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Permit CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97 -0408 - — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/25/97 PARCEL: 2S111AD -10400 SITE ADDRESS...:O879O SW REILING ST SUBDIVISION •SCHECKLA PARK ESTATES ZONING:R -4.5 BLOCK • LOT •55 JURISDICTION: TIG Project Description: - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 – 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 0 201 – 400 amp • 0 SIGN /OUT LINE LTG..: 0 LIMITED ENERGY • 0 401 – 600 amp • 0 SIGNAL /PANEL • 0 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.: 1 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 CHRIS BLOOM type amount by date recpt 8790 SW REILING PRMT $ 35.00 JSD 06/25/97 97- 296394 TIGARD OR 97224 5PCT $ 1.75 JSD 06/25/97 97- 296394 Phone #: 624 -7906 Contractor: SHARPE ELECTRIC INC $ 36.75 TOTAL 22605 SW RIGGS REQUIRED INSPECTIONS BEAVERTON OR 97007 Rough –in Phone #: 642 -7937 Elect' 1 Final Reg #..: 000815 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by the Oregon Utility Notification Center. o • rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -1987. You may obtain a copy of these rules or direct questio - a I'" J f calling (503)' . -1987. Permittee Signature: i w _,�1, i ssued 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 : DATE: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 111 ■ Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Y ,� ;a Permit # (�ZC � -6 �' " ;I� -III Phone (503) 639 -4171 Date Issued 2' '3 7" FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Issued by -- ------,-, --- Inspection (503) 639 -4175 i 1. Job Address: 4. Complete Fee Schedule Below: Name of Development ( COs' Number of Inspections per permit allowed • Address T 90 SL-3 kei /jl ,/ q El Service included: Items Cost(ea) Sum 6 City /State/Zip 17 )0 Q ✓-dam 4a. Residential - per unit 4 �/ 1000 sq. ft. or less $110.00 Name (or name of business) Each add "'°" 500 ft or portion thereof $25.00 1 Commercial ❑ Residential ffJc1 Limited Energy $25.00 Each Manuf'd Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor ins • Ilation only: 4b. Services or Feeders / Installation, alteration, or relocation 2 Electrical Contractor / �! $ , ; / 200 amps or less $60.00 2 Addre . ,. - 10 w ' y 201 amps to 400 amps $80.00 2 /y ( Z 7 401 amps to 600 amps $120.00 2 City _ =! �. Sta - ,V ♦ Zip or) � / 601 amps to 1000 amps $180.00 2 - Phone No. VD---7? Over 1000 amps or volts $340.00 2 - Contractor's License No. x `, C Reconnect only $50.00 Contractor's Board Reg. No :. , I S I $ 4c. Temporary Services or Feeders • Installation, alteration, or relocation 2 Signature of Supr. Elec' NI - 200 amps or less $50.00 2 License No. 33(1115 Pho - No. (Qqa.--791)7 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts 2b. For owner installations: see - b• above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per panel Address a) The fee for branch circuits with City State Zip purchase of service or feeder fee. 2 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 t $35.00 3J i iv 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 $40.00 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: NOTICE 5a. Enter total of above fees $ So cep 5% Surcharge (.05 X total fees) $ d PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 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. ❑ Trust Account # $ Balance Due $ ..Stne"7 ?y r....MWopr,n... l(/ 5 /19 /00 Activities for Case #: ELC97 -00408 2:48:14 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 6/25/97 6/25/97 JSD PASS JD 6/25/97 ELCA003 Permit created 6/25/97 6/25/97 JSD PASS JD 6/25/97 ELCA799 Elect! Final 6/25/97 JMT NOTE JT 11/19/98 11/19/98 inspection request (research) to chuck d ELCA500 (F) Issue permit 6/25/97 JSD PASS JD 6/25/97 ELCA920 Miscellaneous action 12/2/98 CD FAIL CD 12/2/98 visited site, no one home, left notice to schedule for a/c wiring inspection. ELCA799 Elect'! Final 12/4/98 CD PASS CD 12/8 /98 wiring of a/c unit ELCA800 Case finaled 12/8/98 CD PASS J`H 12/8 /98 Wiring of AC unit - pass finaled CC • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 003 X BUP 3 Date Reque ,_ — - � PM BL , Location 8 7 t0 )St'v e , I Suite i .���� Contact Person (�lU),(; LZ[/r .:6 Ph 7 p — Q6 75 = LM Contractor Ph pru BUILDING Tenant/Owner 9 '2 - Retaining Wall ELR Footing Access: Foundation JAI_ /, i 4A C �� /'j/� FPS Ftg Drain r► (s n �� / v SGN Crawl Drain Inspection Notes: p� al 1 PO O Slab SIT Post & Beam all Ext Sheath /Shear Int Sheath/Shear f Framing Insulation Drywall Nailing • Firewall • Fire Sprinkler _ . i G ■■r . / ' / 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 PAS�,. .RARC FAIL LECTRICAL Rough In t e i ej UG /Slab viiv Low Voltage Fire Alarm Final iiel0 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 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.