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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00222 �lj� DEVELOPMENT SERVICES DATE ISSUED: 4/14/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102AB -01801 SITE ADDRESS: 09450 SW TIGARD ST OLD SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P BLOCK: LOT : 056 JURISDICTION: TIG Project Description: Reconnection of electrical service. 59 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 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 ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: ALLRED, DOUGLAS R ELe..G c_ do/LA-kW 5820 SW CHESTNUT / /S( ( (o BEAVERTON, OR 97005 Phone: Phone: 639 4 4; 1 .7 Reg #: 3 4, FEES' Required Inspections Type By Date Amount Receipt Elect'l Sery Elect'l Final PRMT DRA 4/14/99 $50.00 99- 314490 SPOT DRA 4/14/99 $2.50 99- 314490 Total $52.50 • This Permit is issued subject to the regulations contained in the Tigard Muniapa I 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 the - -s or direct questions to OUNC at (503) 246 -1987. Permit Signature: b / • j Issued :y: _ - • 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 I STAL ATION ONLY SIGNATURE OF SUPR. ELEC'N: �� ; v t ' /� DATE: LICENSE NO: /g /4 Call! 639 -4175 by 7:00pm for an inspection the next business day eft , Terripo i6rru-� ciiom o' /oq /99 4ttrouj h oil/ i 40/9 1 116,4p CITY OF TIGARD Electrical Permit Application Plan C 13125 SW HALL BLVD. RECE1vi Rec'd y TIGARD OR 97223 Date Recd y- Date to P.E. Phone (503) 639 -4171, x304 APR 13 1999 Date to DST Inspection (503) 639 -417 Print or Type Permit# LA 97- ooA. ? - .. - Fax (503) 684 -7297 GU Et MMUNITY oEBrplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development r �, I Number of Inspections per permit allowed Name (or name of business) )J 1� (n7 X ORS Service included: Items Cost Sum I Address NSO SW i l5&rCi Sired- 4a. Residential - per unit City/State/Zip xTi ©R G 1.g.•. 3 Each additional it ional 500 sq. ft. or or less $11 0.00 4 ry P QQ t Each addit Commercial J Residential El Limited thereof $25.00 1 Limited Energy $25.00 Each Manui'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) , 4b. Services or Feeders Electrical Contractor ler E . G 0)rn ( r' .rny Installation, alteration, or relocation Address 11A © 514 reinbu d • J 200 amps less $60.00 2 - 201 1 amps t to o 400 amps $80.00 2 City State d(2. -/Zip q7. 401 amps to 600 amps $120.00 2 Phone o. 51,3j 4o3q.- 7 601 amps to 1000 amps - $180.00 2 Job No. 591 (r, 1 Over 1000 amps or volts $340.00 h 2 Elec. Cont. Lice. No. X4' C Exp.Date DI Reconnect only 1 $50.00 T .oa 2 OR State CCB Reg. No. 3741 D Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. 19 g 7 Exp.Date 1 I t 9 9 Installation, alteration, or relocation /�� 200 amps or less $50.00 2 - $75.00 Signature of Supr. Elec'n ��` ��'� 401 amps to 600 amps $100.00 2 r I Over 600 amps to 1000 volts, License No. �/t S Exp.Date 1C101 1C0 see °b" above. Phone No. (S o3J 4,39- 46e). 4d. Branch Circuits New, alteration or extension per panel 212. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circ $5.00 2 - b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on pro • .1 41.4., q`'i E ach additional branch circuit $5.00 2 intended for sale, lease or rent. CZ= 4e. Miscellaneous (Service or feeder not included) Owners Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional Inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. S. Fees: . _ _ 5.75) Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ 5a NOTICE • Subtotal $ 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ . s0 Total balance Due I: \DSTS \ELC96.APP Rev 9196 5/11/99 Activities for. Case #: ELC1999 -00222 9:29:57 AM • Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 4/13/99 DRA DONE No Hold DRA 4/14/99- ELCC003 Permit created 4/14/99 DRA DONE No Hold DRA 4/14/99 ELCC730 Elect'I Service 4/14/99 4/14/99 No Hold DRA 4/14/99 ELCC799 Elect'I Final 4/14/99 4/14/99 4/16/99 CD DONE No Hold CD 4/16/99 repair meter terminations ELCC500 (F)lssue permit 4/14/99 DRA DONE No Hold DRA 4/14/99 ELCC800 Case Finaled 4/18/99 AKJ DONE No Hold AKJ 4/18/99 • • • • • Page .1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 qC/ BUP Date Requested / (o ` / AM )( PM BLD Location qu5() 1) 64 $ - Suite MEC Contact Person (en Ph (039 -cHio z7 PLM Contractor Ph SWR BUILDING Tenant/Owner i vv fri S` &La U ELC I ! q — Q 0Z Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall AA/ �� D Nailin g � ,� � Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling l i✓l�li Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out 1 Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL LECT AL) Service Rough In UG /Slab Low Voltage Fire Alarm in er PART FAIL • Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Ext Other Date �` -/� -9y Inspector Final PASS PART FAIL DO NOT REMOVE.this inspection record from the job site.