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Permit CITY OF TI GARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00236 44 4011A 4 DEVELOPMENT SERVICES DATE ISSUED: 05/09/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC -01300 SITE ADDRESS: 15930 SW 74TH AVE SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L BLOCK: LOT : 035 JURISDICTION: TIG Project Description: Install two (2) branch circuits. 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 ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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: LA RUSSO CONCRETE CHRISTENSON ELECTRIC INC • 15930 SW 74TH 111 SW COLUMBIA TIGARD, OR 97224 STE 480 PORTLAND, OR 97201 Phone: Phone: 241 -4812 Reg #: LIC 000458 SUP 3289S PLM 2468S ELE 26 -34C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT GEO 05/09/200C $42.85 0002006 Elect'I Final 5PCT GEO 05/09/200C $3.43 0002006 Total $46.28 ()RI This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE '/77�irs_cie ISSUED BY: / 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: �n.J ` DATE: 5 .e LICENSE NO: SS 73 t/ . Call 639 -4175 by 7:OOpm for an inspection the next business day CITY OF TIGARD RECEIVED Plan Check # Electrical Permit Application 43125SW HALL BLVD. Recd By TIGARD OR 97223 MY ® Date Recd Date to P.E. Phone (503) 639 -4171, x304 COMMUNITY DEVELOPMENT Date to DST Inspection (503) 639 -4175 Print of Type Permit # Oce - co 274 Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: CKTS FOR HVAC 4. Complete Fee Schedule Below: Name of Development LARUSSO CONCRETE Number of Inspections per permit allowed Name (or name of business) LARUSSO CONCRETE Service included: Items Cost Sum Address 4a. Residential - per unit City/State/Zip TIGARD OR 97223 l 3 � 5'9` 1000 sq. ft. or less $ 117.75 4 p Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial a Residential ❑ Limited Energy $ 60.00 QUESTIONS? CONTACT KEITH 781 -1480 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders • information for COT data base). ' Installation, alteration, or relocation _ _Electrical Contractor CHRISTENSON ELECTRIC, INC. 200 amps or less $ 64.25 2 Address 111 SW COLUMBIA, SUITE 480 201 amps to 400 amps $ 85.50 2 City OR Zip 97201 -5886 401 amps to 600 amps $ 128.50 2 ry p 601 amps to 1000 amps $ 192.50 2 Phone No. 503 241 -4812 $p 1E Over 1000 amps or volts $ 363.75 2 Job No. 64 -12372 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 26 -34C Exp.Date 10/01/00 .4c. Temporary Services or Feeders OR State CCB Reg. No. 458 Exp.Da - 5/, /03 Installation, alteration, or relocation COT Business Tax or Metro No. g 46 E .•.D. e12/31/0C 200 amps or less $ 53.50 2 / 201 amps to 400 amps $ 80.25 2 401 amps to 600 amps $ 107.00 2 Signature of Supr. Elec'n 4....L. Over 600 amps to 1000 volts, 3 � Ex 10 / 01 / 01 see "b" above. License No. ) '� p.Da e Phone No. 503 241 -4812 4d. Branch Circuits New, alteration.or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owners Name Each branch circuit $ 5.35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit 1 $ 37.50 37.50 Each additional branch circuit 1 $ 5.35 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy . • 3. Plan Review section (if required):* panel, alteration or extension $ 60.00 Minor Labels bels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ 42.85 * Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) 8% $ 3.43 Not required for temporary construction services. Subtotal $ 46.28 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 46.28 IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 46.28 i:\dsts\forms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 67 AM PM BLD Location 1 S 1 0 l sAi(i - Suite MEC Contact Person r1 A Ph - 7g t - / P1 O PLM Ol t Contractor ,( S 4_,.JS r,"/ Ph SWR BUILDING: `. -' Tenant/Owner ELC Zd -60 Z Retaining Wall ELR ZOY)D -CX)/ 63 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab - c C2. SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall � Fire Sprinkler ��-r � Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL C...07-: PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final . PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRIC_) Service Rough In UG /Slab Low Voltage Fire Alarm in- i 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 Date _ Inspector _ / Ext Other y Final PASS PART FAIL I '• N 4 T REMOVE this inspection record from the job site. • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 1 Date Requested S� / 000 AM PM BLD Location [ S 13(' 1 Suite MEC Contact Person I/\ Ph 80; - -/ 3 S 2 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 2.CCO -002 Retaining Wall ELR 2030 — 00 1 03 Footing Access: Foundation 7 _ FPS Ftg Drain � � ® SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler , Fire Alarm Susp'd Ceiling E Roof M sc: E L(' 2 27 o - t) ' Final - _ ®l 05 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 Gas Line Smoke Dampers Final PASS PART FAIL E IC ) Service Uo ugh irk_ fSia6 Low Voltage Fire Alar � 4:0 10 T FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for r. spection RE: Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date 1 J Inspector - ,t,�.' Exst Other Final PASS PART FAIL D u NOT REMOVE this inspection record from the job site.