Permit CITY OF TIGARD ELECTRICAL PERMIT
'
, DEVELOPMENT SERVICES PERMIT #: ELC97 -0407
'J.I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/24/97
PARCEL: 15125DB -08000
SITE ADDRESS...:07080 SW SHADY CT
SUBDIVISION -SHADY DELL NO.2 ZONING:R -4.5
BLOCK LOT :53 JURISDICTION: TIG
Pro.j ect Description : add 2 branch circuits without feeder
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 - 200 amp ° 0 PUMP /IRRIGATION ° 0
EACH ADD'L 500SF...: 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/O SRVC OR FDR.: 1 PER HOUR 0
401 - 600 amp : 0 EA ADD'L BRNCH CIRC: 1 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 - --
MARY JANE MATTLOCK type amount by date recpt
7080 SW SHADY CT PRMT $ 40.00 GEO 06/24/97 97- 296376
TIGARD OR 97223 SPCT $ 2.00 GEO 06/24/97 97- 296376
Phone #:
Contractor: -- -•
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW TECH CENTER DR.
--- - - - - -- REQUIRED INSPECTIONS
TIGARD OR 97223 Rough -in Elect'l Service
Phone #: 684 -3600 Underground Cove Elect'l Final
Reg #..: 000522
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 peroit 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 -1 -1987. You way obtain a copy
of these rules or direct questions to OUNC by calling (503 46 -1987.
Permittee Signature: Issued By: k7 ---,
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 SUP R. ELEC' N : Cl DATE : 7
LICENSE NO: -//qd S
++++++++++++++++++++++++++++++++++++++++++++++++ + ++4 + + + + ++ ++ + + + ++ + + + + + ++ + + ++ + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + +-4-+ + + + +-4 + + + + 4 4-
JUN -24 -97 TUE 01:50 PM PHOENIX ELECTRIC FAX N0, 503 684 3611 P. 02/02
. ) . Plan Check* CITY of TIGARD Electrical Permit App Recd al► __:-
13125 SW HALL. BLVD. Date Rer:d _.___
Date to P.E. . _____
T1GAR0 OR 97223 Date to psT _._ �-
Phone (503) 639-4171, x 304 Print or Type Pettit St-e -
Inspection (503) 639.4175 Incomplete or illegible will not be accepted
called- � _ ______
Fax (503) 684 -7297
1. Job Address: 4. Complete Fee Schedule Below:
14uurtber of Inspections per psMK al[ow+rn: •
Name of pevetopme
M1 II
IM wt. Service included: Items Cost sum
II Name (or name of business �
4a. Residential - per unit
• 4
Address : • __ - - -� • 1000 sq. It or less $110.00 _ _
N. portion thereat __ -
C' /State/Zip y)-3 Each additional 500 sq. it. or 525.00 _._ 1
rtY
Commercial ResidentiallK Limited Energy 525 -00 ..
Each Manure Home or Modular
Dwelling Service or Feeder $68.00 -.- . - 2
2a. Contractor installation only: - 4b. Services or Feeders
(Attach cop I curtest licenses l alteration, or relocation
` ti ' , . ..._Fit.. • , $so.00 _. 2
Elec>Tical CiOntr3Ct ' • �w 200 amps to less __ -.- __.._`
Add '11G �f� � of 201 amps to 400 amps 5120.00 2
$80.00 _ 2
6J_ Zip .,. 401 amps to 600 amps $12
Phone - tate �`Kl\ 601 amps to 1000 amps $180.00 _ . - 2
Phone N -1111611) = Ilk -� . _ . `Z amps $340.00 . - - -._ 2
` Re nec a mp $50.00 2
Elec. Cone Lice. No. ' _ -
Job No. -TIM= - Reronn6rt only - -- - -..
1 Exp.Date
>` ,.
OR State CCB Reg. No_ 1 r � temporary► Services or Feeders
°S'�• Da �'�'f Installation, alteration, or relocation
Business Tax or Metro N. � P• � D F� !! 200 amps or lass 2
201 amps to 400 amps $ .__ 2
Signature of Supr. EJec'n j� Over 600 amps amps tops t amps
-
��// Ov to 1003 volts,
License No. /q2
QS Exp.Date see "b" above.
Phone No. a `iG .. - 22 ,(25ZZ) ad. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
•
purchase of service or
larder fee. 55.00 . _. 2
Print Owner's Name Each branch circuit
Address b) The fee for branch circuits
without 8urerrase of
Pho ne No.
First branch circuit Ch State rip without
or feeder tee. \ 535.00 2
Phone additional branch circuit = $5.00 - 2
The installation is being made on property I own which is not
intended for sale, lease or rent 4e. Miscellaneous
(Service or feeder not included) 540.00 _ 2
Each pump or irrigation circle $40.00 0000 2
Owners Signature sign or outline lighting
Signal circuit(s) or a limited energy $q jy.00 _. 2
3. Plan Review section (if required):* panel, alteration or extension Minor Labels (10) 5100.00 ._
Please cluck appropriate item and enter fee in section 58. additional inspection ad
Each ach ef3on over
4 or more residential units in one structure 4t. 4t. ad allowable in any of t1 c above
Service and feeder 225 amps or more
System over 600 volts nominal Per inspection $3 x.00 5.00
Per hour $55.00
Classified area or structure containing special occupancy In Plant
as descrbed In N.E.C. Chapter 5
5. Fees: !-�, ob
° Submit 2 sets of plans with application where any of the above apply 5. Enter total of above fees $ ob
Not required for temporary construction services. 5% Surcharge (.05 X total fees) $ y
Subtotal --
IV �GE Sb Enter 25% of line 5a for
Review if reouireQ (Sec.3) $ -
Ran an
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Re l S _
IS
NOT COMMENCED SUSPENDED ORWABANDONED DAYS, OR FOR A P I ERIO CONSTRUCTION 180 DS OR T ��
Trust Accoun # S
TIME AFTER WORK IS COMMENCED. Total balance Due
5/19/99 Activities for Case #: ELC97 -00407
2:07:56 PM
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 APPlication received 6/24/97 6/24/97 TAT 6/24/97
ELCA003 Permit created 6/24/97 6/24/97 TAT 6/24/97
ELCA700 Rough -in 6/24/97 7/1/97 MJR PASS J *H 7/6/97
ELCA799 Elect'l Final 6/24/97 7/1/97 MJR PASS J *H 7/6/97 Electrical final for bath
approved.
ELCA500 (F) Issue permit 6/24/97 TAT PASS DST 6/24/97
ELCA500 (F) Issue permit 6/24/97 GEO PASS TAT 6/24/97
ELCA800 Case finaled 7/1/97 MJR PASS J *H 7/6/97
Page 1 of 1
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CITY OF TIGARD BUILDING INSPECTION DIVISION
• 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: i(A--- / / / 7 A.M. P.M. MST:
Location: 70 S-U,_) J l(,{.(Yy 0./t BUP:
Tenant: �/ Suite: Bldg: MEC:
Contractor: AS.l� e _ P 4ti JJ ' 4 / lf Phone: 6O '7 36 ()() PLM:
Owner: Phone: ELC:q 6 40 7
ELR:
SIT: .
. BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In C- Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler •
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low VA—,
Approved Approved Approved Apd Approved
Appr /Sdwlk Not Approved Not Approved Not Approved N ove
Ot roved Not Approved
FINAL FINAL FINAL INAL" FINAL
l '--.. ._IVC' = ' c----tr; 4 ,i -. ") --- ;.elc / - 7 -- --..r-_ - ) r----
- ! _ /"/ n
•
•
6
O Call for reinspection O Reinspection fee of required before next inspection O Unable to inspect
Inspector: , / �� ( 4 -r: 4-7 Date: r— ` `—? 7 Page of /