Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT 4: ELC3 . -0 12E
DATE ISSUED: 1213/04/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 131 36 CD- 1500
SITE ADDRESS SW .................. I r �
SUBDIVISION I IID� ONING:
11\LCCR - LOT
F'°oject De,cription: FEEDER & CIRCUITS FOR NEW LIGHTING FIXTURES /3
---- RESIDENTIAL UNIT - - - -- -- -TEMP SRVC /FEEDERS - - -- --MISCELLANEOUS--
1000 SF OR LESS....: 0 - 200 amp.......: PUMP/IRRIGATION--: 0
EACH ADD'L 500SF...: 0 201 - 400 amp - 0 SIGN /OUT LINE LTG... 0
LIMITED ENERCY 0 42+1 -- 600 amp.......: 0 CIGNAL_ /PANEL.......: 0
MAN'. I- -M/ SVC /FDR.. : 0 601+alnps- 10'210 volts.: 0 MINOR LABEL (10) ...: 0
- - -- - -- SERVICE /FEEDER -• BRANCH CIRCUITS - - - ADD' I_ INSPECTIONS--
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION - 0
201 - 42'0 amp...... : 0 1st W/O SRVC OR FDR.: 1 PER HOUR........... 0 0
401 - 600 amp - 0 EA ADD' L BRNCH CIRC: 4 IN PLANT 0
G01 -- 1000 amp.....: 0 -----------------PLAN REVIEW SECTION------------ . -
1000+ amp /volt : !21 ) =4 RES UNITS - > 600 VOLT NOMINAL..
Reconnect only—. : 0 SVC /FDR )=. 225 AMPS..: CLASS AREA / SPEC OCC.
Owner: - -- - - - _- -- - - -_ __ FEES - -- - -
ROBE S ELECTRIC INC type amount by date recpt
5759 S•1 4 TH AVE PRMT $ 55.00 JMH 03/04/96 96- 276589
SPCT $ 2.50 JMH 03/04/96 96- 276589
PORTLAND IR 97221-0000
Phone _b. 5 ; - 244 -7754
Contract or: - - __ -__ - - -- - - - - - - -- - -- --
^OBERTS ELECTRIC INC $ 57.50 TOTAL
575; CW 48TI -I
------ - REQUIRED INSPECTIONS - - - - -• --
PORTLAND OR 97213
Phone #:
Reg #.. .
This permit is issued subject to the regulations contained in the /4/kei4e4.4!.(0
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
apli:able laws. Al. work will he 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 sore
than 180 days. I /ued By
-. - -. - .__._ -. - -•. --- .-- _._.._...__._. -. - -- OWNER I NSTALLAT I C ., ONLY - -- _ ___ The installation is being made on property I own which is not intended for
sale, lease, of rent.
OWNER'S SIGNATURE: DATE:
- - - -- - - - -- - - - -- -- •CONTRACTOR I N STALLAT I CN ONLY - - - - -- -
SIGNATURE OF SUPR. ELEC'N: _12311.‘,„ DATE:
LICENCE NO;
td
Call for inspection -- 639-4175
C F - d /3 6
mfo Community Development ELECTRICAL PERMIT APPLICATION
1
Tigard, OR Hall
97223 Permit # & 1�q�� " ` 3 6
�r�ai Date Issued �I ( IC - . 7
el 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 Dev elopment � 1 ' ,0-c.."-I -- Q. Number of Inspections per permit allowed
Address 116 (DO S w - Pi Service included: Items Cost(ea) Sum
City /State /Zip 1 t a / ` cT ? 2, 2, 3 4a. Residential - per unit
sq. ft. less $110.00 4
Name (or name of business) r Each Each additional l 500 500 0 sq. ft. or
1�
portion thereof $25.00
Commercial PN Residential 111 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
Electrical Contractor f .ci i,,t? Lt- t� C_ JA) C Installation, amps alteration, or relocation $60.00 2
200 amps or less
Address ,,57 5 t S. u--,-- (481/4- 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00
City pa-� -� State 6 / / L Zip .1)22.1 401
amps to 1000 amps $180.00 2
Phone No. 0 2 u4 - --77 Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$50.00 2
contractor's license NO. 34 -Z3C- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. .93 fir O ,...15 q 7 Installation, alteration, or relocation
Signature of Supr. Elec'n !:,/ -/ ' - s A - 200 amps or less 2
6S Phone No. 0 7 ?s' 201 amps to 400 amps $50.00 2
License No. 3$� 401 amps to 600 amps $75.00
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 withou
The installation is being made on property I own which is purchase of service or feeder fee. 6O 2
not intended for sale, lease or rent. First branch circuit $ $ 5 . 00 --
Each additional branch circuit $5.00
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 $ 55 crr)
NOTICE 5% Surcharge (.05 X total fees) $ ar F5 0
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec.3)
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordlcomdeNe&ea ❑ Trust Account #
prm.epp
Balance Due $ 57 6-0
4/24/00 Activities for Case #: ELC96 -00136
5:23:13 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 3/4/96 3/4/96 J'H 3/4/96
ELCC700 Ceiling Cover 3/4/96 J *H 3/4/96
ELCC720 Wall Cover • 3/4/96 J *H 3/4/96
ELCC730 Elect'I Service 3/4/96 J`H 3/4/96
ELCC799 Elect'I Final 3/4/96 1/5/00 BRP PASS AKJ 1/5/00
ELCC500 (F)Issue permit 3/4/96 JMH PAID J'H 3/4/96
ELCC800 Case Finaled 1/5/00 AKJ DONE No Hold AKJ 1/5/00
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 S co AM PM BLD
Location I Vp( Suite MEC
Contact Person V Ph 6931 -zco ( PLM
Contractor Ali Ph L i Q - ( SWR
BUILDING Tenant/Owner 113 C L `Y)b1,6 L 412p 1 % % Q - gr 6513G
Retaining Wall LR ( [ / On2g7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall O/ /�
rywal Nailing 4,,
Firewall r C _ (� / _ (7 iJ ` 3
Fire Sprinkler ` Q
Fire Alarm /_ 1
Susp'd Ceiling !/ �lr S 1C3.c
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab Z-■A _ 9Q A-D / 2 S S
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS P FAIL
E TRI
Service
Rough In
Low oltage
PART FAIL
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: 4 [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D / nsp
Inspector 4 / / Ext Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.