� % L �_-E�c •r Nl,1g.. nu.: -- tiuilr mt.: Tax map/lax lot/arcoum riaLot: Block: Sub ivision: ---
Project name: _ Description and location of work on premiws:
Estimated date of conlplc:tion/iits action:
,lob no: �_ Fee Max
_ // Descrlplion Q". lel total no.imp
Business name: �'IZp/) <<fiaS 'C CAW le Newreshtrntlai-sint;lrormulti-family per
Address: p 4 """ dwellingunir.hniudrsaltarixdRarar,e.
City: r 1tZv State:6A ZIP: 2-/2,- 9ervicelncluded: --�-
I Ixxt.or)sq.fles, 4
F
Phone: ax: E-mail: — -- - -
f ach additional 5011 sq.ft.or portion thereof
B no.: -;7 < Elec.bus.Ile.no:
CC /V Limited energy,residential 2
Limited energy,i on-residential
City/metro tic.no.: _
g Each manufactur i home or modular dwelling
Service and/or feeder 2
Signature of su rvising electrician(required) bate g- J--�-
rvices or feeden-Installation,
Sup.rlect.namclprrntl: Licenseno:a9f>?Salteration or relocation:
PROPERINOWNFIR 200 amps on less 2
201 amps to 41x)amps 2
Name(print): 401 amps to 600 amps _ z
Mailing address: 601 amps to Ilxx)amp, 2
City: - StatC: LIF': �- over 11100 amps or volts 2
-- Recounecionly _
Phone: Fax: E-mail:
Temporary services or reedem-
Owner installation:TI)c installation is being made on property I own In,tauation,allention,orrelocation:
which isnot intended for sale,lease,rent,or exchange according to 200 atttpN of less -
ORS 447,455,479,670,701. 2(Lamps to 41x1 nrnps —_ _ 2
Owner's signature: _- Pall-: _-- _ 401 10 6tx)am
&M 10 NBranch clrcalts-new,alteration,
or extemIon per panel:
Name: _ A. hec for hunch circuits with purchase of
Address:
- —T service or feeder fee,each branch circuit
— -- — - �7
L.IP:- H Fee for branch circuits without purchase
Stale:
1�lt Y_ _ ._ �_ -- of service or feeder fee,first branch circuit: 2
Fax: f: nl:tll: Each additional branch circuit _
Mbc.(Sen Ice or feeder not Included):
Each um or irrigation circle _
U Service over 225 angrs-cominercial U Health Calc lacdny Each sign or outline lighting --
'
U service over 320 amps-rating of IR2 U Hazardous location Signal circuits)or a limited energy panni — —'
familydwellings U Building over 100)0 square feet four or F
U Systemover60(Ivolts nominal rcresidentialunitsinonestnveture alteration.or extension` 2
rurr
U Building over three stones U Feeders,4(1(1 amps or more *D(scri ttion - _. _---
U occupant load over SW persons U Manufactured structures or RV park Facts additional Inspection over the allowable In any of the above:
U Fgress/lightingplat, U Other: _ -- petinspection --
Submit__seta of plane with any of the 2brnvie Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee.....................$
Not all junsdirtions accept credit cant+.Meas call jurisdiction nor marc tinfon.)Ation. Notice:This permit application Plan review(at _- %) $
U Viso U MasterCard expires if a permit is not obtained
__.j_�_ within 180 days after it has been State surcharge(8%) ....$ ,
Credit card number _ ------------ Expires
accepted as complete. TOTAL ......................
Nuns of ceictholder av shown on credit card $
t'rdholderilgrwure - Am u 440-4613 tM1arCOM 1
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 ALI-SYSTEMS)
Service included: Iterns Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq.fL or less $145 15 ,_ 4 ❑ Audio a,id stereo Systems
Each additional 500 sq it or ❑
potion thereof $3340 -_, 1 Burglar Alarm
Limited Energy $15,00
Each Manufd Home or Modular1:1Garage poor Opener'
Dwelling Service or Feeder ,�— $9090 --___
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
2nn amps er less $80.30 &.3 C _ 2Vacuum Systems'
201 amps to 400 amps — $106.85 2
1-1
401 amps to 600 amps _ $160.60 _ 2 Ottio,
6o 1 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 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 relocation (SEE OAR 918-260-260)
200 amps or less $66,85 2
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, ❑ Audio and Stereo Systems
see"b"above.
Branch Circuits ❑ Boiler Controls
Now,alteration or extension per panel
a) rhe fee for branch circuits ❑ Clock Systems
with purchase of service or
feeder fee. -- ❑
Each branch circuit $665 _ 2 Data Telecommunication Installation
b)1 he fee for branch circuils
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
I-irst branch circuit $46.85 _ ❑ HVAC
Each additional branch circuit $665
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
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 ❑ Landscape Irrigation Control'
panel,alteration or extension $75.00 —
Minor Labels(10) _ $125.00 ._ ❑
Medical
Each additional Inspection over
the allowable in any of the above $62 50 ❑ Nurse Calls
Per Inspection _Per hour $62.50_ -_ 1:1In Plant $7.17 5 Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other i _ --
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 applicalion _.__-- Fees:
Total Balance Due $ -- Enter total of above fees :
❑ Trust Account p 8%Slate Surcharge f
-- "- -_-- T.+tal Balance Due f
i.\dsts\fnrms\cic-fccs.doc I0/09/00