Permit CITY OFTIGARD
r s , A i �� � D EVELOPMEN O T SERVICES PERMIT #A 13125 DATE ISSUED: 05/13/97
PARCEL: 2S110DC -02200
SITE ADDRESS...: 15532 SW PACIFIC HWY #5*
SUBDIVISION •WILLOW BROOK FARM ZONING:C —G
BLOCK • LOT •11 JURISDICTION: TIG
Project Description : SIGN PERMIT FOR NAILS 4 U, C-5
- -- 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..: 1
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANE. 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
STERLING DEVELOPMENT CORPORATION type amount by date recpt
LA JOLLA CORPORATE CENTER PRMT $ 40.00 JMH 09/23/96 96- 284288
3252 HOLIDAY COURT, SUITE 225 5PCT $ 2.00 JMH 09/23/96 96- 284288
LA JOLLA CA 92037
Phone #:
Contract or:
ERIC SCHARER $ 42.00 TOTAL
6712 AMY LANE, NE
REPUIRED INSPECTIONS
KEIZER OR 97303 Ceiling Cover Underground Cove
Phone #: Wall Cover Elect'1 Service
Reg #..: 000925
This ervit is issued subject to the regulations contained in the / / Il�/��/IJLJ
P subject 9
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 ,ykitilty).:0q
within 180 days of issuance, or if work is suspended for more
than 1:'. days. I ued By
OWNER INSTALLATIO 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 : DATE:
LICENSE NO:
Call for inspection — 639 -4175
il_
CITY,OF TI 3ARD Electrical Permit Application g 2') 9L ‘y;i
13125 SW HALL BLVD. Date Recd
Date to P.E. .l
TIGARD ,OR 97223 Print or Type Date to DST
(503) 639 -4171 Incomplete or illegible applications will not be accepted Permit# ow C.--q • - 0/'573
/ < i Related - _ •+ ' , - / /53
' I ' ( / � ' � / � Called 10/7 9b mot-
1. Job Address: 4. Com •a=te Fee Schedule Below: "WPM • � �,
Name of Delopment -I b f izoAAQl�11ArDE C - S Number of Inspections per permit allowed
1 53 2 - Pact f''���
Address IF. i�1 W S ervice included: Cost (ea) Sum 11;,, a
City/State/Zip �w , ad
t.
p , (�� D �� 4a Residential - u nit
1000 sq. ft. or fess $110.00 4
Name (or name of business) N p•11. -5 4 (A. Each additional 500 sq. ft. or
portion thereof $25.00 1
Limited Energy $25.00
Commercial Residential ❑ Each Manurd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00 2
(attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor K + K s I ` ' 5 Installation. alteration, or relocation
Address F. O. 60)c 317 200 amps or less 560.00 2
201 amps to 400 amps $80.00 2
City DAyrol4 Sate � Q � R.. Zip '7 i I LE 401 amps to 600 amps $120.00 2
Phone No. 9Q3 • It lo�. "["1$ a 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp Date
OR State CCB Reg No. Z. Ex Date 7 - 1 6 -9,7 4c. Temporary Services or
Signature of Su r. Elec'n Feeders
Installation, alteration, or relocation 2
License No. 125/ Exp Date /o -/ - 95' 200 amps or less $50.00 2
Phone No. 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
COT Business Tax or Metro # Ls-'f7 Exp. Date /, / -9 7 Over 600 amps to 1000 volts
see 'b above.
2b. For owner installations: 4d. Branch Circuits
Print Owner's Name New, alteration or extension per
Address p
City State a) The fee for branch circuits with 35.00
Zip purchase of service or feeder 2
Phone No. fee.
Each The installation is being made on property I own which is not intended b) The tee forr branch circuits $5.0 0 2
for sale, lease or rent.
without 2
purchase of service or feeder
fee.
Owner's First branch circuit
Signature Each additional branch circuit S40.00 2
2
3. Plan Review section (if required): 4e. Miscellaneous $40.0 2
(Service or feeder not $100.00
Please check appropriate item and enter fee in section 53. included)
4 or more residential units in one structure Each pump or irrigation circle
Service and feeder 225 amps or more Each sign or outline lighting
System over 600 volts nominal Signal circuit(s) or a limited energy $35.00 / ' - ,`u�.L d ci
Classified area or structure containing special occupancy panel, alteration or extension $55.00
Minor Labels (10) $55.00 l
as described in N.E.C. Chapter 5
4f. Each additional
Submit 2 sets of plans with application where any of the inspection over the
S
above apply. Not required for temporary construction allowable in any of the
above S
services. Per ins S / G_ 1 - CT
inspection /
Per hour
NOTICE In Plant $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF 5. Fees:
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A 5a. Enter total of above fees $
PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 5% Surcharge (.05 X total
Ltb... bbpm.ddc as fees) $
Subtotal
5b. Enter 25% of line A for
Plan Review if required
(Sec.3)
Subtotal
❑ Trust Account*
Balance Due
r
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 5 ' � � c r� ? Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING 400 Owner (k 27(—Li ELC � — G &S
Retaining Wall ELR
Footing ' Access:
Foundation FPS
Ftg Drain WA-e--ko
Cra wl Drain SGN
Slab SIT
Post & Beam NOT REQUESTED
Sheath /Shear
Int Sheath /Shear FOUND DURING RESEARCH
Int
Framing NO INSPECTION(S) IN FILE
Insulation
Drywall Nailing
Firewall
Fire Sprinkler G A - 37
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F
•
inal
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
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 at // /6 ° 97 Inspecto `� �� E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.