Permit CITY OF TIGARD ELECTRICAL PERMIT
144 DEVELOPMENT SERVICES PERMIT #: ELC97 -0834
'�u�6 DATE ISSUED: 12/23/97
Jr '__.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S103BC -07300
SITE ADDRESS...:12262 SW LANSDOWNE LN
SUBDIVISION - FYRESTONE ZONING:R -4.5
BLOCK - LOT :012 JURISDICTION: TIG
Proj ect Description : Installation of two (2) branch circuits.
- -- 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
MANE. 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
20.1 - 400 amp - 0 1st W/O SRVC OR FDR.: 1 PER HOUR 0
401 - 600 amp - 0 EA ADD'L BRNCH CIRC: 1 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 --
BARRY REYNOLDS type amount by date recpt
12262 SW LANSDOWNE LN PRMT $ 40.00 TJH 12/23/97 97- 301988
TIGARD OR 97223 5PCT $ 2.00 TJH 12/23/97 97- 301988
Phone #: 206 -338 -7114
Contractor:
ELECTRICAL DIMENSIONS INC $' 42.00 TOTAL 1
PO BOX 12146 ;'
3961 SW WILLAMS AVE REQUIRED INSPECTIONS
PORTLAND OR 97212 Rough -in Elect'1 Final
Phone #: 282 -7255 Elect' l Service
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Reg #..: 000440
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 1: days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: 07?, dIssued By: / 4 . /■ __
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:
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CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : liyt a 4;�� o,..� ______ DATE : _ X / /
LICENSE NO: = S
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + ++ + + + + + + + + + + + + + + + + + + + + + + + + + ++
(a
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Community Development ELECTRICAL PERMIT APPLICATION
1 3125 SW
Tigard, OR a 97223 Permit # i m / _- o8.34--
/ I `,I I , I � Date Issued 17/2-3/0
ih�ItN� Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address I ag. (o a s. Land S a eu, Service included: Items Cost(ea) Sum
City /State /Zip i t c cu,42. Or q 712.. 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) B grey nee „► a Ids Each additional 500 sq. ft. or
1 portion thereof $25.00
Commercial ❑ Residential v. Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders •
• �� ^ Installation or less alteration, or relocation
Electrical Contractor
L` Itctrf, co, ay eI nS[ovt
5 200 amps or less $60.00 2
Address PO • _ , 2.4 ti 201 amps to 400 amps $80.00 2
401 a mps to 600 amps $120.00 2
City crv- +c ic+d.d State Or Zip q'7 $180.00 2
Phone No. 2.. 7ZS S Over 000 volts $340.00 2
Job NO. 73,17 Reconnect only $50.00 2 '
contractor's license NO. 2.10 - Y 32 C 4c. Temporary Services or Feeders
Contractor's Board Reg. No.., Y • 0.% Installation, alteration, or relocation
Signature of Supr. Elec'n _f''a %� 200 amps or less 2
201 amps to 400 amps $50.00 2
License No. 2g 6�- Phone No. 28 Z - a�53 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
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. 22 3 2
First branch circuit / $35.00 . eo
not intended for sale, lease or rent. Each additional branch circuit / $5.00 S me
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B: panel, alteration or extension $40.00
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 inspection $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 . $ Ala 64.
NOTICE 5% Surcharge (.05 X total fees) $ L °O
PERMITS BECOME VD IF WORK OR CONSTRUCTION Subtotal $
OI
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. word\comdeNeiec- ❑ Trust Account #
prm.app
Balance Due $ y2 00
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CITY OF TIGARD BUILDING INSPECTION. DIVISION
1 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 .
Date Requested: 4 %) A.M. P.M. MST:
Location: / 2 7,1 . 4/M/so 0 LtlN BUP:
Tenant: A� y/1/6 L- D . Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC: 6 7-/9?-3
ELR: •
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL SITE
Site Post/Beam Post/Beam Post/Beam Cov • - - • ce Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump _ . olt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved . • s roved Not Approved
FINAL FINAL FINAL FINAL FINAL
a i 1 . - ./l 4e- Z_ / n . 124 x O
g ,,e1 - e .0 /I 0
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c) •
1 .
O Call for reinspection - - —4,--Al ' einspection- fee -of -$ required before next inspection CI to inspect
Inspector: ' / Date: / 02 -- FP Page of