Permit CITY OF TIGARD ELECTRICAL PERMIT
•• h,, ,,A DEVELOPMEN SERVICES PEMIT ELC98-0076 e
PARCEL: 281O4DD -0:500
SITE ADDRESS...:12879 SW RIDGEFIELD LN
SUBDIVISION •MOUNTAIN HIGHLANDS #2 ZONING:R -4.5 PD
BLOCK • LOT •022 JURISDICTION: TIG
Project Description : Installation of 2 light circuits, 2 pulp circuits, and 1
heater circuit.
- -- 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: 4 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
GARY LONG type amount by date recpt
8290 SW LANDAU ST PRMT $ 55.00 DRA 02/18/98 98- 303407
TIGARD OR 97223 5PCT $ 2.75 DRA 02/18/98 98- 303407
Phone #:
Contractor:
OWNER $ 57.75 TOTAL
REQUIRED INSPECTIONS
Rough –in Elect' 1 Final
Phone #: Elect' 1 Service /-I'SL denl.Ybi
Reg #..: 999999
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. Those rules are set forth in OAR 952-001 -0010 through OAR 952- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503 x987.
Permittee Signature: Mb ,I I ARA IA f Issued B : .
Nur OWNER INSTALLATIrN ONLY
010
The installation is made o p-Aaerty I own which is not intended for
sale, lease, or ren�� -
OWNER' S SIGNATURE: M, 4.1 # A AA DATE : 4 2- -- /e - 7 (
CONTRACTOR IN LLATION ONLY
SIGNATURE OF SUPR. ELEC' N : DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + ++ + + + + + + + + + + + + + + + + + + + + + + + + + ++
01/15/88 17:60 '8`503 684 7297 CITY OF TIGARD Q 004/004
-
CITY OF TIGARD Electrical Permit Application Plan
13125 SW HALL BLVD. ,5u P l 7 g9 7 R ate Reed
TIGARD OR 97223 7 D
Date to P.E.
Phone (503) 639 -4171, x304 Data to D
Inspection (503) 639 -4175 Print or Type Permit s F g ,�,, r �70
Fax (503) 684-7297 Incomplete or illegible will not be accepted Caned
-
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Z Number of Inspections per permit allowed
Name (or name of business) G II LC Is Senflce included Items Cost Sum
Address I2nq S 1A) 1 ( \'�` l�� 4�ges per unit 5110.00 4
City /State/bp - 1 � &- 1I � . 1 7 Each adaiored 500 sq. It or
Commercial ❑ Ib.f Residential l� a thereof $25.00 1
Umnited Energy $25.00
Each Maned Home or Modular
2a Contractor installation only: D""ea"B""cu or Feeder S68.00 2
(Attach copy of all current licensee) 4b. Services or Feeders
Electrical Contractor brstaCation, aeration. or relocation
Address 200 amps or less 560.00 2
201 amps to 400 amps 380.00 2
City State bp 401 amps to 600 arms $120.0o 2
Phone No. 601 amps to 1000 amps 3110.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont Lice. No. Exp.Date Reconnect only 350.00 2
OR State CCB Reg. No. ,Exp.Date 4c. Temporary Serviette or Feeders
COT Business Tax or Metro No. Exp.Date installation, alteration, or relocation
200 amps or less 350.00 2
Signature of Supr. Elec'n
201 amps to 400 amps 525.00 2 -
amps to 600 amps 3100.00 2
Over 600 amps to 1000 volts,
License No . Exp.Date see •b" above.
Phone Nn 4d. Branch Circuits
New alteration or extension per panel
26 For owner installations: a) The fee for branch circuits with
G A f L1 I �11N C- � �� ofd a or
Print Owner's Name •
Address P, Os - I.X a.6 a (Q3 _ Each branch circuit 56.00 2 -
C City e�+r� State C)C Z ,G ?.iSI b) The tee forbr
dY 1 ) P without purchase of 26.- oD
Phone Nd. a. `-15 - Ligi a l•_____ service or feeder nee.
Fe �a
Rat branch circuit $36.00 N o� � 2
The installation is be' • • ; • e on property I own which is not Each additional branch circuit $6.00 ep 2
intended for sale re t. ,. ' 4e. Miscellaneous
Owners Sign = (Service or feeder not Included)
�� /)l Each pump or Irrigation circle $ 40 - 00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if requir * Signal cirara(e) or a limited energy 2
panel, alteration or extension $40.000
Please check appropriate item and enter fee in section 5B. Minor libels (10)
4 or more residential welts In one sllucture 41. Each additional Inspection over
Service and feeder 226 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection 835.00
Classified area or structure containing special occupancy Par (tour $55.00
as described in N.E.C. Chapter 5 In Plant 866.00 - -
e Submit 2 sets of plans with application where any of the above apply. 6. Fees: 5s, 40
Not required for temporary construction cervices& Se_ Enter total of above fees s
5% Surcharge (.05X total tees) $
NOTICE Mx E rroer 25 % of line 5a for I 71:77-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If rewired (Sec.3) 3
NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR WORK Subtotal 3
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY 0 Trust Account it 5 7
TIME AFTER WORK IS COMMENCED. S
4 4 Tel balance Due
W5r5IELC96.APP Acv 9/96
01/12/2000 Activities for Case #: ELC98 -00076
3:03:21 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 02/18/1998 DRA RECD DST 02/18/1998
ELCA003 Permit created 02/18/1998 DRA DONE DST 02/18/1998
ELCA700 Rough -in DST 02/18/1998
ELCA730 Elect'l Service DST 02/18/1998
ELCA799 Elect'l Final 06/09/1998 BRP FAIL B'P 06/09/1998 No GFCI on lights. Not
standard wiring methods.
Homeowner wired.lnspectiion
terminated. Start over after
owner has finished. Need
manufacturers documents and
instructions.
ELCA920 Miscellaneous action MEMO DST 02/18/1998 Inspect bonding.
ELCA500 (F) Issue permit 02/18/1998 DRA DONE DST 02/18/1998
ELCA725 Underground Cover 02/19/1998 BRP PASS J'H 02/26/1998 Bonding looks good - pool.
ELCA920 Miscellaneous action 01/13/1999 JT 01/13/1999 1/13/99 inspection request
(research) sent to Chuck
ELCA920 Miscellaneous action 03/17/1999 WDJ MAIL WDJ 03/17/1999
ELCA799 Elect'l Final 03/25/1999 BRP PASS AKJ 03/25/1999
ELCA800 Case finaled 03/25/1999 AKJ PASS AKJ 03/25/1999
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BUD
Location f cZ 8 - 7 67 SWA Suite MEC
Contact Person Ph PLM
Contractor 1�%��r ? D P SWR
BUILDING Tenant/C6- ELC --e30
Retaining Wall ELR
Footing Access:
y Foundation jp � ! � FPS
Ftg Drain SGN
Crawl Drain Inspe• ion Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
R Ceiling
Roof
Misc: /� ®� / Gf U /)wco
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
PASS PART FAIL
ELECTRICAL / 4411
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
ASS ART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk 5 D v ( I actor
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.