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Permit . - CITY OF TIGARD 4.00. DEVELOPMENT SERVICES ELECTRICAL PERMIT PERMIT #: ELC2000 -00409 SSUED: 07/21/2000 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S136CB 08600 SITE ADDRESS: 11032 SW 81ST AVE SUBDIVISION: HERB + PEGGY'S PLACE ZONING: R -4.5 BLOCK: LOT : 028 JURISDICTION: TIG Project Description: Two 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: JOHNSON, ROLAND J + PRISCILLA (GARY) COOPER ELECTRIC 11032 SW 81ST AVE 11845 SE 34TH ST TIGARD, OR 97223 MILWAUKIE, OR 97222 Phone: Phone: 653 -8803 Reg #: SUP 2965S LIC 00042918 ELE 3-191C FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT JMT 07/21/200C $42.85 0003880 5PCT JMT 07/21/200C $3.42 0003880 Total $46.27 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 or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE � 47 (xi 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: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day 08%02/99 MON 09:40 FAX 503 598 196D CITY OF TIGARD liti CITY OF TIGARD ��p� Plan Check a - __ z ___� Electrical Permit A • ' �' .Y' ESP V „� Rea Sy 13126 SW HALL BLVD. TIGARD OR 97223 7 , LQO® Date Re JUL gate toe o P.E. Phone (503) 639 -4171, x304 Inspection 503 639 -4175 Date to DST Ins P t ) Print of rUNjTY DEVELOPMENT Permit G -4X) Fax (503) 598.1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _ Number of inspections per permit allowed Name (or name of business) loo Lct,vd .�io( -fn/ 5o/V Service Included: Items Cost Sum Address //0.32 .S g .57 4a. Residential - per unit City/State/Zip %j Gtz-/L d OR , 972023 1000 additional � less sq, ft. or ° 3 117,75 4 Commercial ❑ Residentl Limited Energy of S 6�0 t Each Manufd Home or Modular 2a., Contractor installation only: Dwelling Service or Feeder $ 72,75 2 (PrIor,to,permit 1$auance, appNcants must provide contractor license 4b. Services or Feeders - -- information for COYdata bass), . Installation; alteration, or relocation ElectriceLContractor c-e � � L� Zoo arnpo or leas _ _ $ 84.25 2 Address // S` �� .51-, 207 amps (0 400 amps S 85.50 _ 2 `LcvArJ �t'1 P ,State �.QZ . p .2 401 amps to 800 amps $ 128.50 City 2 y �o Zi 601 amps to 1000 amps S 102.50 2 Phone No ( / /C - 653 / 7 3 Over 1000 amps or volts $ 363.76 2 f 1 ,i t0. / ^ /4)C (05 4 / / 6 . Reconnect only S 53.50 2 Elec. Cont. Uce. No. �5 -- /y/ C.- Exp.Date /d - / - e 0 4c. Temporary Services or Feeders OR State CCB Reg. No.- 4 9 v g Exp.Date - 7 - 27 - D/ Installation, alteration. or relocation COT Business Tax or Metro No. Exp. Da - .. -4 205 amps or lees -- $ 53.50 2 • 201 amps to 400 amps $ 80.25 2 ` Q vu' Signature of Supr. El _ 401 amps to 600 amps $ 107.00 2 V Over 600 amps to 1000 voles, a ✓%i see "b" a bove. --- 77./7 7 7 -7- 9-- License NoP 9 b .�� Exp.Date /c) -,/- o I 4d. Bra nch a bov te Phone No. 43 New, altsration.or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or . feeder fee. Print Owner's Name Each branch circuit 5 6.38 2 i Address b) The fee for branch circuits wtfitoot parches. of service City State Zip or feeder fa. Phone No. First branch circuit $ 37.50 37- Each addltlonal crane► circuit i $ 5.35 , 5% 3.. 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 _ ___ $ 42.76 Owner's Signature Each sign or outline lighting 5 42.75 Signal clrcult(e) or a limited energy panel, alteration or extension $ 60 00 3, ;Pin Review section (if r'equired): * - MIiior Labels (10) $ 107.00 Please check appropriate Item and enter fee in section 5E1 4f. Each additional Inspection over 4 or more residential units in one structure the allowabte.in any of the above Service and feeder 225 amps or more Per hour Per hour ion $ 50.00 $ 50.00 System over 800 volts nominal in Plant 5 50.00 Classified area or structure containing special occupancy as s / described in N.E.C. Chapter 5 Fees: 8 Enter total of above fees $ * Submit 2 sets of plans with application where any of the above apply. $" , 15e, Surcharge (.05 X total fees) $ 1 Not required for temporary construction services, Subtotal $ _ 56. Enter 25% of Pine 8a for NOTICE Ptan Review if required (Sac, 3) 9 PERMITS BECOME VOID IF WORK OR CONSTRUCTION.AUTHORIZED SttbtOdtf $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS 0 Trust Account ii '2/-i AT ANY TIME AFTER WORN IS COMMENCED. Total balance Duo S ' < < /!sits orms\electric. doe / kl 5.e. 4 ' c o co 339 �.ge/Re 5 = S'._ / -.2oo/ 1 CITY OF TIGARD BUIL;�DING INSPECTION DIVISION MST 24 -Hour Inspection Line: 63 Business Line: 6 4171 BUP Date Requested `J- 7 AM PM BLD Location / / 6 3 Z 5 t✓ 8I SA' ' Suite .. MEC Contact Person Ph Co ffy j f Z- PLM Contractor R io --e-fGi Ph � 3 580 3 SWR BUILDING`. , : ` Tenant/Owner ELC 6 -OO q0 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN - Crawl Drain Inspection Notes: / L Slab - SIT d !-2-T Post & Beam n Ext Sheath /Shear VY�4' Int Sheath /Shear Framing Insulation Drywall Nailing Firewall ,#".- Fire Sprinkler —' Fire Alarm 3 Susp'd Ceiling 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 & Beam Rough In • Gas Line Smoke Dampers Final RT FAIL ELECTRICAL Service Rough In a e UG /Slab Low Voltage Fire Alarm 1 0 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 II O r I Inspector ` . _ _ --- Ext Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION* MST -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 W` BUP Date Requested � 'w AM PM BLD Location /t S tti (1 Suite MEC Contact Person Ph PLM • Contractor 614/ Ph (45 3S e) 3 SWR ��// BUILDING'' • Tenant/Owner 06014'L 6g7 9FZ3 ELC a 7ODe eo C 7 0 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 Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 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 & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL Iai IEt.'IT llt Service Rough In UG /Slab Low Voltage Fire Alarm PASS PART spiv SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ,,�; y j / Fire Supply Line [ r�ease call for reinspection RE: /I f �-3�c3 — t� 0 7i0 ? [ able to inspect - no access ADA t J� Approach /Sidewalk Date � �I / PTV Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.