Permit ! „.
CITY O TIGARD ELECTRICAL PERMIT
4� ,„ ry � ;i � , DEVELOPMENT SERVICES PERMIT #: ELC98 -0343
� �I DATE ISSUED: 06/25/98
:may- T11. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111CA -09000
SITE ADDRESS. ..:09990 SW KABLE ST
SUBDIVISION.... :GULF SIDE ESTATES NO 2 ZONING :R -7
BLOCK........... LOT....... °..... :034 JURISDICTION: TIG
Project Description: Swan
---- 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 60.1 +amps -1000 volts.: 0 MINOR LABEL (10) ...: 0
----SERVICE/FEEDER---- -- - -- BRANCH CIRCUITS--- -- - - -- -- -ADD' L INSPECTIONS--- -
O -- 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 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 ------ ---
CHRIS SWAN type amount by date recpt
9990 SW KABLE ST PRMT $ 35.00 JSD 06/25/98 98- 306831
TIGARD OR 97224 SPCT $ 1.75 JSD 06/25/98 98- 306831
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Phone #:
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Contract or --
THE ELECTRIC GROUP $ 36.75 TOTAL
4726 SE M"ILWAUKIE AVE
REQUIRED INSPECTIONS
PORTLAND OR 97202 Rough -in Elect '1 Final
Phone #: 232-2499 Elect' 1 Service
Reg #..: 000438
This permit is issued subject to the regulations contained in the Tigard unicipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordanceji app oved p : This permit will expire if work is •ot started within 180
days of issuance, or if work is suspended for more than 180 d s. A ION: Oregon law requires you to f..∎ ow the rules adopted by
the Oregon Utility Notification Center. Those rules are set f rth i 1'' 952-001-0010 through OAR -9 -+'M1- `87. may obtain a copy
of these rules or direct questions to 0.1'-ii , i 03)2 9 -' 1 / " �i�
Ae�
Issued B
Permittee Signature. _ _ y °____ -___ _ _ _
1
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:
LICENSE NO:
+++++++++++++++++++++++++++++++++++- F++++++++++++ ++++++ ++ + ++++++++++++++++ ++ ++ ++
Call 639 -4175 by 7 :00 p..m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + +++ + + +++ + + ++ + + + ++ + ++ ++ + + + + +-t+
•
CITY OF TIGARD Electrical Permit Application Plan Check :
13125 SW HALL BLVD. RECEIVED Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 JUN 2 �' 1998 Date to DST r
Inspection (503) 639 -4175 Print or Type Permit # (r /LC.9 g O 5'1 j
3
Fax (503) 684 7297 Incomplete or illog;ibJ accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) C� /► // ''/5 (� -- w� y Service included: Items Cost Sum
< f /
Address SW K RC .57 4a. Residential - per unit
Ci /State /Zi 6A ✓ 6 Dom- r 1 Z Z 1000 sq. ft. or less $110.00 4
ty p / Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residential
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
�� Installation, alteration, or relocation
Electrical Contractor 1 e '74;1 Ctpr} c. 6 re. r in c_,
/ 200 amps or less $60.00 2
Addre s L i 9 & SE u>>u/G rL five_: _ 201 amps to 400 amps $80.00 2
City Pa t'-+- I v,,,( State Di' Zip 9 2 kn-?., 401 amps to 600 amps $120.00 2
Phone No. o , -ar-1 X ct 601 amps to 1000 amps $180.00 2
Job No. 9 ,�.df0i3i 1'' Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. N.47 Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No. 4' 3R .5/ Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. /, Z Exp `late Installation, alteration, or relocation
200 amps or less $50.00 2
1 � a ;,�� 201 am to 400 am $75.00 2
Signature of Supr. Ele - ,6-0 _ 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. f`408 5-7.-- -- 5:- p.Date see "b" above.
Phone No. .' "3 7 7 Y j
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. I 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. Jr. Fees: 55-------
Not required for temporary construction services. 5a. Enter total of above fees $ / - 7, - -
5% Surcharge (.05 X total fees) $
NOTICE • Subtotal $ h
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 71"
TIME AFTER WORK IS COMMENCED. El Trust Account # j •-°--
Total balance Due $
I: \OSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639-41 5 usiness Line: 639 -4171
7111 v; °" / BUP Date I.y��led AM PM BLD
Location b ' ) e- u� Suite MEC C � - I
Contact Person ■ 5 5W &A-" Ph ( - Ri PLM
Contractor Ph SWR (,
BOIL` DING= r . y. Tenant/Owner ELC CAS - 0
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 s'
Firewall
Fire Sprinkler
Fire Alarm c s ;;:r/1)
Susp'd Ceiling
Roof
Misc: _
Final
PASS PART FAIL •
PLUMBING'' .} ;s` p"
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS—PART, FAIL
ffIECH`
Pos I eam
Rough In
Gas Line
•Dampers
- / ` _PART FAIL
UG /Slab
Low Voltage
Fir- =_.rm
`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 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.