Permit ELECTRICAL PERMIT
CI OF T I GARD DATE I ISSUED: LC OI /08/96
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 281 O2BD -01503
S I T L31 1 25lNftLattiv . d.Ti g ard, P 839 -4] V
SUBDIVISION - FREWINGS ORCHARD TRACTS ZONING:C —G
BLOCK • LOT •1
Project Description:
--- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- M ISCELLANEOU --
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/O SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 2 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
ATG INC type amount by date recut
515 SW 3RD PRMT $ 45.00 B 01/08/96 96- 274702
5PCT $ 2.25 B 01/08/96 96- 274702
PORTLAND OR 97214
Phone #: 503- 274 -8702
Contractor:
MATES ELECTRIC $ 47.25 TOTAL
DAN MATES
15120 NE CLACKAMAS - - - - - -- REQUIRED INSPECTIONS
PORTLAND OR 97230
_
Phone#: -- ----- ----- - - -� -- ------- - -- - --- . __ -__ .
Reg #.. •
This permit is issued subject to the regulations contained in the •�( - •f —
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee S' gnature
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 I _ __ _
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 q
SIGNATURE OF SUPR. ELEC' N : _ _ , _ DATE : _ U ( � ^
LICENSE NO:
Call for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION • 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # ELC 0(0 -0(1
U � � ,f� Date Issued i - q -1 tr
� .� I I Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: pp / 4. Complete Fee Schedule Below:
Name of Development 0 Ihd / H Number of Inspections per permit allowed
Address /2:760 S w P / C - Service included: Items Cost(ea) Sum
City /State /Zip - Ti &fi�6 02 q 72_2, 4a. Residential - per unit
//�� L / // 1000 sq. ft. or less $110.00 4
Name (or name of business) / 7'l/ ,LIL1��6tr> Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial Residential Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor P.74-7 E. LE c/ iQ i C Installation, alteration, or relocation $60.00 2
200 amps or less
Address /5 (2-d /v& Ga..cKcr frt.o n S 201 amps to 400 amps $80.00 2
City P o r -f-`o i _ / State 070-- Zi of 7Z i) 401 amps to 600 amps $120.00 2
`r Zip 3 601 amps to 1000 amps
Phone No. Le 6 '� 6 Z,8 6 Over 1000 amps or volts $340.00 2
/� $50.00 2
Job NO. I lid 4 Reconnect only
contractor's license NO. Z to - A 2._8 G 4c. Temporary Services or Feeders
Contractor's Board Reg. No. '' 00 - 7 Installation, alteration, or relocation 2
Signature of Supr. Elec'n C(Q Z o �_. 200 amps or less 2
License No. 'b 94.2_ Phone No. 2--5 --6� 201 amps to 400 amps $50.00 2
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. , 2
not intended for sale, lease or rent. Eat ddcha bit $ °-S
Ea
addltlonal branch circuit 2., $5.00 i (7
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 circuh(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 $ U- 5 _
NOTICE 5% Surcharge (.05 X total fees) $ Z ss
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 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. wordlmmdaAalec. ❑ Trust Account #
$
prm.app
Balance Due $ 47 - 2...s-
•
4/19/00 Activities for Case #: ELC96 -00013 •
• 5:52:07 PM
Assigned Hold Updated
• Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC700 Ceiling Cover 1/8/96 2/29/96 MJR FAIL MJR 2/29/96 corrections not complete track
• light not installed per NEC art.
• • 410 need written information
• about testing on plugs that were
covered with out inspection
cable from panel requires
physical protection correct
• service main
ELCC500 (F)Issue permit 1/8/96 B PASS B 1/8/96
ELCC700 Ceiling Cover 1/26/96 MJR FAIL • MJR 2/1/96 lights and plugs not installed
• • per NEC .
ELCC700 Ceiling Cover 2/1/96 MJR FAIL MJR 2/1/96 support flex protect cords test
plugs in divider wall - covered
without insp. need listing
information on track lights - #
• per fixture main for 3 phase
• panel
ELCC800 Case Finaled 3/19/96 MJR YES • MJR 3/19/96
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service 411110,
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 3- /1- ! (1 A.1. P.M. Entry:
Address: t a 7 6,0 S w vo-r u r:
Tenant: Ste: MST:
e BUP:
Con /Own: 0 n� ' 140�TC n MEC:
ei6-I Sto PLM:
ELC:
THE FOLLOWING_C.O' RECTIONS ARE REQUIRED: ELF C57-3
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I n pector: i//.//�i? ./1WW�AR� Date: 6
APPROVED _ DISAPPROVED /CALL FOR REINSP. CF 0