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Permit ' CITY' OF T ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC99-0122 ��m~�m~u~�~n n�nu~u�u ��m~»x�o~�m~�� DATE ISSUED: 03/03/99 6 11. /3/25SN/ Hall 0hut, Tigard, ORg7223(503)639-4/71 PARCEL: 2S111CA-04400 SITE ADDRESS...:09700 SW LAKE SIDE DR SUBDIVISION ^SUMMERFIELD NO.12 ZONING:R-7 BLOCK ^ LOT........ ..... :664 JURISDICTION: TIG 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 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: 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 WILLIAMSPEAR type amount by date recpt 9700 SW LAKESIDE DR PRMT $ 35.00 DEB 03/03/99 99-313401 TIGARD OR 97224 5PCT $ 1.75 DEB 03/03/99 99-313401 Phone #: 624-2122 Contractor: WEST SIDE ELECTRIC CO INC $ 36.75 TOTAL 1834 SE 8TH AVE REQUIRED INSPECTIONS PORTLAND OR 97214 Elect'l Service Phone #: 231-1548 Elect'l Final 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 r-' es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952-m1-001 rough OAK -m1-1987. You may obtain a copy of these rules or direct questions to OUNC by lli 503)246-1987. ���� . Permittee Signature : U� 1 Ma(� » '' /) � Issued B. ^ ^� ���" 'N�' Ai ^�� 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 INSTA ATIC4 ONLY . �� ' SIGNATURE OF SUPR. ELEC'N: t J��'. ` ���~� . �4 DATE: • LICENSE NO: ~L55.�� +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ MAR -02 - 99 04:40 PM WEST SIDE ELECTRIC 503 736 0677 P.01 ' A CITY OF TIGARD Electrical Permit Application Plan Ch ItT� z / '13125 SW HALL'BLVD. Rec'd e A a 145 TIGARD OR 97223 08 to Date Rec'd _� °` ',P ^.,.. tit Phone (503) 639 -4171, x304 Dale to P.E. Date to DST Inspection (503) 839 - 4175 Print or Type � '�'� Permit N EGC q ? ' • 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) �y i JD Service Included: Items Cost • Sum Amm % Address 700 S4. 40Z2, r 1c4 . 4a. Residential - per unit City/State/Zip 7/:90b o 9 v y woo sq. ft, orless ., $110,00 / Each additional 500 sq, ft. or Commercial ❑ Residential 12--- portion thereof $25.00 1 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 cu rent Ice • es / 4b. Services or Feeders Electrical C n : ctor a A / /C f %? / C/ C. Installation, alteration, or relocation Addres - . ` . 20o amps or less • $60.00 2 r I �� 201 amps to 400 amps 580.00 2 City Or 0/r - , State I � Zip AW 401 amps to 600 amps $120.00 2 Phone No. .2 / - / SV ' 601 amps to 1000 amps _ 5180.00 2 Job No. 70/ - 002- Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. 26 ' /JS`� Exp.Date Reconnect only 550.00 _ 2 OR State CCB Reg. No. /3306 , Exp.Date sr .Temporary Services or Feeders ` COT Business Tax or Metro No. . Exp.Date installation, alteration, or relocation 200 amps or less $50.00 _ 2 Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 LlcensA No Over 600 amps to 1000 volts, CSC Exp .Date see "b" above. Phone Nr 23/ /'S` 4d, Branch Circuits 2b. For owner installations: New, alteration or extension per panel a) The fee for branch circuits with purchase of service or Print Owner's Name feeder 1st • Address Each branch circuit �_ $5.00 2 City State Zip b) The lee for branch circuits ty p without purchase of • Phone No. service or feeder fee. ' First branch circuit / $35.00 3S 2 The installation is being made on property I own which is not Each additional branch circuit $6.00 2 intended'for sale, lease or rent. 4e..Misceltaneous (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 Revi section (if required):* Signal clrouit(a) or a limited energy _ alteration or extension $40.00 2 Minor labels (10) $100,00 Please check appropriate Item and enter fee In section 66. 4 or more residential units In one structure 4f. Each additional Inspection ever � • 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. 5. Fees: 3S- . Not required for temporary construction services. 6e. Enter total of above fees $ 5% Surcharge (,05 X total fees) . $ NOTICZ Subtotal - Sb. Enter 26% of line Se for PERMITS VOID IF WORK OR CONSTRUCTION-AUTHORIZED-IS - - P_Ian.ReviewI1 r (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Sub ! ,, $ '. IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account q 3)Lo A TIME AFTER WORK IS COMMENCED. tr Total balance Due leafT CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3 - 3. -q9 AM y PM BLD Location q 7 n L P. t - Y9Y Suite MEC Contact Person aQfQ,C irkA l` Ph '-g44 -Z03 PLM / t0- Contractor T 4 r po A - -c Ph SWR BUILDINGAtiA ,., : = Tenant/: L.O ?( jV) � Y ELC 9 7 10/ 7 Z 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 Fire wall Fire Sprinkler Fire Alarm - Susp'd Ceiling Roof Ja Misc: ` Final PASS PART FAIL �( cPLUMBIRG:=? Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains n3 G 't?} PART FAIL Post& Rough In Gas Line Smoke Dampers Final P PART FAIL LECTRICr Service Rough In UG /Slab Low Voltage Fi - larm : • S 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: F . 7 ] Unable to inspect - no access ADA Approach /Sidewalk Q t Ext Date / I 9 Inspector �iic /� — Other D VaLi ! Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.