Permit CITY OF T I GA R D ELECTRICAL PERMIT
P ERMIT #: ELC1999 -00679
DEVELOPMENT SERVICES DATE ISSUED: • 11/12/1999
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134AB -00300
SITE ADDRESS: 11304 SW IRONWOOD LP
SUBDIVISION: ENGLEWOOD ZONING: R -4.5
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Install 2 branch circuits in single family dwelling.
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:
LASCINK, GARTH V AND RUBY E BOONES FERRY ELECTRICAL
11304 SW IRONWOOD LOOP PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Phone:
682 -4936 t► 11 A
Reg #: SUP 00088 ORIGINAL.
LIC 00088482 � y f"�
ELE 3 -223C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT KJP 11/12/199 $42.85 99- 319728 Elect'l Final
5PCT KJP 11/12/199E $3.43 99- 319728
Total $46.28
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 `7 c ISSUED BY:
i
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: 1 r l / Z /9'9
LICENSE NO: 3/70 S
Call 639 -4175 by 7:00pm for an inspection the next business day
•
•
' CITY OF TIGARD Plan Check 4 _
13125 SW HALL BLy(� s 9 1999 Electrical Permit Application Recd By
Date Recd
TIGARD OR 97223 �1t1 ,• gELOK I Date to P.E.
Phone (503) 639 -417 Date to DST
Inspection (503) 639 -4175 Print of Type - Permit ire L C I qq 9 -O06 79
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) 6A'47 - ,/1 4 etSo /1i a Service included: Items Cost Sum I
Address 1 / 'J'C>Y S i f,) J?' t u}i9 O J.1 o 4a. Residential - per unit
City/State/Zip -- 7 - 11 a�'rd o/€ 97a .g. / 1000 sq. ft. or less . $ 117.75 4
Each additional 500 sq. ft. or
portion thereof S 26.25 1
Commercial ❑ Residential
Li mned Energy $ 60.00
Each Manurd Home or .Modular
2a. Contractor instal only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT dab base). Installation, alteration, or relocation
Electrical Contractor BOONES FERRY ELECTRI 200 amps or less $ 64.25 2
Address P 0 Box 6.2 8 201 amps to 400 amps $ 85.50 2
City W i l s o n v i l l mate O R A> Zip 9 7 0 7 0 401 amps to 600 amps $ 128.50 2
ry p 601 amps to 1000. amps $ 192.50 2
Phone No. 5 0 3- 6 8 2 -49 3 6 ' OI c ?ver 1000 amps or volts 5 363.75 2
Job No. B ,r/ Reconnect only _ $ 53.50 2
Elec. Cont. Lice. No. 3 - 2 2 3 C Exp.Date 1('O1/00 4c. Temporary Services or Feeders
OR State CCB Reg. No. 8 8 4 8 2 Exp.Date 2 / 2 3 /01 Installation, alteration, or relocation
COT Business Tax or M: s , ,No. 0 2 8 5 1 Exp.Date 8 /1 / 9 3 200 amps or less $ 53.50 2
` 201 amps to 400 amps 5 80.25 2
Signature of Supr. El - 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts.
License No. 317 0 S Exp.Date 10/1 / 01 r see "b° above.
Phone No. 6 8 2 -49 3. 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 Owner's 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 circuit / $ 37.50 37. So
Each additional branch circuit / $ 5.35 6 of
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
Owners Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ - 60.00
3. Plan Review section
(. Minor Labels (10) 5 107.00
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
Per Inspection $ 50.00
Service and feeder 225 amps or more 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 $ 42,867
* Submit 2 sets of plans with application where any of the above apply. $ Ib %.Surchar (.05 X total tees) $ 3, 11.3
Not required for temporary construction services. Subtotal $ J dq 8
5b. Enter 25% of line 5a for
• NOTICE ,. Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN. 180 DAYS. OR IF CONSTRUCTION' OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. I Total balance Due $ ../ 6 a g
7(
i• tds5ttfonnstetcctric.doc .
TTC'nri ,r fl rrrn nn ...... .-. . _... _.. ._ _ .__
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested j(/ (5 (7g AM PM BLD
Location (j, (1 J(5Xi... J c d, L '1 D Suite MEC
Contact Person -fPaa-e'34_1_.( 6rre 5 1 € ( Ph se4 PLM
Contractor ( Ph SW
BUILDING ; e H "y; : Tenant/Owner ELC-' /??9 7 ,
Retaining Wall
Footing Access:
Foundation - FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: (1, J ¢ 4JC�"u�
�K�/ SIT
Post & Beam
Sheath /Shear et.- 61- L (.4I
Int Sheath /Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling CC YCu L f' Fr') ✓ [^ () Y'1. Q C 'Q 4
Roof
Misc: ' -
Final l /, €7A
PASS PART FAIL ^ / K ��' , , q � c
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
FrEM L'
'ervrce
Rough In
UG /Slab
Low Voltage
Fir
final
PASS 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
Fire Supply Line [ ] Please call for reinspection RE: A [ ] Unable to inspect - no access
ADA r
Approach /Sidewalk
Other Date ! G ( � Ins pect or �, , _ /1,i /� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.