Permit f "
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
!l+;71J . 13125 SW Hall Blvd., Tigard, OR 97223 503 639.4171 PERMIT #: ELC97 -0303
DATE ISSUED: 05/23/97
PARCEL: 2S104BA -10700
SITE ADDRESS...:13643 SW LIDEN DR
SUBDIVISION -CASTLE HILL NO. 3 ZONING:R -12 PD
BLOCK • LOT :137 JURISDICTION:
Project Description: Installing first 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/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
JANET TEAFF type amount by date recpt
13643 SW LIDEN DR PRMT $ 35.00 B 05/23/97 97- 295036
TIGARD OR 97223 5PCT $ 1.75 B 05/23/97 97- 295036
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 )C Vim
Tigard Municipal Code, State of Ore. Specialty Codes and all other P k t t e e S i gna ure
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started n /1 within 180 days of issuance, or if work is suspended for more 1 v'Ak 16-4
�—�
than 180 days. 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: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : OY\ ITIKAGIN DATE :
LICENSE NO:
Call for inspection — 639 -4175
MAY 23 '97 15 25 BOX_628_WILSONVLE ORKE CITY UT. P.2 ,
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd,
Tigard, OR 97223 Permit # , Elm / - 1 - 0303
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�,� . Date Issued , ' 5 -2.Z-47
v .
VII, Phone (503) 639-4171 i
``�'� FM (503) 684 -7297 I
CITY OP•TIGARD TDD No. (503) 684 -2772 i
Inspection (503) 639.4175
t, Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit alloweif ,
l ' r
Address /.t'o 1 $ 54' /lJ /de/7 ,,P.. Service included: Items Cast(ea) Sum i
City /State/Zip /) ri ak 9/ �et f 4a. Residential - per unit I •
J r 1000 sq. ft. or u:si: $1.0.00 4
Name (or name of 'business) Each addional 500 _ •
Patton thereof ' q. It. or 325.00 ----,--1.
-
Commercial ❑ Residential Limited Energy $26.00 - - T '
Each Maned Home or Modular •
1?tielling. iervicn of Feeder Sod.00 I 2
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2a. Contractor installation only: I
4b. Services or Feedors
r Instavatton afteratien, or relocation
Electrical Contractor dor rw .f �� r1G 203 Writ: o r lc $oo.00 _ 1 2
2
Address Qv.� Cl4h eri'.. _ th P_ -44/re A4, 201 amps to 400 amps _ z
City IAA; (ee.vl/. State_ Zip 4 70 401 amps to 600 amps $lso.00 $120 00 2
601 amps to 1000 amps -_;.
Phone NO. 4,4? 07 sf (c• Over 1000 amps or cons a-440.00 2
Job NO.
Reconnect only 460.00 I 2 •
contractor's license NO. -•V.. 2- - G 4c. Temporary Services or Feeders
Contractor's Board: Reg. No. L : Z► Inataltal,on, alteration, or relocation •sr Signature of Supr. Elec'n it: _ _ . 200 sunpu of less � _
1 201 amp= 4o duo amps x:;0.00
License No. '"Z it ' 0 Phone o. fCa-;l q2 401 amps to 600 amps �` 575.00
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6 • i 'it0 •�� ya - 7 9 [1 F over (00 amps to •10u0 awns 5100,00
2b. For owner installations: •See'0" littn,e•
4d. Branch Circuits
Print Owners Name New, alteration Or extension per pane I ' •
Address a) The fee for branch &arks with J • •
State
purchase or seN te
lca or ener ree. I 2
City • Zip Each uanch circuit 55.00 '
Phone. No. b) The fee fer•brench circuits without � 2
The installation is being made or, property I own which is purchase of service or fewer fee. 2
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not intended for sale, lease or resit. Fit br4ri th Cirwn �_ S55,
Each :additional branch circuit SS,aO
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Owne?s S ignature 4e. Miscellaneous
(Service or feeder not included) I 2
3. Plan Review section if required): Eft pump or irrigation circle 540,00 2
- "T
Each Sign or outline lighting $40.00 T
Signal eircuit(s) or a 6610 energy 2 •
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Pieese.eheek appropriate item and enter fee in section 58. panel, alteration or extension x40.00 � • ,
a or more residential units in one structure Minor labels (10) $100.00 --T
Service and feeder 225 amps or more 1 .
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System over ed0 volts nominal cif Each additional inspection over
Classified area structure containing special occupancy the allowable in any of the above
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Per inspection 335.00
as described in N.E.C. Chapter 5 Per hour -- 555.00 T i
• In Plant 555.00
Submit 2 sets of plans with application where any of the above - i ,
3 apply. Not required for temporary construction services_ 5. Fees: C ' '
Sa. Enter total of above teas $ J J
NOTICE • 5% Surcharge (.05 X total fires) $ I- ?41 •
PERMITS BECOME WIC IF WORK OR CONSTRUCTION . Su $ It, T�
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 2 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. - ••omma..te.> ❑ "crust Account 0 1
$ I •
Balance Due $ 36.75 •
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CITY OF TIGARD BUILDING INSPECTION DIVISION
a.
• 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ; / 7 A.M. ✓ P.M. MST:
Location: 1 6) 3 5 L� � Q/) BUP:
Tenant: ° Suite: Bldg: MEC:
Contractor: (X(,Z•(,d.� 1,1L/ T j" CCWJ]V Phone: 6511— 3 / 15 PLM:
Owner. 911 4 ∎ . a., Phone: ELC: - / 7-6303
��// �v n iC1.4Q1 Cgla m 'C /, ELR:
CA (L/7 I _-_I / �I SIT:
BUILDING BLDG (con't) PLUMBING 1 MECHANICAL • LECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam 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 Low Volt
Approved Approved Approved A. .roved Approved
Appr /Sdwlk Not A p p r o v e d N o t Approved Not Approved N. i=. �, • _ oved Not Approved
FINAL FINAL FINAL FLNAL FINAL
/0 .6 - 30 4 CG 111/ PA -NFL. M! ' - 30 on/ A/ Ait1E ,►1-7'6
I Ns rA - AT / p 1i . / 4 A- FL. A - / .2 Cfri kit R E 4K,
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O Call for reinspection 13 p R 'on fee of $ , r before ne inspection O Unable to inspect
Inspector: Date: lU • 1 ' Page of