Permit 1
CITY OF TIGARD ELECTRICAL PERMIT
t ifi ,i, DEVELOPMENT SERVICES D ETEIT S: D 06 06/12/97
2
_. !+� ' ( 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
DATE ISSUED
PARCEL: 2S1O4BA -15900
SITE ADDRESS...:13644 SW LIDEN DR
SUBDIVISION -CASTLE HILL NO.3 ZONING:R -12 PD
BLOCK • LOT •189 JURISDICTION:
Project Descr : instl 1 branch circuit // job * ?
- -- RESIDENTIAL UNIT - - -- ----TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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/0 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
DAN LUU type amount by date recpt
13644 SW LIDEN DR PRMT $ 35.00 TAT 06/12/97 97 -295852
TIGARD OR 97223 5PCT $ 1.75 TAT 06/12/97 97- 295852
Phone #:
Contractor:
BOONES FERRY ELECTRICAL $ 36.75 TOTAL
PO BOX 628
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 Ceiling Cover Underground Cove
Phone #: 682 -4936 Wall Cover Elect'1 Service
Reg #..: 000884
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 Center. , • rules are set forth in OAR 952- 001 -0010 through OAR 952- '.I1-1987. You may obtain a copy
of these rules or direct questions to u" b calling ( )2 -1987.
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Permittee Signature: t. 4 , / „_ L_, Issued By: / / r
/
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 : 6,-/2-
______122„jalalLi____ LICENSE NO: r/705
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
[d
_ 1 1' Aisraw
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Community Development ELECTRICAL PERMIT APPLICATION
r 13125 SW Hail Blvd.
Tigard, OR 97223 Permit # L,_ ` / ` 4 LZ jTi Date Issued
-' , Phone (503) 639 -4171
1 7 FAX (503) 684 -7297
�. /1 0; 9IGirsRD TOO No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule elow:
Name of Development Number of Inspections per permit allowed
`�ffeur
Address 13644 SW Liden Dr _ Service included: Items Cost(ea) Sum
.m.�.
Ciry /StateiZip Tigard ,__OR 97223 4.a. Residential • per unit
1000 sq. ft. or less 5110.00 _ 4
Each edartonal 500 :q. r. or
Name (or name c:. business) Dan Luu _ 325.00
pertton thereof -- Sam 1
1 Limit Energy
Commercial t__t Residential Ril Each Manure r4cme or MCCclar
Dwelling Service or Feeder 5ee.00 2
2a. Coritlaccor ir)s iailatioii oh 1: •
4b. Services or Feeders
>^ Installation, alteration. or relocation
Electrical Contra ^c :' r__Boo } r j r '•r� xl�s Fe ry „QS 1 200 amps orlese _� 250.00 2
Address P 0 B0x 628 _ 201 amps to400amps 5;60.00
City 2
SttatP 401 amps to 600 amps
W 1ISSZD3L111Q___ �R -_ Zi p_g��- 601 amps to 1000 amps $160.00 _
Phone No. 6132_4_93_6 Over 1000 amps or vows ,_ 3340.00 2
J NO. Reconnect cniy 550.00
contractor's license NO. 3 -771 r 4 c. Temporary Services or Feeders
Contractor's Beard Reg. • R8422 installation. aneretic.. orrelocation
2 00 amps or lase 2
Signature of Suer. Elec __ 2
. 2 01 amps to 4 00 amps 550.00 2
License No. 31-7 OS- .- Phone No. 682_4_936 .,
401 amps to 600 amps -_ 37500 -
2b. Over 600 amps to 1000 volts 5100.(.0
2b. For owner installations 5Ce'1:1"above.
4d. Branch Circuits
• Print Owner's Name • _ New. alteration or ex'enelon per pane
Address e) The fee for branch circuits with
-- -- p urch2.Sd or aervlco or sander tee. 2
City State J` Zip Each branch circuit 55.00
• Phone No. b) The lee for Drench circuits without 2
The installation is being made on properly I own which is purchase Of Service or fender fee. 2
n at branch circuit • 1 575.00 _19.00
not intended for sale, lease or rent. San eadlllonal branch circuit 55.00 -
Owner's Signature • . 4e. Miscellaneous
2
(Service or feeder not included) 2
3. Plan Review section (if required): EBCT pump or Irrigation circle 540.00
Each sign or outline lighting 510.00 2
Signet eeeud(s) or a limited enorgy
Pleaoe Check appropriate ite.T and enter fee in s•?Ction 5B. panel. alteration of erienelon t.40 CO
4 or more residential units in one structure Miner Labels (10) 6100.00 i
Service and feeder 22 amps or more 4f. Each additional inspection over
System over 600 volts nominal the allowable In any of the above •
Classified area or structure containing special occupancy
Per inspection 5 35.00
as GSt:SCfiD,:;. in N.E.C. Chapter 5 Per hour 55500 -
in Plant 555.00
Submit 2 sets of plans with application where any of the above
apply. Not required for trriporary construction services. 5. Fees:
Se. Eater total of above fees 5 -3"5 Q •
NOTICE , 5% Surcharge (.05 X total fees) g _---i-r-7
Subtotal s -3_6, 75
PERMITS
BECOME VOID IF WORK OR CONSTRUCTION gb, Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED .1TI- N 100 DAYS, OR IF Pian Review if required (500.3) g
CONS 1 cWCTIC)N OR 1NOR<< IS SUSPENDED OR ABANDONED FOR Sublo:aJ _ __
A PERIOD OF 180 CATS AT ANY TIME AFTER WORK IS r� $
COMMENCED. ,,,,e,,,,,, IJ Trust Account 4
S
v••.r.
Balance Due
$ =36 :'T� --
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' CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: &J1�4) A.M. P.M. MST:
Location: 1 3G, T 4 St ya,,c,cter-, BUP:
Tenant: Suite: Bldg: MEC:
Contractor: T Yl Phone: PLM: p /
Owner: a-ii' , L(A C, j Phone: ELC: [ 7 3 to f0
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL CjLECTRICA SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFI/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 F 1 : - Temp Service MISC.
Masonry Ceiling Rain Drain 0a010 UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr - p Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved , . • w oved Not Approved
FINAL FINAL FINAL FINAL
'49 A if/1C2 c3 2 4 PLR Cool) lWS7
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O Call for reinspection einspection fee of $ rep' ed befor ext inspection 0 Unable to inspect
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Inspector: Date: 4t Page of