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Permit
• CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: CAL ELC2000-00623 � DEVELOPMENT SERVICES DATE ISSUED: 11/6/00 ca 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CB -09100 SITE ADDRESS: 12436 SW QUAIL CREEK LN SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 • BLOCK: LOT : 049 JURISDICTION: TIG Project Description: Installation of one branch circuit for heated swimming pool. 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 1 IN PLANT: 601 - 1000 amp: • PLA `REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DON MORISSETTE HOMES KELSO ELECTRIC INC 4230 GALEWOOD STREET 16670 SW WRIGHT SUITE 100 BEAVERTON, OR 97007 LAKE OSWEGO, OR 97035 Phone: 274 -5223 Phone: 591 -9665 Reg #: LIC 001162 SUP 4270s ELE 34 -433c FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 11/6/00 $46.85 2720000000( Elect'I Final 5PCT CTR 11/6/00 $3.75 2720000000( PRMT CTR 12/28/00 $80.15 2720000000( (additional fees not listed here) Total $137.16 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_ OUNC at (503) 246 -1987. — C1.2G iejirtf PERMITTEE'S SIGNATURE ISSUED BY: 19 , 2^`d 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: /�. �-- DATE: / 2 - vv LICENSE NO: GZ70S Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Dater ceived: Permit no.: s' �,L'' , City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT (l & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: /v y3r �4„/ © /G ",4 c Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: I Description and location of work on premises: Estimated date of completion/inspection: , CONTRACTOR APPLICATION ',. FEE SClIEDU.E Job no: Fee Max J�EGS v /5 Description Qty. (ea.) Total no. lnsp Business name: /�i Newresidential -single or multi - family per Address: JA„ - S ,G,/ //l.(�` /7 — dwelling unit. Includes attached garage. • City: A I State: oe I ZIP:g - -7 Serviceincluded Phone: qq6( I Fax: I E -mail: 1000 sq. ft. or less 4 �� - ° Each additional 500 sq. ft. or portion thereof CCB no.: j( 2 Sy I Elec. bus. lic. no: cf. ZJ33C. t� Limited energy, residential 2 City /metro lic. no.: Limited energy, non- residential 2 /- i Z , 7 z) o Each manufactured home or modular dwelling Signs a supervising electrician (required) Date Service and/or feeder 2 Sup. e ect. name (print): L License no: Servicesorfeeders installation, ofd alteration or relocation: PROPERTY OWNER 200 amps or less / 2 • Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts • 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - - which is not intended for sale, lease, rent, or exchange according to Installation, alteratloa,orrelocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2.. 2 • City: I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2 Each additional branch circuit: PLAN REVIEW' (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps - commercial 0 Health- carefacility Each pump or irrigation circle 2 O Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration, or extension* - 2 O Building over three stories 0 Feeders, 400 amps or more *Description: O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan O Other: Per inspection I I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa O MasterCard expires if a permit is not obtained' Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 4404615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY /� Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40. 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular El Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ , 201 amps to 400 amps $106.85 2 Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps' $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 6 6 ' (2 (SEE OAR 918 -260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see "b" above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or ❑ Clock Systems . feeder fee. O Each branch circuit A $6.65 / , 3 ,,, 3 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable In any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: C� /� ❑ Protective Signaling L Enter total of above fees $ U 0 ' n Other / 8% State Surcharge $ C� • `T // � 1 Number of Systems 25% Plan Review Fee See "Plan Review" section on $ ' No licenses are required. Licenses are required for all other installations - front of application. Fees: Total Balance Due $ C( / , , S�o • • Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ • Total Balance Due $ i:'dsts\forms\elc- fees.doc 10/09/00 CITY OF T' G A R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00623 �y DEVELOPMENT SERVICES DATE ISSUED: 11/6/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CB -09100 SITE ADDRESS: 12436 SW QUAIL CREEK LN SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT : 049 JURISDICTION: TIG Project Description: Installation of one branch circuit for heated swimming pool. RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DON MORISSETTE HOMES KELSO ELECTRIC INC 4230 GALEWOOD STREET 16670 SW WRIGHT SUITE 100 BEAVERTON, OR 97007 LAKE OSWEGO, OR 97035 Phone: 274 -5223 Phone: 591 -9665 Reg #: LIC 001162 SUP 4270s ELE 34 -433c FEES Required Inspections Type By Date Amount Receipt Rough - in PRMT CTR 11/6/00 $46.85 2720000000( Elect Final 5PCT CTR 11/6/00 $3.75 2720000000( Total $50.60 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 . - - es or direct questions to OUNC at (503) 246 -1987. , PERMITTEE'S SIGNATURE �� ISSUE. BY: ( , 4 , C /�/ 6/414_,d4 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: - - DATE: LICENSE NO: g9 Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: //(/0.0 Permit no.: e( ,,...).f. �.,, City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT iif 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement 0 New construction O Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: / 2y36 0)(//-1 /4 GRarx L,u Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: 'Subdivision: • Project name: I Description and location of work on premises: 0.1 / /4i, (f,Ud j,Q,(,L/) Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max name /��c -LS, �� Description Qty. (ea.) Total no. insp Business �L r �T� New residential - single or multi - family per Address: /(06 7o si,J 1 ,2 1 2,61-,7.— dwelling tut% Includes attached garage. , City: f/ I State:0,2 I ZIP: 970.0,7 Service included Phone: '9 / _96 6 s I Fax: I E -mail: 1000 sq. ft. or less - 4 CCB no.: /16 Z s / I Elec. bus. lic. no: ,Ty_ y3 G _ Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: Limited energy, non- residential 2 / yJ /�� 4' // — 00 Each manufactured home or modular dwelling Signaturtf supervising electrician (required) Date Service and/or feeder 2 Sup. eect.name(print): 6i4 %.t e. License no: yZ 70S Services or feeders— installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): • 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: 'Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - -- which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 . City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: ' 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of I &2 O Hazardous location Each sign or outline lighting 2 family dwellings ' O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension' 2 O Building over three stories O Feeders, 400 amps or more *Description: O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan O Other. Per inspection I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other • Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440.4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees:. - Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY P Restricted Energy Fee $75.00 • Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ • Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation 200 amps or less $66.85 2 Fee for each system $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. ❑ Branch Circuits Audio and Stereo Systems New, alteration or extension per panel ❑ • a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ❑ Clock Systems Each branch circuit $6.65 2 b) The fee for branch circuits ❑ Data Telecommunication Installation without purchase of service 4 � ❑ Fire Alarm Installation feeder c. First branch ranch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation circle $53.40 _ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 Minor Labels (10) $125.00 I:: Landscape Irrigation Control Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 Per hour $62.50 ❑ Nurse Calls In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: .8< ❑ Protective Signaling Enter total of above fees $ 8% State Surcharge $ n Other Number of Systems 25% Plan Review Fee See of application. n "Plan Review" section on $ ro front * No licenses are required. Licenses are required for all other installations Total Balance Due $ O Fees: Enter total of above fees $ ❑ • Trust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts \forrns \elc- fees.doc 10/09/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / 2 2_ AM PM BLD Location 12, $ 64 4' l � f i�c��C - Suite MEC Contact Person /e-e-r-tert JO)? ek Ph PLM Contractor�S'v �L Ph SWR BUILDING Tenant/Owner ELC - GU Z-3 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 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 PASSPART FAIL CAUSLEI"ICAL Service Rough In UG /Slab • Low Voltage Fire Alarm -ART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at ity Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for rein pection - : Unable to inspect - no access ADA Approach /Sidewalk � U Ins actor Ext Other Date p Final PASS PART FAIL D • NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24- I Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested /1 e AM PM BLD Location / Z- 3 $w Qu 41 1 07.2.e -A Suite MEC Contact Person t `1 dl h ACten- Ph /f/- 9/ f P PLM Contractor / SE) � / e -,- r Cal/ SWR C' BUILDING Tenant/Owner 124'4Se Gl ELC 2iLd -G0 lv 13 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes n Slab Q / r- SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Z/01/ / �f / / ) /� J Fire Sprinkler `v ]/ Fire Alarm Susp'd Ceiling L. 1 Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final I PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PAS FAIL ge _ r E I CTRI ice Rough In V-N St 1 UG /Slab PG v� Low Voltage Fire Alarm F•• .. FART 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 l � Approach /Sidewalk / / Other j Ext D Inspector Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.