Permit CITY OF TIGARD ELECTRICAL PERMIT
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1, DEVELOPMENT SERVICES DATE ISSUED: 5/9/00
`'J PERMIT #: ELC2000 00238
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2S1 11 AD -16000
SITE ADDRESS: 14972 SW 91ST AVE
SUBDIVISION: MALLARD LAKES ZONING: R - 4.5
BLOCK: LOT : 026 JURISDICTION: TIG
Project Description: Installation of one branch circuit, Job No. 01491.
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: 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:
DANIELSON, MARK A + SHARON E WEST SIDE ELECTRIC CO INC
14972 SW 91ST AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
231 - 1548
Reg #: LIC 13306
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 5/9/00 $37.50 0002018 Elect'I Final ORIGINAL
5PCT DEB 5/9/00 $3.00 0002018
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0080. You may obtain copies o s or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE 9 0P ISSUED Y: IkaZ■14-(.4. OWNER INSTALLATION ONLY
The installation is being made on property I own'which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRA TOR INSTALLATION ONLY
A '
SIGNATURE OF SUPR. ELEC'N: `-) .% � � DATE:
LICENSE NO: 1 55Le S
Call 639 -4175 by 7:00pm for an inspection the next business day
MAY -08 -00 06:37 PM WEST SIDE ELECTRIC 503 736 0677 P.01
� SIT . OF TIGARD Electrical Permit A • • ation Recd a I-ft _
!131 SW HALL BLVD., Recd Bl ry_ 4-,IC 'TIG'• RD OR 97223 Date Recd — �S�v
I i Date to P.E. ----
{
Rho e (503) 639 -4171, x304' Date to DST
I ! Ins.':ction (503) 639 -4175. Print of T. pe 1 Permit &e —� da3$
Fax 503) 598 - 1960 Incomp or Illegible w not b : <ccepted Celled
I
I–
. b Address: 4. Complete Fee Schedule Below:' •
•
%P am of Development Number of Inspections permit allowed •
am: (or name of business) ` .?, 2�i1�Mr ei 'j Service Included: Items Cost Sum Z
` r /IATdd : - "/ � 1 72. S'4/ le ,( , 4a. Residential per unit
I CtiryiS •te/Zip • 7;5 4 i "cV i OR 972 z r 1000 sq, ft. or less $ 117.75 4
Each additional 500 sq. ft. or
I, portion thereof $ 2835 1
q om ercial ❑ Residential Limited Energy $ 60,00
1 Each Manufd Home or Modular
/a. ontractor Installa only: Dwelling Service or Feeder _ S 72.75 2
. 1(Orlor • permit issuance, applicants must provide contractor license 4b. Services or Feeders
i Inform non for COT data base). Installation, alteration, or relocation
lectr :l Contractor A)4.0 ( ■ ti 5-/ E. TT 4 e)e- 1'; C , . 200 amps or less S 64,25 2
ddre s,— r 'c
' / < •- L 7 -e 201 amps to 400 amps S 85.50 2 —
dd i ty G2/ 6 5 ,- , < State • '(. Zi p if �4�/ 401 amps to 600 amps $ 128,50 2
'' 11 801 amps to 1000 amps S 192,50 - 2
hon= No, ,l.3/ / $ 7^ Over 1000 amps or volts $ 363.75 2
j b N 3 L/4 ) Reconnect only $ 53,50 2
i. l ec, ont. Lice. No. 2'/1 2e,-/its Exp.Date /U/ 1 14.:_o sc. Temporary Services or Feeders
R S :te CCB Reg. No. I 3.10 Exp.Date 3 `//L' Installation, alteration, or relocation
OT : usiness Tax or Metro N . R 7 Exp,Date • r e 200 amps or leas S 53.50 2
I 201 amps to 400 amps S 80.25 2
Cigna re of Supr, �lec'n r� 401 amps to 600 amp $ 107.00 2
l Over 800 amps to 1000 volts,
L)cen: = No.
Z .S : Exp.Dete /0/// o a" "b" above.
Fihon: No. 3/- /..c" y 4d. Branch Circuits •
New, alteration or extension per panel
a) The fee for branch circuits .
412. ' or owner Installations: with purchase of service or
� f • feeder fie.
hrint • wner's Name • Each branch circuit $ 5.35 2
Iddre S b) The fee for branch circuits
• without purchase of service
ity S tip 'or feeder ree. • it
I First b ranch circuit � S 37,50 3
, hon < No
Each additional branch circuit $ 5,35
The i : tailation is being made On property I own which Is not de, Miscellaneous
Ir ten•. -d for sale, lease or rent.' (Service or feeder not Included)
Each pump or Irrigation circle $ 42.75
urine s Signature Each Sign or outline lighting $ 42.75
Signal circuit(a) ore limited energy
"Ian Review section ( q i required):* :5 Mi panel, alteration or extension $ 60.00
nor Labels (10) $ 107,00
Plea •: a check appropriate Itejn and enter fee in section 58. 4f. Each additional Inspection over
e or more residential units in one structure the allowable In any of the above
1 Service and feeder 225 amps or more Per Inspection $ 50.00
Per hour $ 50.00
System over 600 volts norhlnal In Pant $ 69.00
•
• Classified area or structure containing specie! occupancy as
described in N.E.C. Chapter 5 5. Fees:
i Be, Enter total of above fees 5 3 •,_
• 8u. It 2 sets of plans with appl`cation where any of the above apply. 5% Surcharge (.05 X total fees) $___—/......7.r
Not - quired for temporary con ruction services Subtotal S
I NOTIQg Sit Plan Review If rectulred (Sec. 3) $
P ERM i S BECOME VOID IF WOR OR CONSTRUCTION AUTHORIZED Subtotal $
i l NO COMMENCED V i\ThW 190 ;`1 S, OR IF CONSTRUCTION OR /�
WOR • IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS LLL'ddd Trust Account 0 7 Y� ...1 AT AN TIME AFTER WORK IS COMMENCED. Total balance Due 7 $ • 1 1 0
1 000c90 /g
1;\dsis\ rms\clectric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested S/2- 3 AM * PM BLD
Location ` 4117 2i 77 4- / 4 -' Suite MEC P, J0
Contact Person Ph PLM
Contractor Ph SWR
BUILDING ` Tenant/Ow r, y— g /c5 7 ELC 00 0) eOZ,j
Retaining Wall ELR
Footing
Foundation Access: ✓_ ��� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear "
Framing
Insulation
Drywall Nailing L/ C 41Z -
Firewall
Fire Sprinkler
Alarm
Fire Alarm
Susp'd Ceiling L7
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 111- •c--" i
Gas Line
Smo a Dampers
ASS ART FAIL
CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
F ART 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 reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk D Inspector /
Other Ext
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.