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Permit ` A PERMIT #: ELC1999 -00446 A-400.1& DEVELOPMENT SERVICES DATE ISSUED: 7/21/99 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 • PARCEL: 2S 111 AD -05600 SITE ADDRESS: 08730 SW PINEBROOK ST SUBDIVISION: PINEBROOK TERRACE ZONING: R -4.5 BLOCK: LOT : 079 JURISDICTION: TIG Project Description: Service or feeder to 200 amps • 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: MILA THOMPSON OWNER 8730 SW PINEBROOK • TIGARD, OR 97224 Phone: 503 - 639 -9279 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'l Service 5PCT BON 7/21/99 $4.50 99- 317036 Elect'l Final • PRMT BON 7/21/99 $64.25 99- 317036 Total $68.75 OR\G\NAL 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 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. • Permit Signature: >C * %' Issued By: ig J OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: Ve-.4 Q DATE: 7-2—(-1/ 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 Che 13125 SW HALL BLVD. Rec'd By KTILI Date Rec'd 7 -2 TIGARD OR 97223 Date to P.E. Phone (503) 6394171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # r Pk f L2-V t r C Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: • 4. Complete Fee Schedule Below: N of Inspections per permit allowed Name of Development �' ;�� l�; I ti � o.u�p.Sor1 ' Name (or name of business) Service included: Items Cost Sum Address i3.3.0 5 f' 4 e I, r S . 4a. Residential - per unit City /State /Zip I,'7 a eci DN. 1 17,2, 1 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial ❑ Residential Limited Energy $ 60.00 Each Manuf'd 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 c � Electrical Contractor 200 amps or less ) $ 64.25 co 7` Z 2 Address 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 City State Zip 601 amps to 1000 amps $ 192.50 2 Phone No. Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders OR State CCB Reg. No. Exp.Date Installation, alteration, or relocation COT Business Tax or Metro No. Exp.Date - 200 amps or less $ 53.50 . 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, see "b" above. License No. Exp.Date Phone No. 4d. Branch Circuits New, alteration extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or e /l feeder fee. Prin Owner's Name 4.1 i r J4,, �Se/7 Each branch circuit $ 5.35 2 b) The fee for branch circuits Addr ess e.9,30. .1.0 �iilrbrovr . i/ State Zip '97:R. o without feeder fe chase of service City fr d,J p or feeder fee. Phone'No. (soy / 3 g - 9 z7 ' 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 L / I E ach sin or outline li htin $ 42.75 • • Owner's Signatur= 4 � � /_li �, g 9 g _ � _ _ _- ____ ._ _ ___ Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension $ 60.00 Minor Labels bels (10) $ 107.00 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 Service and feeder 225 amps or more Per inspection $ 50.00 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 $ (_4 ZC * Submit 2 sets of plans with application where any of the above apply. fib Surcharge (.05 X total fees) $ --I, Sly Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ 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 # _ AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ W ' 1 is \dsts \forms \electric.doc 6/6/00 Activities for Case #: ELC1999 -00446 2:07:33 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 7/21/99 BON DONE No Hold BON 7/21/99 ELCA003 Permit created 7/21/99 BON DONE No Hold BON 7/21/99 ELCA730 Elect'I Service 7/21/99 7/21/99 4/27/00 BRP PASS No Hold AKJ 4/30/00 ELCA799 Elect'I Final 7/21/99 7/21/99 4/26/00 CD FAIL No Hold AKJ 4/26/00 1) install additional ground rod for service total of 2 6' apart, grounding electrode conductor must be continuous 2) don't enclose service ground in metal conduit unless bonded at each end . 3) install ground bat in subpanel ELCA500 (F) Issue permit 7/21/99 BON DONE No Hold BON 7/21/99 ELCA800 Case finaled - 4/30/00 AKJ DONE No Hold AKJ 4/30/00 • Page 1 of 1 6/9/00 Activities for Case #: ELC1999 -00446 3:37:07 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 7/21/99 BON DONE No Hold BON 7/21/99 ELCA003 Permit created 7/21/99 BON DONE No Hold BON 7/21/99 ELCA730 Elect'I Service 7/21/99 7/21/99 4/27/00 BRP PASS No Hold AKJ 4/30/00 ELCA799 Elect, Final 7/21/99 7/21/99 4/26/00 CD FAIL No Hold AKJ 4/26/00 1) install additional ground rod for service total of 2 6' apart, grounding electrode conductor must be continuous 2) don't enclose service ground in metal conduit unless bonded at each end 3) install ground bat in subpanel ELCA500 (F) Issue permit 7/21/99 BON DONE No Hold BON 7/21/99 ELCA800 Case finaled 4/30/00 AKJ DONE No Hold AKJ 4/30/00 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639-41 Business Line: 639 -4171 "PM BUP Date Requested 27 0 AM BLD Location ? v / 73 © , .._ ii-�, �� Suite MEC Contact Person '7 - fp f 5 C2zki Ph f — PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 79419,-- ep��/� �7'� Retaining Wall ELR Footing ACC ss Foundation FPS Ftg Drain /rkee u4,5 (-VOL I ,r./ SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam f i Ext Sheath /Shear Ake--d le 4.1- e_t�...) 9 , ft / 1l , 6 Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof �� VIA C€ Q �,� 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 04 Final PySS- --BART FAIL gLECTRICAL Rough In UG/Slab Low Voltage Cf Fir- larm : 4, PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before ■ - spection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ I Unable to inspect - no access ADA /� Approach /Sidewalk D 1 v Inspector o It 0 ' Other LLLA — t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP c7 Date Requested - a- Co AM PM BLD Location �5 7 p 3 6 / -vl2.P St-Suite MEC Contact Person Ph 6 3 5 1- Fa 7? PLM Contractor Ph SWR / L BUILDING Tenant/Owner ELC 199q-c20 T�(0 Retaining Wall ELR Footing Foundation 4107 / FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation � ••��f -- s Drywall Nailing J 4`f'�� fig-0411 , x1Yyt , /60 Firewall /,' L Fire Sprinkler AA_ SE��- L//. t' P ) t� Fire Alarm �— �, L -\ Susp'd Ceiling �/ 7'4) � ctc Roof �� Misc: �' r��J 4' _0 le-- /1.1 iJ:S d L ( 14v1Jc7 c/� Final PASS PART FAIL PLUMBING Q AA0 f PitelA_C-• Post & Beam Under Slab / 11 S / l � l G � ' //1/ I�7�T�/J�� /Q�c% 1; Ai Top Out / Water Service Sanitary Sewer Rain Drains Final L PASS PART FAIL 3 �� / Iii �i MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough In • UG /Slab Low Voltage Fire Alarm Final PASS PART SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for r inspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk t I Date ✓ Inspector / = _ — Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.