Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00215
4i'lii DEVELOPMENT o
SERVICES 639 -4171 DATE ISSUED: 04/27/2001
- 13125 PARCEL: 1S136BB-00500
SITE ADDRESS: 08109 SW LOCUST ST
SUBDIVISION: METZGER ACRE TRACTS ZONING: R -5
BLOCK: LOT : 004 JURISDICTION: WAC
Project Description: Installation of service, sub panel, water heater and garage circuit. (2) branch circuits. Job #99.5017
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: 2 W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
MILLER, ROSEMARY J TICE ELECTRIC
8109 SW LOCUST PO BOX 15009
PORTLAND, OR 97223 2139 SE BELMONT ST
PORTLAND, OR 97293 -5009
Phone: Phone: 233 -8801
Reg #: LIC 166
SUP 2586S
ELE 26 -126C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRM3 CTR 04/27/2001 $173.90 2720010000( Wall Cover
Elect'I Service
5PCT CTR 04/27/2001 $13.91 2720010000( Elect'I Final
Total $187.81
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 rules adopted by the Oregon Utility Notification Center. Those
rules are 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 -6699 or 1 -800- 332 -2344.
Permit Signature: ij A 1 , 0 i Is sued By: t
• 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: ( 0 10 f)_e1i T /ini DATE:
LICENSE NO: �SK6
Call 639 -4175 by 7:00pm for an inspection the next business day
•4/26/2001 :11 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 02
9 . 1 • /00 TUE 09 :00 FAX 503 598 1980 CITY OF TIGARD W002 t
Electrical Perini t Application
• Pt iink a7 (1 / Penult ne,ar, • ,.,6 iZag
_;u.' ail_' City of Tigard ,W.s ProjaVappL sc aspire date:
ChyofrIgard Address: 13125 SW Hall Blvd, Tigard, OR 97 Dewieseed: By J Receipt no.:
Phone; • (503) 639.4171 •
Fax (503) 598.1960 V • Case file no.: Payment type: ,
Land use approval:
•
. 11'1'1.•' 01 1'1 :It.1111 '
1 t?A & 2 family dwelling or accessory 0 Cotnrrtercial/itidustrial 0 Multi - family 0 Tenant improvement
0 New construction CX Add 'uion /alteratlonireplacetrreat 0 Other • '6, partial
JOB S i l l l :Nt•OltNI I U)N •
Job address: 8109 Sw Locust St Bldg. no.: Suite no,: ax map/tax lot/account ro.:
Lot: IBionic JSubdivit:ion:
Project name: • R Miller I De3046oa std location of work on promises: Service, sub PaneLwater
Estimated darts of coin . letion#nspectioo: ' heat- • ara • - cir '
CU!1 rum :sou Al'riI(...11(11N l-hl s( 111:1)1 •
Job no: _ • Fes
Business name Qty so.) Total
`l' C Flo ir` •- - 'me e ekleadal - doge or sssldtmailyper
Address: nn new 1 .50ns dweitbsuah.ltrdudeimmenedpreae. •
•
City: • • a _ .. State: •,. ZIP: e e : seraceboxedon
Phone: 5 e _ algid ling .: t ax:: _ • s 1000 •. ft. brim 4
CCB no.: .. :+o 4*DM:ea700 •.Ror • •. to thereof a
Ory /m lie no.: Malted , ,ee.IQeutbl
2014 Limited , ,oem addeo
l T 26 � uel
�' 4 t' 113acb murmured ... , . e ...
Sign re of p wieieg electrician moulted) Dale service ced/orleader 2
6er/am ar [seders »
tWmill
Sap. elect. name (pdat): • 1 s u _ •, - Umoaeno: -
ollorsdmorrelocation:
1'1COL'k1111 t1117%41C . • 100 orleo 2 . =^ •160,60:
301 a so 4110 • • . 2 •
_ -= 401 error o • .. 2
•. - 11 OH 01 0 •.e 1
City: Ti • and ^t ' e1: .4 : • • J1Y•Y.i inaalil t Oyer 1000 • or vets 2
Phone: Fax: B441411: Reconnect • •111111111111■1■111111101111
Owner Installation: The installation is beiug made on property I own redporae7 • °t 'W - •_
which is not intended for sale, lease, rent, or according to bmllatiba,aluratlaa,or,tloWlsa
ORS 447, 455, 479, 670 701. 200 mope oelos 1
' 301 amps to 400 amps 2
Owner's sl :. • . ,e a 60
— Date. • 431 0 am 2
1:1'GIN1.11( „ d• WM. • • .
or exOwsloa per weir
Name: A. Pee for branch drredle *tit pmchue of •
Address: weeks wkedrfta, emir booth dttult 2 +
13 0 2
City: State: B.
B. Pee Bo branch awns without puashor
Phone: Fax: H.ratell: of service or feeder fam that breach elrcuIC 2
Esdi addldoaal brume circuit
FLAN ItLVIa: % (I'lesue i•lii r6 :ell tli: ( apph) ' lag 6enlaser • riot - adadle
0 Swim over 233'artpl-commerdal 0 Healtb.earo fadllty Bach • em • offal $loa nude 2
7 Service ever 320wrtpe• iiNgof 14.2 0 Hetedwulouden = e�i t hfiof 2
levelly dh•etlInae 0 Bonding over 10,000 square tem lour or Slaaddrrult(s) or a angled eeetay panel.
I7 Sy arm rower 603 veto nominal neon regidendal unite is ore annum elreretlon,oraztemtoo• 1 I 2
O Building Mow nodal 0 Paedels.400 amps ormom • nci
0 Qc,rpant lead ever P) peering t7 M nufeetured eeucruree v RV p,:!�5
bon additbeu1 l=ea ogv t!o altotRablu d say or almrgr
7 Egters/Ilahunaplea 0 Mee: , - Pert oe
oepe4[I I _.1 I 1
9ubn11 seta of plans *Many of the above. . 'Investigation fee
The above are not appllcible to temporary eoaetraelon service. other
r Not gl Jarirdkdona eooeyt quill cards, please a0 itaiadk6eo for moo rafa®da►' Notice: This permit application Permit foe S 173.90
um,. o }tgsteiCud expitw it. pGrfmle is sot obtained plan tev1ew (et _rib) $
Coat sass meant: within ISO days attar Sr Rosh= Stain at vharge (896) •••• S 13.9J
sampled — \sine at c e r d y b T d e r is Maws as m e a l � P1O in complete . TOTAL S 1112-8.3--
.S Trust Acct •
crammer .Immure A 1110111 4104615 tem+C+ru • •
o
04/26/2001 13:11 503 -872 -8290 TICE ELECT.SERV.DEPT PAGE 03
8109 SW Locust St Tice Electric Co Job #99.5017 .
E1edt Permit Fees: • Limited Energy Fees:
Complete Fee Schedule Below: Restricted Energy Fee $73.00
Number of inspections per permit allowed OF WORK INVOLVED - RESIDENTIAL ONLY
allowed (FOR ALL SYSTEMS)
• Service included: Items Cost Total 4. Check Type of Work Involved;
Residential - per unit
1000 sq. ft or less $145.15 _ 4 ❑ Audio and Stereo Systems
Each additional 500 sq. It. or
portion thereof $33.40 _ 1 ❑ Burglar Alarm
Limtled Energy $75.00
Each Manul'd Home or MoOular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener'
,,
installation, alteration, o r relocall '' :" ,..!•.., . ..• " . , „He ti
Services or Feeders. Ventilation and Air Conditioning System'
200 amps or lass 2 $80.30 160.60 2 -
VaSlJUm Systems'
• '. ,� .
201 amps to400 amps . . . $108.85 • .. 2 l J
. 401 amps to 600 amps $160.80 2 •• • . -• • • .
601 amps to 1000 amps - $240.60 2 0 Other
Over 1000 amps or volts - $454.55. • 2
Reconnect only • $66.85 2
Temporary Services or Feeders = :.... • ` . • .... • •
installation, alteration, or relocation ' TYPE OF WORK INVOLVED - COMMERCIAL ONLY ,•a.
200 amps or lees •.. $66.85 2 Fee for each system. .- 575.00
201 amps to 400 amps _ . $100.30 2 (SEE OAR 918-260-260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 vans, ... • • Check Type of Work Involved:
see "b" above. . r
Branch Circuits .. ❑ Audio and Stereo Systems
New, alteration or extension per panel • Q
aJ The fee for branch circuits Boller Controls
with purchase of service or
fee4erfee. ❑ Clock Systems
• Each brandvdrwit .2 .$6.65 13:30 2
e) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service
. or feeder fee. ; ..;:.:... ❑ Fire Alarm Installaton
First branch circuit $16.85 • • • • _
Each additional branch circuit $6.65
0 HVAC
Miscellaneous
. (Service or feeder not incWCed) • ❑ Instrumentation
Each pump or irrigation circle 553.40
Each sign or oiidine lighting $53.40
Signal circuit(s) or a limited energy 0 Intercom and Paging Systems
• panel, alteration or extension $75.00 •
. Minor Labels (10) 5125.00 ❑ . Landscape Irrigation Control' •
Each additional Inspection over ❑ Medical
the allowable in any of the. above
Per inspection $ •
Per hour $6250 ❑ Nurse Calls
In Plant $73.75
. ❑ Outdoor Landscape Lighting*
Fees:
El Protective Signaling
Enter total of above fees $ 171 , 9n
8% State Surcharge $ 13_91
❑ Other
25% Plan Review Fee Number of Systems
• See 'Plan Revlew'secion on 3 187.81
front of application. ' No licenses are required. licenses are required for all other Installations • •
Total Balance Due 1 . Fees:
• (J Trust Account # , 1 A, Enter total of above fees $ .
8% State Surcharge $ _
•
• Total Balance Due $
i :l dskslformsklc•fees.doc 10/09/00
//, 3to 1
CITY OF TIGARD BUILDING INSPECTION DIVISION .
MST'
24-iHour inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Cs Z- 7 AM PM BLD
Location fil'& 9 5 w a> CsS f ` Suite MEC
Contact Person / Ph 97z- 7 36 PLM
Contractor 77C �/e C YJC Ph SWR
BUILDING Tenant/Owner A oS. /4/7 r y frh1lP Y� ELC "0 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
Firewall
Fire Sprinkler
Fire Alarm
F"'" Susp'd Ceiling q 1
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out 0‘/
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
/1/
Post Beam
Rough In
Gas Line
Smoke Dampers
Final
S PART FAIL
LEC TB1G717.�
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
r
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before n - inspectio4 at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: ' nable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk - '�,` 7 - 0 / �� �r
Other Dat / I nspector ,!/1 ` , Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.