Permit CITY OF TIGARD
°NPx DEVELOPMENT SERVICES ELECTRICAL. PERMIT
7 /e nnn " 'b6�,i
-A l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: ELC 97- 055
DATE•ISSUED: 01/31/97
PARCEL: 2S112DB -00400 -
SITE ADDRESS...: 07337 SW ('.ABLE. LN ,. -°•- • ,., . • .
SUBD°LVISION_ .. :' •SO, PACIFIC TI.GARD IND-. PARK - ZONING :I -L
BLOCK_.........: LOT.- ono........ :4
Project Description: Installation of 1 branch circuit
- -- RESIDENTIAL UNIT - -- -- -TEMP SRVC/FEEDERS---- MISCELLANEOUS
1000 SF OR LESS... _ : 0 0 - 200 amp..; - - _ _ - ': 0 PUMP/IRRIGATION....: 0
EACH ADD' L 500SFo.. :;. 0 ,, :. , . 201 -• 400- amp_ . e ...: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY...._: 0 401 - 600 amp.......: 0 SIGNAL /PANEL.......: 0
' MANF_ HM /, S.VC /FDRa n 0v7,,• t 80 +am•ps - -1..000 ; vo;l.t . 0; . ; 'MINOR LABEL ,(10) - - o..: 0
- - --- SERVICE /FEEDER - -- - - -- BRANCH CIRCUITS --- -ADD'L INSPECTIONS-- -
• 0 ; , -. 2OO,,.•ampe. o , . .•� ° W /,SERV;ICE,. ORS, .FEEDER,° ,. a PER; INSPECTION.....{. : 0
201 - 400 amp......: 0 1st W/O SRVC OR FDR.: 1 PER HOUR............: 0
401 - 600 amp..... _ .: a . EA ADD:' L BRNCH. CIRC: 0 IN PLANT. . _ , .: 0
601 - 1000 amps,...: 0 - - - - -- PLAN REVIEW SECTION • - - - --
1000+ amp /vo•lt, n ;.,,0-,;, . ,)74. RES_ UN,ITS., _ .. _ . m > 600 VOLT NOMINAL..:
Reconnect only..._.: 0 SVC /FDR )= 225 AMPS. -: CLASS AREA /SPEC OCC.:
Owner: - - -- '— - - - - FEES --- - - - - --
0 D TED SUPPLY type amount by date recpt
y! .A
BLE LANE F RM :T $- ,,, 35, 00. DRA 01/31/97. 97-289768
5PCT 1.75 DRA 01/31/97 97-289768
• TIGARD OR 97224
... .F on e , ' #to ' 503 -620 -7050 0
Contractor-::
ELECTRICAL DIMENSIONS INC $ 36.75 TOTAL
PO BOX 12146
3981.. S.W;• WILLAMS : :.AVE .,. _ „ REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Underground Cove
Phone #: 503 -282 -7255 Wall Cover Elect'1 Service
Reg #..: 44008
I lli & 111
This permit is issuedk subject to,�the ,regulations. contained in the _
gbh .;
Tigard . Municipal Code, State• of Or•e..SpecialtysaCodes :and, all other - ^m.i t ` e, Signature -
applicable laws. All work will be done in accordance with
approved plans. :This per®.it wi -l1 eupire,.if work44is_not,1started;
/
within 180•- days issuance; •ordf work. is .sus,pended far more . . . _A.,. . Ii i/ A. At _ e-P
than 180 days.. ..... . .. . . - -. .- -- • I + ' ued By , ;
-----OWNER INSTALLATION ONLY-- - - - - -- -- •- --
The installation is being. made.- on• property° I owm which, is not intended for
sale lease, or rent. .
OWNER'S SIGNATURE :, _ .. - DATE :.
-- CONTRACTOR INSTALLATION ONLY - - • - - ---
SIGNATURE, C1F SUP._,., ELECT' Ni_ ' >, ' • • . DATE,
LICENSE NO:
. - - .Ca.l,l. fo.r,,.inspect._i.o•.n;, -- 63974175 ...
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
,. Tigard, OR 97223 Planck/Rec. #
,' "M1l ,a Permit # CLCi7`
�� + ( Phone (503) 639 -4171 Date Issued
"°'` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1 1. Job Address: 4. Complete Fee Schedule Below:
Name of Development CO /SOLI bAT‘) 5t1 PAW
y Number of Inspections per permit allowed
Address 7x37 S eW r K 2$ L- E L H , Service included: Items Cost(ea) Sum
City /State/Zip 71 &iK1) OQ, t 4a. Residential - per unit 4
1000 sq ft. or less $110.00
Name (or name of business) C 0 NSOU,DATTD <,IUPPIX Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial 14 Residential ❑ Limited Energy $25.00
Each Manut'd Home or Modular 2
4 t t04 5 Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Con ractore LE,C -� Rjc L D V' EfS6 NS 200 amps or less $60.00 2
Addr ss ( Mil Kt t W I (.I . I A Gv f . v, 201 amps to 400 amps $80.00 2
City VOQ�'t', State O t�,, Zip ! 9 7 2,Z,i
401 amps to 1 00 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. a1 I- 7 155 Over 1000 amps or volts $340.00 2
Contractor's License No. ; .►�. l (7(4 Reconnect only $50.00
Contractor's Board Reg. No. (4- ('5(CtP 4c. Temporary Services or Feeders
•
, � Installation, alteration, or relocation 2
Signature of Supr. Elec'n , /� /%_-__ / 200 amps or less $50.00 2
License No. / Phone No.2 2 -7 ?S3 201 amps to 400 amps $75.00 2
1 /�,� p'7 401 amps to 600 amps $100.00
M tir10 117 X 7 - t / Over 600 amps to 1000 volts
2b. For owner installations: see •b• above
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The fee for branch circuits with
r�
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. a0 2
not intended for sale, lease or rent. First branch circuit $.00 J / 2
Each additional branch circuit $5.00
. Owner's Signature • 4e. Miscellaneous
(Service or feeder not included) • 2
3 Plan Review section (if required): E ach pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limded energy 2
. Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
i 4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspectio $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 35 °
NOTICE 5% Surcharge (.05 X total fees) $ I ,'70
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account #
$
Balance Due $ 36 . ?S
wadtantloNNec xm.app •
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
q q BUP
_ Date Requested I�,, 5 -5 1 I AM PM BLD
Location 133 V LL J • Suite MEC
Contact Person Ph -8Z -70S--S'?r PLM
Contractor p Ph � C*1 W SWR / -
BUILDING' F i wner (o, + S- s n
U ELC '7 4 092
Retaining Wall ELF 97 — 00SS)
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation w / /
Drywall Nailing f LYe✓1 lip( F Ai f9p 'e Xc'c.T 17rr v' ✓
Firewall k A Fire Sprinkler or LU & r <C / .S / , l7S'SA
' 4 —
Fire Alarm ^^ j
Susp'd Ceiling I (2 /
Roof
Misc: S Y - _ Co / .i C' r
Final
PASS PART FAIL
PLUMBING; :1;
Post & Beam L /
Under Slab l b s e l') [/ /` - - L L' - 9 (O - D
Top Out �-
Water Service /5 J C 9 7- Q C S
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL`; °r.:..
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL t l
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm -
ASS 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: [ ] Unable to inspect - no access
ADA /
Othe�ach /sidewalk Date 6 - 2-- 0(f --c ? ( q Inspector G � A Ext
Final
PASS PART FAIL DO. NOT REMOVE this inspection record from the job site .