Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00293
" „� II & DEVE SERVICES DATE ISSUED: 5/17/99
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 63197
PARCEL: 2S103DA -04500
SITE ADDRESS: 10600 SW PARK ST
SUBDIVISION: FANTASY HILL /61/ ZONING: R -3.5
BLOCK: LOT: 002 44ZRISDICTION: TIG
Project Description: Relocation of existing service.
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: 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:
TERRY WEESE OWNER
10600 SW PARK ST
TIGARD, OR 97223
Phone: 620 -7930 Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DRA 5/17/99 $60.00 99- 315466 Elect'I Final
5PCT DRA 5/17/99 $3.00 99- 315466
Total $63.00
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -001 S. rough OAR 952 - 001 -0080. You may obtain co - • - - les or direct questions to OUNC at (503)
246 -1987.
Permit Signature: Iss ed By:
` • JL t 2
OWNER INSTALLATION ONLY
The installation is being made on propert n which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: � <r DATE: / --ci/
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan C,
13125-SW HALL BLVD. Rec'd :y WA >
TIGARD OR 97223 Date Recd 7 `
Date to P.E. ---------
Phone (503) 639 -4171, x304 r -
Inspection (503) 639 -4175 Print or Type Pe t #ems / -g,:
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 7Z RA/ ,1 Number of Inspections per permit allowed
Name (or name of business) / LR�_ & C Service included: Items Cost Sum
I
Address / 6 &O 5u) A ( '(� / �i W 5 t 4a. Residential - per unit
rf 1000 sq. ft. or less $110.00 4
City /State /Zip / / J/ t °Re nf / q a 3 Li Each additional 500 sq. ft. or
Commercial ❑ / Residential QSI portion thereof $25.00 1
Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Installation, alteration, or relocation . � , OQ 2
200 amps or less Address 201 amps to 400 amps +Z° - $80.00 ` 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job N0. Over 1000 amps or volts $340.00 2
Reconnect only - $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Su r. Elec'n 201 amps to 400 amps $75.00 2
9 P 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
�� 1 , ' purchase of service or
[r
/
Print Owners Name Rj EEcE feeder fee.
Address JO 6 00 S W A s7- W Each ocuit - $5.00 2
b) The fee e f for r branch braannch circuits •
City 1? 9 . .4 State 6,e& Zip ?72 Z3 without purchase of
Phone No 3) f'oa0 7936 service or feeder fee.
First branch circuit $35.00 2
Each additional branch circuit - $5.00 2
The installation is being made o roperty I own which is not
intended for sale, lease or r 4e. Miscellaneous
(Service or feeder not included)
Owner's Signatur Ge = ° - Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):*
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
Service and feeder 225 amps or more Per inspection $35.00
System over 600 volts nominal Per hour $55.00
Classified area or structure containing special occupancy In Plant - $55.00
as described in N.E.C. Chapter 5
5. Fees: o v
* Submit 2 sets of plans with application where any of the above apply. 5a. Enter total of above fees $
Not required for temporary construction services. 5% Surcharge (.05 X total fees) $ O
Subtotal $
NOTICE 5b. Enter 25% of line 5a for
Plan Review if required (Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK O
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ❑ Trust Account # /„ .0
TIME AFTER WORK IS COMMENCED. Total balance Due $ �Y J
I: \DST \ELEC98.DOC REV 4/98
7/25/99 • Activities for Case #: ELC1999 -00293
6:24:02 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To , Done By Disp. Level By Updated Notes
ELCA001 APPlication received 5/17/99 DRA DONE No Hold DRA 5/17/99
ELCA003 Permit created 5/17/99 DRA DONE No Hold DRA 5/17/99
ELCA730 Elect'I Service 5/17/99 5/17/99 No Hold DRA 5/17/99
ELCA799 Elect'I Final 5/17/99 5/17/99 7/9/99 CD PASS No Hold AKJ 7/11/99
ELCA500 (F) Issue permit 5/17/99 DRA DONE No Hold DRA 5/17/99
ELCA800 Case finaled 7/11/99 AKJ DONE No Hold AKJ 7/11/99
•
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
2 BUP
Date Requested 11�� �� ' �] ( AM PM BLD
Location IOCD( J f Ak1 Sf Suite MEC
Contact Person 1 (.3 Ph CO20 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 7 ! po
q -cq 3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: ()Ail i ° O ,/ ST
Slab D r
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler �t'.L .0
Fire Alarm V /
Susp'd Ceiling
Roof
Misc: -
Final
PASS PART FAIL �U
PLUMBING
Post & Beam CD;;-) 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
<ILECTR
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
F' _.
' 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 7 9 99 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .