12963 SW Tearose Way 12963 S.W. TEAROSE WAY 1 OF 1
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested ///'al- /q% A.M. P.M. MST: _
Location /`•?—` (e 3 __ .,?_ — —L., .)q-4 / BU?:_
tenant• Spite: r/� Bldg: MIC:
-t- -- - to r/ � •l
r,
TIC- — — Phone: 7 --___33;4-
__3 PLM:
Ower: �./ ---'- - Phone. ELC: 9 -7e/
1 LR:
SIT:
BUILDING BLDG(con't) PLUMBING MECHANIC Al. ELECTRICAL -- SITE
Site Post/Bann I'ost/Neam Post/llearn Cover/Service Sewer/Storm
rooting Roof I1ndFUSlah Rough-In Ceiling Water Line
Slab Framing fop Out Oas Linc Rough-In 11(i Sprinkler
Foundation Insulation Sewer Itoos.lNIC t Reconnect Vault
!Ism!I Mmp I bywall Storm Furnace Temp Service MISC.
Masonry "eil'aig Rain Thain A/C IIG Slat
Shear:ihcath Fire Spklr/Alm Crawl/Found I k I teat Pump I Vol:
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved oved Not Approved
FINAL FINAL FINAL FINAL,
_ 2c`?A_ CQ- __of. P4 NEL
.Z�ti_ A f=c.N►2 - Fu5ET' coM A'i wi ti N4M L
--
co Cali for reinspection C>119ispection Ice of.., .___ aired nest lion II linable to inspect
Inector _ -_- Date _ ._ _
lime( L - Page- —of
I _ __ _ _
A CITY OF TIGARD ELECTRICAL PERMITAiiiiii1
DEVELOPMENT SERVICES PERMIT *s ELC97-0591
DATE ISSUED: 08/29/97
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
PARCEL: 2S1O5BC-03200
SITE ADDRESS : 1c963 SW TEAROSE WY
SUBDIVISION :BULL f IOUNTA I N MEADOWS NO. 3 ZONING:R-E5
BLOCK : LOT • 166 JURISDICTION: URB
Project De scr i pt ion: ACO FIIIST IIINCH CIRCUIT TO EXISTING SINGLE FAMILY MELLING.
---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- MISCELLANEOUS-----
1000 SF OR LESS : 0 0 - 200 amp : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5O0SF. . . : 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 INSPE1TIONS-- -
0 -- 200 amp : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION . . . : 0
201 -- 4O0 amp : 0 1st W/O SRVC OR FDR. : 1 PER HOUR : 0
401 - 600 amp. : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT • 0
•
601 - 1000 amp : 0 -- PLAN REVIEW SECTION---
1000+ amp/volt : 0 ) 1s4 RES UNITS : ) 600 VOLT NOMINAL. . :
Reconnect only : 0 SVC/FDR > e 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: -- ---- _ - FEES _ . ..
JOHN RAZOR type amount by date recpt
12963 TEAROSE WAY PRMT $ 35. 00 GEO 08/29/97 97-298785
TIGARD OR 97223 5PCT $ 1. 75 GEO 09/29/97 97-29878`;
Phone It:
Contractor:
JPC ELECTRICAL SERVICES INC $ 36. 75 TOTAL
4120 SE INTERNATIONAL. WY
STE A-107 -------- REQUIRED INSPECTIONS --
MILWAUKIE OR 97222 Rough-in Elect' I Service
Phone M: 654-3325 Underground Cove Elect' 1 Final
Reg M. . : 093774
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within Ifill
days of issuance, or if work is suspender! for sore than 181 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification renter. Those rules are set forth in OAR 952-♦11-111 through OAR 952--I11-1917. You say obtain a copy
of these rules or direct questions to MC by calling I. 1987.
/
Permittee Signature : _ I ,.s'ipd Rye,
41,7 .
-- -- OWNER INSTALLATION ONLY - -- --The installation i ' being made on property I own which is not intended for
sale., leaise, or rent.
OWNER' S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY -------
SIGNATURE OF SUPR. ELEC' N: DATE: 01(/.707
LICENSE NO: 14(W -S _
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ I
Ia
■
(Age
}I.TY OF TICARD Electrical Permit Application PlanCheckN
'3125 SW HALL BLVD. Recd By
I.'GARB OR 97223 Date Recd
Date to P.E
:Hone (503)639-4171, x304 Date to OST
section (503) 639-1175 Print or Type Permit Neal q" - (3 Sri
(503) 684 7297 Incomplete or illegible will not be accepted Called_
1. Job Address• 4. Complete Fee Schedule Below:
Name of Developrnent_. Number of Insnectlons per nermlt allowed
Name (or name of business) x;,1'1 ill Ba 7 or /. l' Ser."ce included: Items Cost SumL
Address_"!i.�of -�3 t t 7k.A- r`o &� 4a. Residential-per unit
r 1000 sq ft or loss ?1 10 00 i
1 City/State'Zip_11Ott'`-�' 1 t'tn` 7 1 .-3 3 Fach additional 500 sq ft.or
' portion thereof $25 00 i
Commercial ❑ R lsidenlialP- a imited Energy $25 00
// Fach Manufd Home or Modular
Dwelling Service or Feeder _ $68 00
2a. Contractor installation only:
(Attach copy of all current Homilies) 4b.Services or Feeders
TI
Electrical Contractor L. t '` ( 4 f r c S ' Installation al.‘ration,or relocation
,, n�� l`� 200 amps or less $60 00 2
A !heseL[()t. SL JI -r a't /r r 1 201 amps to 400 amps __ $8000 2
City pl.uk.-.►..-at State (AK.. Zip ( /.1 7 y 401 amps to 600 amps
$120 00 2
Phone No__ 3 1 601 amps to 1000 amps $tap 00 2
Joh No. �, J"G.,�- , ) Over 1000 amps or volts --_ $340 00 2
Elec Cont Lice. No. '3(i-- 7)c- Exp.Dat:_ I y Reconnect only $SU o0 2
OR State CCB Req No C '1 3 7_7YExp.Date 4c.Temporary Services or Feeders
C"IT Business Tax or Metro No. _Exp.Date Installation,alier,dion,or relocation
• 200 amps r r less __ $50 00 _. _ 7
_�-- 201 amps to 400 amps $75 00 7
Signature of Supr. Elec'n l,- __ 401 amps to 600 amps $100 00 _______ 7
Over 600 amps to 1000 volts,
License No. Y ��i/' Exp Date see"b"above.
G,Phone No. , 5 4 . •i .) 1 4d.Branch Circuits
New.alteration or extension per panel
2b. For owner installations: a1 The fee for branch r'rrtilts with
purr haae of Fervlce or
Print Owner's Name, feeder fee
Address Eachbranch circuit —— S5 00 __ _ 2
t'1 The foe fni branch circuits
City_ State_ Zip _ without purchase of
Phone No service or feeds,lee. 1� Li i)
I est branch circuit -` $35 00V 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2 i
intended for sale, lease or rent 4e.Miscellaneous
IService or leerier nc.i included)
Owner's Signature __ Each pump or vngatron circl $40 00 _ 2
Each sign or outline lighting _.__ S40 00 - 2
3. Plan Review section (if required):' Signal circuitlsl or a limited energy
panel,alteration or oxtensir,n S40 00 _
Minor 1 abets 1101 $100 00
Please check sppropriate Item and enter fee in section 5B.
_ 4 or more residential units in one structure 4f Each additional I rspection 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 how _ $55 00
ac described in N E C Chapter r In Plant v $55 00 ____.
*Submit 2 sets of plans w.'h application where any of the above apply. 5. Fees:
Not required for temporary •onstruction services. Ss.Enter total ,1 air ye fees S s± - 0 Li
5 Surcha'le(05 x total fees) S —L_-5
►yOTICE Subtotal $
Sb.Enter 25 of line Si for
V F.RMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review 1i reQurr (Sec 31 S
NOT COMMENCED WITHIN 180 DAY-.OR IF CONSTRUCTION OR WORK Subtctal $
is SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED ❑ Trutt Account y -'_/ 1 S
l
Total balance Due
I\D5T54 I CrII,Ai." nak,nw,
w
mommiumminamil
RECEIVE[)
AUG 2 91997
COMMUNITY DEVEI�i►'h,
DEPARTMENT OF LAND IJSE &TRANSPORTATION
411% WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, LSBORO, 011 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/681-3699 or 681-3697
AO ( Q � S — k ,,� �,c, �,
-CY'a / 2 II.
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DEPARTMENT OF I AND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
0". COUNT1', INSPECT'ON REQUESTS: 503/840-3581/693-4415
lye OREGON
NOTICE This permit becomes null and vole II the work or construction for which it Is issued Is not commenced within IRO days Once construction has started
the permit becomes nun and vr,id I construction is interrupted for a period of ISO days I certify that the information presented by the applicant and
his agent or agents in support of tt is permit is true and correct to the best of our knowledge I acknowledge that the Building Department's reliance
upon taus and misleading informal or may invalidate this permit All provisions of applicable laws and ordinances governing the construction and use
rit this building nr atrucbrrs will be omplied with whether or not specified on the puns or noted on the plans correction sheets I acknowledge that
the granting of a permit does not grant authority to access private property nr to use easements I further actin,'wledge that the use or occupancy of
the structure or building permitted iiepende upon my calling for inspections al various times during the process of construction and the howling
inspection staff verifying compliant,'with the various codes Ute or occupancy of the building or structure permitted prior to approval by the
Building Department is solely at the risk of the applicant and such use or occupancy is revocable until all inspection requirements are satisfied and
approval is given by the Building Official I further acknow edge that a lien may be placed on the title of the property upon which the permit is issued
specifying that the use or occupancy of the building or structure is provisional and teem able until ie satisfaction of ell inspection requirements
APPLICANT'S SIGNATURE
I
WASHIF:GTON COUNTY
AO%
Departmcarrt of Land Uit.r &Transportation ELECTRICAL PERMIT
Electrical Inspection Sectiort
�
M n r---1
155 North First Avenue,113.,0-12 A P P LI CATI N �1
,1 Hillsboro,Oregon 97124
C
-
h • -lotion: (503)640-3470 rax: (503) 681-3993 1 C c.:4. 7�f
iosiiii
t'i.e_ASE PRINT •i. Permit //` .l j.
I Number V r7Uc7 1 -� f t.It' .19/
F'?ease complete all sections. 7.thio gh 5.
location t installation 4. Complete Fee Schedul�'belowr r
A � 1Z- b5 a1 �r` ,, lea te0Se Number of inspections per permit allowed
_ -
Building Service included: Items Cost(ea.) Sum
City �tl(I�c� ._ . Suite o. .. ------
Tenant Name A. Residential - per unit
Of cnmmerciali -- ------- '000 sq ft or less $110 00
i ach additional 500 sq ft
Map No. .-_--Tax Lot or portion thereof - $25 00
united Energy $25 00
Thomas Map Book: Page. _ Section i ach Manurd Home or Modular
Directions —_.__— -__.- -- Dwelling Service or Feeder $68 n,)
B. Services or Feeders
Commercial❑ Residential 1P, ,stallabon,alterations or relocation
JO amps or less $60 00
2a. Contractor installati n only: ?01 amps to 400 amps $80 00 ;
_c `,."-'10 401 amps to 600 amps $120 00
Electrical pntraclgi 1.- c C c .1 cd - << 001 amps to 1000 amps $ 50 o0
Address �l1-),() t 1}t t► ' 0`t � 4,01 Iver 1000 amps or volt $340 oO
City1 t 'ti le.,t State ,l ZIP 41f-
1 3-?1- ilernnnect nniy $50 00
M ( xS
Date Job Numbs
Property Ownera.211 il''iiC. Temporary Services or Feeders
Contractor's License No. i L tallabon arteratan or rnon
Contractor's Board Reg. No � 'OO amps or less ti`s+�r)0C617 Y 201 amps to 400 amps $75 00
401 amps to 600 amps $100 00
Signature of Supb I�.C'n t �. — J T 'T)vnt 600 amps to 1000 volts see"B above
License N 1 t 's s Phone No. -.�Y`. . 7.447—
FAX
.�4
FAX No cj 5r-.1 di? )..1 D Branch Circuits
alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or feeder fee.
Print C,r.nr,,Name r+ignrriNo Each branch circuit $5 00
bi The fee for branch circuits without
Address
purchase of ion*.or woo,fee �,� L.`
Lost branch circuit $'t5 00
City etas Tp Each add til branch, i rust $5 00
E. Miscellaneous(Service or Feeder not Inclurh ril
The installation is being made on property I own Each pump or xrigabon curie $40 30
which is not intended for sale, leace or rent. Each sign or outline lighting $4o 00
Signal cucwtls+or a limited
f,caner s r,rgrranue energy panel.alteration
_ or e•Imisrra, $40 On
•
3. Plan Reviel i section (it required) F Each additional inspection over the allowable
Please check appropriate item and enter fee in section °r+ in any of the above
4 or more residential units in one structure Per hour $55 00
Service and feeder. f100 amps or more In Plait $55 00
System over 600 vols nominal
Cla4sified area or structure containing special 5, Fees
occupancy as described in N.E.0 Chapter 5A. Enter total of above fees $ -3 S - o
Submit 2 sets of plans will application where any of the above 5% Surcharge ( 05 X total fees) $ 1 . 1 5
apply Not required for to nporary construction services Subtotal $
This permit her nrnro null and void If the wr,rt Author lied by the permit is not B. Enter 25% of line A for
ommenced wither iRn days from date of issuance of such permit or if it,. Plan Review if required (Section 3) $
wort;authorited is suspended or abandoned at any time iSir work is Subtotal $
c,,mn,enced for a pe,rod of IRO days Eiertrir at Permits ars non•refundabie ri Trust Ar,CnUnt a
and nomtranahnble i
For Inspections call Balance Due $ 71=5
681-3699 or 681-3698
24-hour recorder, one working day in advance of need Pt I'R . R q•,
I