Permit . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00305
DEVELOPMENT SERVICES DATE ISSUED: 5/24/99
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 114AB -14400
SITE ADDRESS: 09390 SW JULIA PL
SUBDIVISION: KNEELAND ESTATES NO.2 ZONING: R -4.5
BLOCK: LOT : 103 JURISDICTION: TIG
Project Description: Add a first branch circuit to an existing 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: 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:
JOHN CAM RIO GRF ELECTRIC
9390 SW JULIA PLACE 15460 SE PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: Phone: 503 - 829 - 4146
Reg #: LIC 001015
SUP 3003S
ELE 26 -878C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT GEO 5/24/99 $35.00 99- 314630 Elect'I Final
5PCT GEO 5/24/99 $1.75 99- 314630
Total $36.75
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.
Permit Signature: 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: r J DATE: '> a � ? Q
LICENSE NO: G 3043 -5
Call 639 -4175 by 7:00pm for an inspection the next business day
•
"05/24/1999 13:25 5038295747 GRF ELECTRIC PAGE 01
\,
i RECEIVED
CITY OF TIGARD MAY 2 41fjgctrical Permit Application in Check a
13125 SW MALL BLVD. Rec'd By
TIGARD OR 97223 COMMUNITY DEVELOPMENT Date Rec'd
a"
Phone (503) 639 -4171, X304 - 1 -- 1 Date to P.E.
Inspection (503) 639 -4175 Print or Type Date to DST
Incomplete or illegible a ��
Fax (503) 684 -7297 P g ble wi ll 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) � � D k Ca r� k Service Included: Items Cost Sum
Address g g j, J V 3 �/ J14 � A PL , 4a. Residential - per unit
City /State/Zip 1 �y 4 L 'I') Z.-2-V-- 1000 sq. ft. or leas $110.00 4
Each additional 500 sq. ft. or
Commercial 0 Residential 111---- porter thereof $25.00 :_ 1
Limited Energy $25.00
Each Manurd Home or Modular
2a. Contractor installation only: Dwgging Service or Feede $66.00 _ 2
(Attach copy of all current Ilcenesa 4b. Services or Feeders
Electrical Contractor t I . tt 44 t:. Installation, alteration. or relocation
Address j 4, tr) Pq 200 amps, or less $e0 00
t'G 201 amps to 400 amps $80.00 _ 2
City Ai , f in c State h IL Zip 9O ti...? 401 amps to 600 amps - _ $120.00 2
Phone No. $ L4 - 9-r mpo amps 2
fi 801 amps to 1000 5180.00 2
Job No. r Over 1000 amps or volts $340 2
Elec. Cont. Lice. No. 4 ,242 - S Exp.Date Reconnect only $� 2
OR State CCB Reg. No. / jrt.13 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. . w? 2 Exp.Date Installation, alteration, or relocation 4 • 200 amps or less $50.00
Signature of Supr. Elec'n 201 amps to 400 amp $7s.00 ----- 2 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 011_.S Exp.Date see "b" above.
Phone No. 8 zji - , . a
f te 4d. Brandt Circuits
New, alteration or estenslon per panel '
2b. F ®r owner installations:
a) The fee for branch circuits with
Print Owners Name
pure/lase fa f �M� or
Address Each branch circuit 55.00 2
City State Zip b The fee for branch circuits
without purchase f
Phone No. service rvice or feeder red.
First branch circuit f $35.00 3 2
The Installation is being made on property I own which Is not Each additional branch circuit 55.00 2
intended for sale, lease or rent. 4e. Mlscellrnaotte
Owner's Signature (Service or feeder not included)
Each pump or Irrigation circle $40.00 - 2
Each sign or outline lighting $40.00 2
3. Plan Review section (If required):" Signal clrcult(s) or a limited energy
panel, alteration or extension $40.00 2
Please check appropriate item and enter fee In section 5B. Minor Labors (10) $100.00
4 or more residential units In one structure 41. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 800 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: 3 " _
Not required for temporary construction services. Sa_ Enter total of above fees $ S 7
5% Surcharge (.05 X total fees) $ -4- S
NOTICF Subtotal $
• bb. Enter 25% of line ba for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it r@guired (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR WORK Subt I $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY .4 4 3 3 '� /
TIME AFTER WORK lB COMMENCED. 9 runt Aocount If 16/, `r
oral balance Due
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 g Buu � siness Line: 639 - 4171
-1 ( r ( 1 BUD
Date Requested A M PM BLD
Location l t o Y . 1 A C am - • Suite MEC t 2 9 - (?_ /9
Contact Person V�Cst -- Ph Zg 3 T/1
PLM
1( p
X
Contractor Ph SWR a�j co BUILDING ` ;`: ` A , '.. Tenant/Owner ELC J - I `Z ( co 30S
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 ` 9 e
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling "9 oo,Ted ` `✓A-/-0
Roof
Misc:
Final
PASS PART FAIL
PLUMBING ..v _..E
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P • - • RT FAIL
CH PIICA , .:;
Rough In
Gas Line
Smoke Dampers
PART FAIL
E_L'° _PT 7 r► =u
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
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 A_
other Date ! •— f / / - J C r Inspector Ext
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the, job site.