Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00033
DEVELOPMENT SERVICES DATE ISSUED: 01/21/2000
I ' L t � 111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S104CA -02600
SITE ADDRESS: 13571 SW LAUREN LN
SUBDIVISION: HILLSHIRE ZONING: R -7
BLOCK: LOT : 026 JURISDICTION: TIG
Project Description: Installation of a first branch circuit.
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:
BOHRINGER, WILLIAM JOSEPH + BA OWNER
13571 SW LAUREN LN
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 01/21/200C $37.50 00- 321324 Elect'I Final •
5PCT GEO 01/21/200C $3.00 00- 321324 • ORIGINAL
Total $40.50 •
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all otherapplicable 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 a re 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. 7
PERMITTEE'S 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: v`) • - 60 DATE: / v / - o o
NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
Date Recd
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 I-7Q-- Date to DST
Inspection (503) 639 -4175 Print of Type Permit # �GL ROoO 0
Fax (503) 598 -1960 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) (A; ILL /AM '3 ROW PINI6F R Service included: Items Cost Sum
Address 13571 S W LA U R r /J LA 4a. Residential - per unit
' City /State /Zip TI(-1( OR q7 a a3 1000 sq. ft.' or less $ 117.75 4
1 Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial ❑ Residential 1g Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
• (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor 200 amps or less $ 64.25 2
Address 201 amps to 400 amps $ 85.50 2
City State Zip 401 amps to 600 amps $ 128.50 2
ry p 601 amps to 1000 amps $ 192.50 2
Phone No. Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders .
OR State CCB Reg. No. Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Su r. Elec'n 401 amps to 600 amps $ 100.00 2
g p Over 600 amps to 1000 volts,
• see "b" above.
License No. Exp.Date
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
BOA L feeder fee.
Print Owner's Name Vl)1 U. I ,4M , I -t- r BUA R.I MG C., R Each branch circuit $ 5.35 2
Address 13571 ,St,t,) LA o Q F Al LA) b) The fee for branch circuits
without purchase of service
City fl c 2.1u State OP_ Zip e 1? as 3 or feeder fee.
Phone No. ( 5c )) 590 -- E) ?,c15 First branch circuit 1 $ 37.50 31.50
Each additional branch circuit . $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature • rll�� � -- Each sign or outline lighting $ 42.75
i 4 Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 amps or more
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 3'3.50
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 3 „O O
Not required for temporary construction services. Subtotal $ 40 o 5o
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested J7/ AM PM BLD \\ c
Location / 3 S 7 � lr6/ Suite MEC
Contact Person w ? I t 1 CUAn Ph SqD _ & 3q . S PLM
Contractor Ph SW
BUILDING Tenant/Owner E421006-0D03
Retaining Wall ELR
Footing Access: /
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear e
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL I
Post & Beam
Rough In
Gas D
Smoke Dampers
Final
PASS PART FAIL
L ECTRI
Service
Rough In
UG /Slab
Low Voltage
- Alarm
P • - PART FAIL
SI
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 /C) ,, j O ther h /Sidewalk 2 / Ls/ Ins pector 7 6 Ext
other Date /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•