Permit CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00436
,,,,,, 4A11( DEVELOPMENT SERVICES
O
SERVICES 639 -4171 DATE ISSUED: 7/19/99
SW Hall
PARCEL: 2 S 103 BA -00142
SITE ADDRESS: 11875 SW LYNN ST
SUBDIVISION: LERON HEIGHTS NO. 2 ZONING: R-4.5
BLOCK: LOT : 032 JURISDICTION: TIG
Proiect Description: 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:
ALAJMI, ABDULHADI M + MARCIA M ABC ELECTRIC CORPORATION
11875 SW LYNN ST 135 NE 9TH
TIGARD, OR 97223 PORTLAND, OR 97232
•
Phone: Phone: 233 -7551
Reg #: LIC 000002
SUP 1241S
PLM **SEE**
ELE 26 -2C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 7/19/99 $37.50 99- 316965 Elect'I Final
5PCT BON 7/19/99 $2.63 99- 316965
•
Total $40.13 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 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 or direct questions to OUNC at (503)
246 -1987.
Permit Signature: ei l t p L cAlk e y k _ Issued By: a 1 . 414 , 04 .A r 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
t ' I Si�ALLATION ONLY
(Cl 'C
SIGNATURE OF SUPR. ELEC N: �� ey DATE:
LICENSE NO: JJJ vvv
Call 639 -4175 by 7:00pm for an inspection the next business day
Ju1-16 -99 12:34P P -02
CITY OF TIGARD Electrical Permit Application Plan Cher:
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd 1
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Data to DST Permit # etc ( 99 - poy3(,
Inspection (503) 639 -4175 Incomplete or illegible will accepted
I not b
Fax (503) 684-7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of inspections per permit allowed
• Name (or name of business) / 4f i i 2/ ' A cutGY Se ice Included: Items Cost Sum _�
Address v� 4a. Rasldentlal - per unit
�� � WOO sq. n. or less $110.00 4
City/State/Zip al
�� Each additional 500 sq. ft. or
.00 1
COmmQrci Residential ® portion thereof
Limited Energy $25
. # -'�/ i ar f -, Each Manure Home or Modular
�}} y7 �� Dwelling Service or Feeder $68.00 2
2a. Contractor installatiorfohly: -
(Attach copy of a r : t tic : • : :.) - 4b. Services or Feeders
Electrical Contractor,.. . / •{ • Installation, alteration, or relocation
200 amps or less $60
Adder J /3S.i� /�i�r_ 2
201 amps to 400 amps $80,00 2
City .�if(tt / ' State a! Zip /I!talf 401 amps to 600 amps $120.00
Phone N. 3 .�� ? 601 amps to 1000 amps $180.00 2
2
Job No. X .. / o - .."Its{ Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 26,- ? l' .. Exp.Oate JO/ t / 9 9 I K R only $50 2
OR State CCB - - - ..: -- ; . Exp.Oate Ali 6 1 OK- 4c. Temporary Services or Feeders
COT Busines ax or i : ro o.fiajal t ) Exp.Date le /, 99 Installation, alteration, or relocation •
// / 200 amps or less $50.00 2
- 201 amps to 400 am $75.00 2 -
401 amps to G00 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 1 � / - .
e‘• e ate JA/ I see "b° above.
Phone No. , - 7'5 '"; /
4d. Branch Circuits
New, alteration or extension per panel
212. For owner installations: a) The too for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circui $5.00 2
b) The fee for branch circuits
City State , Zip without purchase or 7
Phone No. • service or loader fee.
_ _ _ First branch circuit $35.0 2
The installation i- • eing _ • • e o , property I owl which is not Each additional branch circuit olt 5.5,00 2
intended for sal:. leas nt. ��� \_
4e. Miscellaneous
�= f>r1 r-r (Service or feeder not included)
Owner' Si •oat i r: � ~ Each pump or irrigation circle $40.00 2
•
Each sign or outline lighting $40.00 2
3. Plan Review section (if requ -d :* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labols (10) $100.00
Please check appropriate Item and enter fee in section 5B. -
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of tha above
System over 600 volts nominal Per Inspection . $35.00
• Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of Elbows foes
5% Surcharge gas X1otar tees) $ - T -'��' i Z f
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reyujred (Sec.3) $
NOT COMMENCED WI CHIN 1Rn DAYS. OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 28 -r
Total balance Due s = -L��
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171 -
G�j BUP
Date Requested $-ZS l ( AM PM BLD
Location I Ji5 10(14 f �� I • Suite / MEC
Contact Person J ,7 610 -• Ph ;''7.S.5 1 PLM
Contractor Ph SWR ,�ey� 2�
BUILDING Tenant/Owner ELC ) —1 G 99 (�t..J q J`O
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 I� I? P [ , 6O K c- W t Y e 1 ( £- L /_ r ) / F to .
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING AC Al Q / / S 5
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
(E
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
gig) PART FAIL ti69
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
Approach /Sidewalk F— ,20 = C Inspector Ext
Other Date
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.