Permit ELECTRICAL PERMIT
CITY OFTIGA
PERMIT DATE ISSUED: 07/31 /96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: `S 102CB -0030`
SITE ADDRESS...: 13285 SW PACIFIC HWY
SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING:C —G
BLOCK • LOT • 33
Project Description: Installing a limited energy panel.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS , : 0 0 — 200 amp 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp - 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 — 600 amp 0 SIGNAL /PANEL • 1
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/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp ° 0 EA ADD'L BRNCH CIRC: 0 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
7 -11 type amount by date recpt
13285 SW PACIFIC HWY PRMT $ 40.00 CJS 07/31/96 96- 283252
5PCT $ 2.00 CJS 07/31/96 96- 283252
TIGARD OR 97223
Phone #:
Contractor.
JAMES BL K JR $ 42.00 TOTAL
15701 S GOPHER VALLEY RD
l REQUIRED INSPECTIONS - --
SHER AN OR 97378 ' t % Wall Cover Elect'1 Final
Pho a #: 1 1 0 Elect'1 Service
Re #..:
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 Cho olo C Caen 4----
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 --
SIGNATURE OF SUPR. ELEC' N : I?'YIGci DATE: 7/3/46
LICENSE NO: •
Call for inspection — 639 -4175
~ Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # r-L -o Q8
,� I , Date Issued 3/95
� I1 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 Development Number of Inspections per permit allowed
I
Address 1 2 ; )2..P6 f •t 0 .Th-e-cti. C', Service included: Items Cost(ea) Sum
City /State /Zip - II 6 f 2 -__ 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) 1 -II Each additional 500 sq. ft. or
portion thereof $25.00
Commercial El Residential III 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 Installation, alteration, or relocation
200 amps or less $60.00 2
Address Q.6 .60-1 9S' n 201 amps to 400 amps $80.00 2
4 01 amps to 600 amps $120.00 2
City ?DY'� State a_ Zip q l Z`61 $180.00 2
601 amps to 1000 amps
Phone No. [DM " 2 Over 1000 amps or volts $340.00 2
/, Reconnect only $50.00 2
Job NO. / / ^r ��J
contractor's license KO. - - ,3i PC-/-6 4c. Temporary Services or Feeders
Contractor's Board Reg. N •. /o4c3 Installation, alteration, or relocation 2
Signature of Supr. Elec'n �v'"'/ 200 amps or less 2
License No. 313 SZ r ' hone No. 1! -POW- 201 amps to 400 amps $50.00 2
( A ,O 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. First branch circuit $
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 _IL__ $40.00 ...1() ,-
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 $ L ib -
NOTICE 5% Surcharge (.05 X total fees) $ ___2.-Z-_
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 1 -I2 r -
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. wordlwmdrAelao ❑ Trust Account #
$
prm.app
Balance Due $ GD
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location '5 Suite MEC
Contact Person Ph PLM
Contractor Ph (03 ? — 3 Z(PZ_ SWR
BUILDING 411, Owner f I ELC � — cn.5
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing CL—hone 0 1 0
Insulation
Drywall Nailing / /✓4-Z ∎ /9
Firewall
Fire Sprinkler
Fire Alarm �
Susp'd Ceiling
Roof
Misc:
Final
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
_� ...
Se
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
AS PART FAIL
SITE
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 Date 4 f - /J r � I nspec t o r i g E x t
Other v
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.