Permit CITY OF T ELECTRICAL PERMIT
400, f& DEVELOPMENT SERVICES PERMIT #: ELC98 -0686
„ � , DATE ISSUED: 11/16/98
-' !� ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134CD -01100
SITE ADDRESS. ..:11665 SW KATHERINE ST
SUBDIVISION °LERON HEIGHTS NO.3 ZONING:R -4.5
.BLOCK........... LOT...... ..... . .:081 JURISDICTION: TIG
Proj ect Description: Haas
•
---RESIDENTIAL UNIT - - -- -- -TEMP SRVC/FEEDERS---- M I SCELL-ANEOUS--•---
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 -1000 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: 2 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
ARTHUR HAAS type amount by date recpt
11665 SW KATHERINE ST PRIYIT $ 45.00 JSD 11/16/98 98-310816
TIGARD OR 97223 SPCT $ 2.25 JSD 11/16/98 98-310816
Phone #:
Contractor:
WEST SIDE ELECTRIC CO INC • • $ 47.25 TOTAL.
1834 SE 8TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Rough —in Elect' l Final.
Phone #: 231 -1548 Elect'1 Service
Reg #..: 13306
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 Ce .-r. Those rules are, set forth i OAR 952-001-0010 through OAR 952 -001 ':7. You may obtain a co
of these rules or direct questio'- u 1 ■ calling i5O 46 -1'. .
Permittee Signature:. , Issued . —�0
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:
++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + +•+ + + + + + + + + + + + + + + + + + + +.
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
NOV -15 -98 03:38 PM WEST SIDE ELECTRIC 503 736 0677 P.01
•
‘,., r#) /ill •
CITY OF TIGARD Electrical Permit Application Plan Check Ir
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Reo'd // /
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit a - L-c _IS- v6 G
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) MeC Service included: Items Cost Sum
Address Par j! 1 An t fine si 4a. Residential - per unit
City /State/Zip r O, 7 Z•Z3 1000 se. It or Tess $110.00 4
Each additional 500 sq. R. or
Commercial ❑ Residential rg portion thereof ____, $625.00 1
Limited Energy
E
-
ach Manul'd Home or Modular
2a. Contractor Ins allation only: ()waning Service or Feeder $88.00 2
(Attach copy of all is rrent lice s , 4b. Services or Feeders
Electrical Co actor L / so c /C Installation, alteration, or relocation
Addres / ` 4 41 , ZOO amps or less $80.00 2
z 00 201 amps to 400 amps $80. 2
City Or • -. ' State OM Zip ° M I MI . 401 amps to 600 amps $120.00 2
Phone No. 2 - / 4L -' 801 amps to 1000 amps $180.00 2
Job No. --- Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No.6 - /3 Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No. '17 3 04 Exp.Date 4c. 'Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date installation, alteration, or relocation
200 amps or lees $50.00 2
Signature of Supr. Eleen. 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100 -00 2
� t Over 600 amps to 1000 volts,
License Nn _ ��,�� J Exp.Date see "b" above.
Phone Nr- ' / 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 lee for branch circuits
City ! Slate Zip without purchase of
Phone No. :. service or feeder fee.
First branch circuit i $36.40 2
The Installation is being r iiade on property I own which Is not Each additional branch circuit 2 $5.00 i 2
Intended for sale, lease o rent. 4e. Miscellaneous
Owner's S1W (Service or feeder not Included) naf tJIE • Each pump or irrigation circle $40.00 2
• Each sign or outline lighting _ $4 2
3. Plan Review section (if required) :' Signal drcuR(s) or a limited energy $40.00 2
panel, alteration or extension $40.
Minor Labels (10)
Please check appropriate Item and enter fee In section 5B.
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.t. Chapter 5 In Plant 555.00
Submit 2 sets of plans With application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5e. Enter total of above fees $ Z,S
5% Surcharge (.05 X total fees) $$
NOTICE Subtotal
6h. Enter 25% of lino 6e for $
PERMITS BECOME VOID IF:wORK OR CONSTRUCTION AUTHORIZED IS Plan Review jiequiresi (Sec.3) $
MX CaM1UIENCED W1T1.11 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
15 SUSPENDEP OR ARAN ONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account 4 _ 1/7
TIME AFTER WOR S COMMENCED. !
Total balance Due
�11
FR X el) /Al
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
117///9 Date Requested 1 1 " F f • >< PM BLD
Location i ■• , _ _.1!" t. dI ! If Suite 7 '05/46)
Contact Person 911411 Ph M3? ! M
Contractor 4 DE H I I C:l 6 Ph SWR
BUILDING. Tenant/Owner dIP 9 (1'668.6
Retaining Wall ELR
Footing
Foundation Access: • FPS
Ftg Drain - SGN
Crawl Drain Inspection Notes:
Slab - SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ,
Framing �Q.P .�C „ ��,,... __.G�c.FF' / / ,4 , 1 , ,,r _OD
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING'..` 'oe,Ae; ff;
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post - & I3eam
u h
as
- Dampers
Final •
1111[*-'■ PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
•
anal
7 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 //s /g-` & Inspector -O ` Ext
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site.