Permit A .:., CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00101
` is ie DEVELOPMENT SERVICES DATE ISSUED: 2/16/01
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S114BD -01200
SITE ADDRESS: 09860 SW RIVERWOOD LN
SUBDIVISION: PICKS LANDING ZONING: R -4.5
BLOCK: LOT : 073 JURISDICTION: TIG
Project Description:
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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:
TORRENCE, EVELYN P K + WILLAMETTE ELECTRIC INC
STANLEY E TRUSTEES PO BOX 230547
9860 SW RIVERWOOD LANE TIGARD, OR 97281
TIGARD, OR 97224
Phone: Phone: 624 -3631
Reg #: LIC 75059
SUP 1965S
ELE 34 -283C
FEES Required Inspections
Type By Date Amount Receipt Rough - in
PRMT CTR 2/16/01 $66.80 2720010000( Elect'l Final
5PCT CTR 2/16/01 $5.35 2720010000(
Total $72.15
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 • - • 2- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATUR ISSUED BY: , .t ,
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
Date received: "Mini Permit no.: / d20b ( 6tj/
.- ti'.>1Ih; - 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
:XJ_ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
... JOB SITE INFORMATION ,.... ,
Job address: qS 6 p SG,/ ii.c.,:v4..A_W, -,,,C1 LA „, Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: IBlock: ISubdivision: _
Project name: SfiA„i 1 nKP we e I Description and location of work on premises: i eat .. , e,t f'
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCIIEDI.LE
Job no: 9 z p I / Fee Max
Business name: (A) , l (� ,1 t e C I ., c 1 .(. t c_ !ia- Description Qty. (ea) Total no. insp
New residential - s or multi - family per
Address: ,p ,A3 230 S i 7 dwelling unit. Includes attached garage.
City: r, /a rt O I State: O. I ZIP: 5j )- Z$ ( Service included:
S
Phone: 62 4 - 36 r l I Fax: 4z 000 sq. ft. or less 4
ZS3t�s I E-mail: E mail:
'7 Each additional 500 sq. ft. or portion thereof
CCB no.: ?-5- S R I Elec. bus. lic. no: 3 4 - Z is j' L Limited energy, residential 2
City /metro lic. no.: '(s ‘ Limited energy, non- residential 2
--.:5z- 2 _ �. F .p ( Each manufactured home or modular dwelling
Signs u o supervising a ictan (required) Date Service and/or feeder 2
Sup. elect. name (print): , -,,., r, . - License no: (94 S 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
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, alteration, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owners 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 g� Y
of service or feeder fee, first branch circuit: / r /` '1d 2
Phone: Fax: E -mail:
Each additional branch circuit: 3 6 11
PLAN REVIEW (Please check all that apply) misc. (Service or feeder not included): .
❑ Service over 225 amps-commercial • ❑ 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's l 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
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 $ �! !0
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ S -7i
Expires accepted as complete. TOTAL $ 0' ?- 2 / I:—
• Name of cardholder as shown on credit card
$
Cardholder signature . Amount 440 -4615 (6/00/COM)
p ta . : :„.....
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ON
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 0 Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 _ 1 El Burglar Alarm
Limited Energy _ $75.00 _
Each Manuf d Home or Modular Door Opener
Dwelling Service or Feeder _ $90.90 2
Services or Feeders n 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.
pi Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel n Boiler Controls
a) The fee for branch circuits
with purchase of service or
feeder fee. n Clock Systems •
Each branch circuit $6.65 2
b) The fee for branch circuits n Data Telecommunication Installation
without purchase of service
or feeder fee. n Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 n HVAC
Miscellaneous
(Service or feeder not included) D Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53:40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
•
panel, alteration or extension $75.00 •
Minor Labels (10) $125.00 n Landscape Irrigation Control
Each additional inspection over n Medical •
the allowable in any of the above
Per. inspection $62.50 Calls
Per hour $62.50
In Plant $73.75 ❑
Outdoor Landscape Lighting
Fees: . . _
- [1 Protective Signaling •
Enter total of above fees $
n Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
front of application. * No licenses are required. Licenses are required for all other installations
- Total Balance Due $ . Fees:
Enter total of above fees $
El Trust Account #
8% State Surcharge $
Total Balance Due $
•
•
i:Adsts \forms \elc- fees.doc t /09/00 . . - ' ,7". ` �-
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST"
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested ( AM PM BLD
Location ? e 'O 5t RIIJ— cvcry c L Suite MEC `
Contact Person Ph 2Y - / PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC 2Ce1 / ° G ° /
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 t�Q A
Susp'd Ceiling Cs
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
PASS PART FAIL
4t: w e rRICA"
Rough In
UG /Slab
Low Voltage
Fire Alarm
'',Ualk 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 W/I‘ . Inspector ( Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.