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Permit - CITY OF T I G A R D ELECTRICAL PERMIT • PERMIT #: ELC2000 -00656 , I DEVELOPMENT SERVICES DATE ISSUED: 12/1/00 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BD-03700 SITE ADDRESS: 09545 SW RIVERWOOD LN SUBDIVISION: COPPER CREEK STAGE 3 ZONING: R -7 BLOCK: LOT : 077 JURISDICTION: TIG Project Description: Branch circuit to sauna at back of lot 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: 2 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: NELS MICKAELSON 9545 SW RIVERWOOD LN TIGARD, OR 97224 Phone: 598 -9636 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT CTR 12/1/00 $93.60 2720000000( 5PCT CTR 12/1/00 $7.48 2720000000( Total $101.08 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 ordirect questions to OUNC at (503) 246 -1987. • PERMITTEE'S SIGNATUR ISSUED 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 7:00pm for an inspection the next business day • " Electrical Permit Application �� Datereceived: .2.- i 51 Permit no.: . t , DD , ! _,1) ,I�, City of Tigard Project/appl.no.: Expire date: CityofTigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 55 563 Rr∎i£a v DO D La Bldg. no.: Suite no.: Tax map /tax lot/account no.:ZS Pi o p Lot: '77 IBlock: ISubdivision: (o PPE2 GO.E Project name: I Description and locatio of work on premises: B Rc, r+ c-14 Gr r c.0 r r To 5 w inl fr Estimated date of completion/inspection: (0,.. S w U L o f [-a i CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: - Description Qty. (en.) Total no. insp Address: New residential - single or multi - famil per dwelling unit. Includes attached garage. City: I State: I ZIP: Service included: Phone: I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: I Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: Limited energy, non- residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders — installation, PROPERTY OWNER alteration or relocation: 200 amps or less 1 2 Name (print): N el.. 5 ,n.. 5 CV_ as a _-S a rJ 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 55q 5 - S a, mt.( Er10Oc) I> t.N 601 amps to 1000 amps 2 City: (J& 2 I State: 0 e I ZIP: ct 1 2 Z 4 Over 1000 amps or volts . 2 Phone: $a 3.5 -4 63t. I Fax: I E -mail: N 1'c.5 e..Taredel Reconnect only 1 Owner installation: The installation is being made on property I own' c"" Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to Installation , alteration, orrelocation: ORS 447, 455, 479, 67 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: t t 171 I D 401 to 600 am s 2 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 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): ❑ Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ 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 $ ❑ Visa ❑ MasterCard expires if a permit is not obtained' Plan review (at _ %) $ Credit card number: I / 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: . TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4 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 Limited Energy $75.00 ❑ Burglar Alarm Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less I $80.30 (i Da. 3 0 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 ice" Fee for each system $75.00 . 200 amps or less _ $66.85 tl � 8 9 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 New. alteration or extension per panel ❑ Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. • Each branch circuit $6.65 I ' 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ or feeder fee. Fire Alarm Installation 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 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems • 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 E Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: !� ❑ Protective Signaling Enter total of above fees $ 3 ( I I Other 8% State Surcharge $ 7 ' U 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. � 0 ! . Fees: Total Balance Due $ Og Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts\forms\elc- fees.doc 10/09/00 • / CITY OF TIGARD BUILDING INSPECTION DIVISION MST , .24 -Hobr Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3 — Z 3 AM PM BLD Location C gSK j L Suite MEC Contact Person Ph PLM Contractor c -(. J /1/4142--- Ph SWR BUILDING Tenant/Owner ELC vo�ia t:s4• Retaining Wall ELR Footing Access: Foundation _� J � / FPS Ftg Drain Jv /1.� - 9� — / A4 , /(vii - L you coy/u .4c SGN Crawl Drain Inspection Notes: Slab C; 2 /tea) -r S s9 t� , - SIT Post & Beam l Ext Sheath /Shear LA ` A T int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ Final PASS PART FAIL PLUMBING Post 8 Beam EXPIRED 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 <_CTRICT Zj Service Rough In UG /Slab Low Voltage Fire Alarm PART SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Rei spection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Al Fire Supply Line [ Please call for reinspection RE: e 20) v - )OC_ b / I able to inspect - no access ADA Approach /Sidewalk Other Date 3/-3/ Inspector /� _ = _ E 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 w Date Requested /2-: & -r PM BLD c yc e Location 95 S S tz.� � ci e24 /C ) Suite MEC Contact Person Ph ec-ao - PLM Contractor Ph SWR BUILDING Tenant/Owner LC 2evo -pbb 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 EXPIRED Rough In Gas Line Smoke Dampers Final P T FAIL CTRI me Clough Ind UG /Slab Low Voltage Fire Alarm Fin ASS PART FAIL SITE 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 / 2-6 Inspector To 141 Ext 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 . Date Requested l2 — Sv AM PM BLD. /I Location F,c (1$ Suite MEC IF, Contact Person Ph -SO, — SSG - 3brz� PLM Contractor Ph SWR • BUILDING Tenant/Owner 04 f/7 C.S.f Cal‘eigt,44DA ELC fi /) o -0 Retaining Wall 7%7a 4- �; .7 ELR Footing Access: Foundation X4/4 ® FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall C. `6 C v f / &zy �/� c Fire Sprinkler J Fire Alarm Susp'd Ceiling Roof C L Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab 4D 2 &j /Z0(/ /VD //L?r !> V ,/e C ?o (_ Top Out Water Service 7) s ✓ OG9 /tol C ;/41- S 1C/c/ TL Sanitary Sewer � \ Rain Drains gl) / '?� Nyj Z— vT l ✓ $' NU /9'7 G Final PASS PART FAIL V r C G 4../Le C% L MECHANICAL 6 -O% j�Q 0 Post & Beam (/�- Rough In Gas Line Smoke Dampers Final RT FAIL EX PIRED ELECTRICA EXPIRED Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE 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 / Other he Date ° 2 — -D U Inspector / Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • CITY OF TI GA R D ELECTRICAL PERMIT PERMIT #: ELC2000- 00656' ; - DEVELOPMENT SERVICES DATE ISSUED: 12/1/00 _ 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BD-Q3700 SITE ADDRESS: 09545 SW RIVERWOOD LN SUBDIVISION: COPPER CREEK STAGE 3 ZONING: R -7 BLOCK: LOT : 077 JURISDICTION: TIG Project Description: Branch circuit to sauna at back of lot 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: 2 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: NELS MICKAELSON 9545 SW RIVERWOOD LN TIGARD, OR 97224 Phone: 598 -9636 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'l Final PRMT CTR 12/1/00 $93.60 2720000000( 5PCT CT: - 1/00 $7.48 2720000000( xWI.: � 9 01.0 V ol 3— 6 :1 This Permit is • subjec - • = - gu - .ons co • al • • he Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws. 0 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. _ 1 PERMITTEE'S SIGNATUR ISSUED 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: 6 114 CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day BUP - Building Permit ELC - Electrical.Perrtit - inspection Description Date Passed By 4 Inspection Description Date.Passect By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in /Z - Slab Electrical service l Z — ( --eV Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing •I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit I Inspection Description Date Passed By BU P - Fire Protection System Permit Plumbing underslab I Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP/backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils J Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS