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Permit A- CITY OF TI GARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00042 1 6 DEVELOPMENT SERVICES DATE ISSUED: 2/1/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 10X8 -02600 SITE ADDRESS: 13066 SW PACIFIC HWY SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G BLOCK: LOT : 020 JURISDICTION: TIG Project Description: Installation of one service /feeder of 200 amps or less and 4 branch circuits. Job No. 3001. 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: 1 W /SERVICE OR FEEDER: 4 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: CAPONE, ANTHONY M VINER ELECTRIC 13056 SW PACIFIC HWY PO BOX 301386 TIGARD, OR 97223 PORTLAND, OR 97294 • Phone: Phone: 408 -8836 Reg #: ELE 37 -828C LIC 113650 SUP 2134S FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 2/1/00 $85.65 00- 321547 Elect'l Final 5PCT DEB 2/1/00 $6.85 00- 321547 Total $92.50 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 adopte. • • - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copie : these rules • • irect questions to OUNC at (503) 246 - 1987. PERMITTEE'S SIGNATURE - • ISSU = D BY: OWNER INS TION ONL The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: • • CONTRACTOR � IN TA TION ONLY SIGNATURE OF SUPR. ELEC'N: 1.' a `��I DATE: > `IT LICENSE NO: A 1 . ' •• " Call 639 -4175 by 7:00pm for an inspection the next business day CITY.OF TIGARD Electrical Permit Application Plan eck 13125 SW HALL BLVD. Rec' N. Date Recd ' - 06 TIGARD OR 97223 Date to P.E. ------ Phone (503) 639 -4171, x Date to DST Inspection (503) 639 -4175 Print of Type Permit# ¢_� 0 - a"442- Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1.. Job Address: /+ 4. Complete Fee Schedule Below: Name of Development C4 -g S Number of Inspections per permit allowed Name (or name of business) v`4' ess) ,G Service included: Items Cost Sum Address ` 306 f0 / r�=/c. I a q. Reside o ntial per unit $ 117.75 4 r City /State /Zip Each additional 500 sq. ft. or portion thereof $ 26.75 1 Commercial Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 • (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders / information for COT data base). Installation, alteration, or relocation • , S0 Electrical Co,(ltractor V! A/61 ... C]g)C 200 amps or less / $ 64.25 4► 7 2 Address /9:1/( 1 Mb 201 amps to 400 amps $ 85.50 2 City State OR Zip p7,_94 401 amps to 600 amps $ 128.50 2 ty P r 601 amps to 1000 amps $ 192.50 2 Phone No. .03- i/Og- $fS 3l. Over 1000 amps or volts $ 363.75 2 Job No. P / 10 Reconnect only $ ' 53.50 2 Elec. Cont. Lice. No. 31- g Z� CExp.Date /0 -/ -Q o 4c. Temporary Services or Feeders OR State CCB Reg. No. )13 4 5n Exp.Date 'X- l( I Installation, alteration, or relocation COT Business Tax or Metro No. �� 7 5 Exp.Date 2-! • -6/ 200 amps or less $ 53.50 2 � A ` 201 amps to 400 amps $ 80.25 2 Signature of Su r. Elec 401 amps to 600 amps $ 100.00 2 g p Over 600 amps to 1000 volts, l0 - - i' . , ■ see "b" above. License No. 2-Lag- S Exp.Date Phone No. 008 -s7,345 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. ' Print Owners Name Each branch circuit y $ 5.35 2/ Me 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 , Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service'or feeder not included) Each pump or irrigation circle $ 42.75 Owners Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy if required):* panL alteration or extension $ 60.00 3. Plan Review section ( Minor Labels (10) $ 100.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Per inspection $ 50.00 Service and feeder 225 amps or more Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: • 5a. Enter total of above fees $ * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ Not required for temporary construction services. Subtotal $ NOTICE 5b. Enter 25% of line 5a for / • g. Plan Review if required (Sec. 3) $ cO PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # sO AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ?go " i:\dsts\forms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested �/ y �� -/ ) AM PM BLD J 2 Location I 2 Par_ 14u) Suite // MEC Contact Person V 1 nm Ph `6 PLM Contractor Ph SWR BUILDING Tenant/Owner ff:PO 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 C/ _ _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final r q PASS PART FAIL PLUMBING 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 CELECTRIZ Ar Service ough UG /Slab Low Voltage • - - arm 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: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date v (9 a Inspector t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.