Permit •
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC99 -0035
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/15/99
PARCEL: 2S115RA -00100
SITE ADDRESS...:161O0 SW 108TH AVE
SUBDIVISION ....: W I LLOWB ROOF. FARM ZONING: R--25
BLOCI- ,........... LOT.......... ..: 036 JURISDICTION: TIC
Project Descri. pt i on : Alteration to electrical 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- -1 'Z'OO volts..: 0 MINOR LABEL ( 10) .... : 0
----SERVICE/FEEDER---- - - -.- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp......: 0 W /SERVICE OR FEEDER: 0 PER INSPECTION.....: 0
' 201 - 400 amp......: 0 1st W/O SRVC OR FDR. 1 PER HOUR..., ........: 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLAT............: 0
601 -- 1000 amp— — 0 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
GREAT WESTERN PROPERTY MNGMT type amount by date recpt
1525 SW PARK PRMT $ 35.00 DLH 01/15/99 99-- 312225
SUITE 101 SPCT $ 1.75 DLH 01/15/99 99- 312225
PORTLAND OR 97201
Phone #:
Contractor: - - - - -- _-._-_..-.___.-_.-
FARWEST ELECTRIC INC $ 36.75 TOTAL •
• 7402 NE 189TH AVE.
REDUIRED INSPECTIONS
VANCOUVER WA 98682 Rough-in Elect' 1 Final
Phone #: 360- 892 -1022 Elect'1 Service
Reg #..0 000623
' 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 more 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 952-0@1-0010 through OAR 952-w1-1987. You nay obtain a copy
of these rules or direct questions to DUNG by calling (503)246-1987.
Permittee Signature: /1/9 Issued By:_4j r
-. _ OWNER INSTALLATION ONLY --- - -- - -- - - -_
The installation is being made on property I own which is not intended for
sale, lease, or rent. ``//
OWNER'S SIGNATURE: N - DATE:
CONTRACTOR INSTALLATION O II_Y- -.__--- _.- _- _. - - -___
SIGNATURE OF SUPR. ELEC' N: _071 /9 / � ' — DATE:
LICENSE NO:
+ +-t- + + + + ++ + + + + + +-t + + + + + +•f ++++++++++++++++++++++++ + + ++ ++ + + + + + + + + + + + + + +++ + + ++ + + + ++ i-
Call 639 --4175 by 7:00 p.m. for an inspection needed the next business day
+• f-+- fr±+++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + ++ + + + ++ + + + +- + ++ + ++ + + ++
•
CITY OF TIGARD • RECEIVED Electrical Permit Application Plan Check'#
13125 SW HALL BLVD. Rec'd By ••
TIGARD OR 97223 JAN 15 1999 Date Rec'd //5-/9
Date to P.E. -----
Phone (503) 639 -4171, x a&\ iMUNITY DEVELOPME Date to DST -
Inspection (503) 6394175 Print or Type Permit # ELe99 -0035
Fax (503) 684 7297 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) DURI ,4y.tt "f}Rk /47:1 /s Service included: Items Cost Sum
Address /0 0 . (.J l - S r I ' 4a. Residential - per unit -
1000 sq. ft. or less $110.00 4
City /State /Zip ^ Each additional 500 sq. ft. or
Commercial ❑ Residential LS / Limited thereof $25.00 1
Limited Energy $25.00
' Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor FA-/it t)EST E(C%4 z, t.NC- Installation, alteration, or relocation
0Z NE l9 q•t-t_ #kl E 200 amps to less $60.00 2
Address 7 201 amps to 400 amps $80.00 2
City Pit/Cacti/64c State -W l Zip L 84 v y 401 amps to 600 amps $120.00 2
Phone No. i-S[� cr -Z-5 -St 5 601 amps to 1000 amps $180.00 2
l 9 76, - / (7( Over 1000 amps or volts $340.00 2
Job No. l _/ Reconnect only $50.00 2
Elec. Cont. Lice. No. 37 - 2-7.7 e-- Exp.Date l C5 i ' ✓ y
OR State CCB Reg. No. !o Z-3 5 Exp.Date m q " 4c. Temporary Services or Feeders
COT Business Tax or Metro No. c t I: 5- SExp.Datee 12 O 9°/ Installation, alteration, or relocation
�/ "��u[1��5`-� 200 amps or less $50.00 2
Signature of Supr. Elec'n p 401 amps to 600 amps $75.00
100.00 2
Over 600 amps to 1000 volts,
License No. /4t14+6 S Exp.Date ,76/C) ( see "b" above.
Phone No � 7.; : �,: ��` , .. .. ;:r"�,, -.. .. - :�, �,
- ,1; `dck BrancCicuits {'A . ', ; f
.. . ,r
., ' .� • ti . m;.y,1\�, :;° ,,, ''; � ^ ; �- ;9` �+ tite . h'
. , t. + . .
• ... - � , 1
�, ° - =...i.;', ;, New alteration.owezte per panels . .; .
. J ?• �' ''•:S ` a'° - 7 ' ', 4iti _ ..... e S'... w. _.3i Mt �- I,
k : 4. " e
2b: For o I 1 ` . • • T li R
e:fee for; bra; nch•clreuits -wftli
.. purchase.of service or .
Print Owner's Name. .. _ . . . _ • .. .. _ feeder fee. . . -
Each branch circuit $5.00' 2
Address
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. CO • First branch circuit / $35.00 35 60 2
The installation is being made on property I own which is not Each additional branch circ $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:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ t
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 # $ 3-6 7
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP wer
4 5 - Date Requested �� /f 9 AM PM BLD
Location /6 /M) /2F- Suite MEC
Contact Person Ph PLM
Contractor Ph ,510 SWR
BUILDING;.. ; Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: (- J1 Z
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing 2 3 -C7 lip I oL 3 4- t h4 cm%
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 brains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
cELECTRICA k. ;
Service
Rough In
UG /Slab
Low Voltage
ire Alarm
PART FAIL
h
S . tr
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 --(7) Inspector Ext
Final -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.