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Permit A CITY OF T ELECTRICAL PERMIT � DEVELOPMENT SERVICES DATE I ISSUED: C98-0720 /08/98 PARCEL: 1S135DB -04100 SITE ADDRESS...:11330 SW 92ND AVE SUBDIVISION.... :DOGWOOD RIDGE ZONING:R -4.5 BLOCK. LOT .............:014 JURISDICTION: TIG Project Description: Installation of a 200 AMP service. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS ° 0 0 - 200 amp ° 0 PUMP /IRRIGATION ° 0 EACH ADD'L 500SF...: 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 INSPECTIONS - -- . 0 - 200 amp . 1 W /SERVICE OR FEEDER: 0 PER INSPECTION.....: 0 201 - 400 amp......: 0 1st W/0 SRVC OR FDR.: 0 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 > =4 RES UNITS........: ) 600 VOLT NOMINAL..: Reconnect only 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.: Owner: -- FEES . JOSEPH H BUI type amount by date recpt 11330 SW 92ND PRMT $ 60.00 GEO 12/08/98 98- 311378 TIGARD OR 97223 5PCT $ 3.00 GEO 12/08/98 98- 311378 Phone #: Contractor: ALFA ELECTRIC $ 63.00 TOTAL 13365 SW BARLOW RD REQUIRED INSPECTIONS --- BEAVERTON OR 97008 Rough -in Elect'l Final Phone #: 626 -0325 Elect'1 Service Reg #..: 121141 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 permit will expire if work is not started within 180 days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 -1987. You may obtain a copy . of these rules or direct questions to OUNC by sr ling (503)246-1987. --- Permittee Signature: L j Issued By- I ' OWNER INSTALLATION ONLY The installation is being made an property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTR; -TOR I STALLATION ONLY -• - -- SIGNATURE OF SUPR. ELEC'N: • A A �i DATE: /0 • LICENSE NO: 5 O — + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ • CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By Date Rec'd TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Print or Type Date to DST Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit# b S - 67ad � Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _goo A ',re Cp! /P,'a.., Number of Inspections per permit allowed Name (or name of business) � - (i / Service included: Items Cost Sum I Address / / ?3e 56) 471f`1 �/ !'9/ 4a. Residential - per unit 9F---O'9___ 1000 sq. ft. or less $110.00 4 City /State /Zip / Each additional 500 sq. ft. or portion thereof $25.00 1 Commercial ❑ Residential Li mited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all c rrent licenses) 4b. Services or Feeders Electrical Contractor a . - ,a II. ' , Installation, alteration, or relocation 200 amps or less $60.00 6 ..4.._. o 2 Address e"/ 4GcY ir 201 amps to 400 amps $80.00 2 City - r State Oie Zip ,...-,`' 401 amps to 600 amps $120.00 _ 2 Phone No. - 62 6 -n ? S 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. _ ?L f -I.1 ?C Exp.Date 4U2 OR State CCB Reg. No. /2/14' Exp.Date R1 / 9 /Gt) 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation ac,/,--,,i,„.---------- 200 amps or less $50.00 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 00 2 Over 600 amps to 1000 volts, License No. J/3 2c7p Exp.Date /a/G /4/ see "b" above. Phone No. 626 h --n-32 S 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $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 property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's 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. 5. Fees: j _ �_ Not required for temporary construction services. 5a. Enter total of above fees $ Ce 5% Surcharge (.05 X total fees) $ 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 # ,• (� Total balance Due $ I: \DSTS \ELC96.APP Rev 9/96 CITY-OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �` 7 / BUP /72.1 Date Requested / c -1()Ii AM PM BLD Location /1330 ?QA) ?c Suite MEC Contact Person - 1 Ph quo - 19 3 ? PLM Contractor Ph /OWL. SWR BUILDING Tenant/Owner dap c f7 7, Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: _ SGN � uLy Slab ���� ,,,, / L A � � � - � ,y� SIT Post & Beam Ext Sheath/Shear Ow /Q.12, Cali. . L L 1 GV (/La Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ��✓I:' Fire Alarm Susp'd Ceiling Roof /i 6 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 v. ELECTRICAL - eMce UG7S1a Low Voltage F - larm 'ASS 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 Other Date / 2_/ 7 1 3 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.