Permit •
r ~ a CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00215
" DEVELOPMENT SERVICES DATE ISSUED: 4/12/99
rl li 13125 SW Hall Blvd.. Ticiard, OR 97223 (503) 639 -4171
PARCEL: 1S135BD-01100
SITE ADDRESS: 09780 SW SHADY LN
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Replacement of 2 service or feeders of 200 amps or less and 4 branch circuits.
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: 2 W /SERVICE OR FEEDER: 4 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:
LEWIS, GLORIA & ANDREW P$oE .)% El-CCM Cr Co
7720 SW WESTGATE WAY 737? rich' C E,vr e-/L �Q-
PORTLAND, OR 97225 !CakQ -b OQ- C7 •9-3
Phone: Phone: (c 8y -'?CO •
Reg #: 59.aB
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
Wall Cover
5PCT DRA 4/12/99 $7.00 99 314421 Elect'l Service
PRMT DRA 4/12/99 $140.00 99- 314421 Elect'l Final
Rough -in
Total $147.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 or direct questions to OUNC at (503)
246 -1987. .
Permit Signature: Issued y:
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 IN TALLATION ONLY
SIGNATURE OF SUPR ELEC'N: DATE: T' f�
LICENSE NO: 4/410
CaIII 639 -4175 by 7:00pm for an inspection the next business day
'APR -09 -99 FRI 10:53 AM PHOENIX ELECTRIC CO FAX NO, •
15036843611 P. 02/02
CITY OFTIGARD Electrical Permit Application Plan eck
13125 SW HALL BLVD. R - - d By J ' e
• Date ` _ 'd
TIGARD OR 97223 Date to P.E.
Phone (503) 639-4171, x304 Print or Type Date to DsT
Inspection (503) 639 -4175 Incom lete or illegible will not be accepted Permit it `GL.- /99�t- NOOo?I
Fax (503) 684 -7297 P 9 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
n
Name (or name of business) X i.I C)-%e e. . Service included: Items Cost Sum
c-N �<�'t.,�) � = s�-�F 4a. Residential - per unit
�
Address ' 11 5<0 _,� �. Y -
1000 sq. ft or less $110.00 4
City /State/Zip ( k ,.,\_, (- 11 a ')- 3 Each additional 500 sq. ft. or
� portion thereof $25.00 1
y
Commercial ICJ Residential ❑ limited Enorgy $25.00
-
r' ,^` -C � ; \ - C ` l S< \ Each Manutd Home or Modular
• J� `A\ `t �1�� Dwelling Service or Feeder $68,00 2
2a. Contractor installat only:
(Attach copy it current license 4b. Services or Feeders
Electrical Contractor • ' ' '- c' !'ty.. Lo� Installation, alteration, or relocation
200 amps or less (- $60.00 /a( DP 2
8.451m4s r) 9g6N n'kJ - )•°- / 201 amps to 400 amps $80.00 2
City (v . State Clt Zip, f - ) ? 401 amps to 600 amps $120.00 2
Phone N6i. (cAkl. t -1 601 amps to 1000 amps $150.00 2
Job No. `'=) c a� 1 _ c �o C O. over loon amps or volts $340.00 2
Elec. Cont. Lice. No. LL - r)t1) I✓ i Exp.Date Reconnect only $50.00 2 -
OR State GCB Reg. No. `5 'eN ,Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. );)(0(4 Exp.Date Installation, alteration, or relocation
200 amps or loss $50.00 2
Signature of Su r. Elec'n i _ ��.,,r 201 amps to 400 amps $75.00 2
g p - 401 amps to 600 amps 2
stiO Over 600 amps to 1000 volts,
License No. L"//L /as Exp.Date see "b" above.
Phone No. U -)SL( IpOU 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) Tho fee for branch circuits with •
purchase of service or
Print Owner's Name feeder fee. l
Each branch circuit $5,00 cg-C) 2
Address b) The fee for branch circuits
City_ State Zip without purchase of
Phone No.. service or feeder foe.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit 55.00 2
intended for sale, lease or rent. 4o. Miscellaneous
(Service or feeder not Included)
Owner's Signature Each pump or Irrigation circle $40.00 - 2
Each sign or outline lighting $40.00 . 2
i
3. Plan Review section (if f Signal circuit(s) or a limited energy
. panel, alteration or extension $40.00 2
Minor Labels (10) $100.00 .
Please check appropriate item and enter fee In section 5B.
4 or more residential units in one Structure 4f. Each additional inspection over
Service and feeder 225 amps or more . the allowable In any of the above
System over $55.00 ver 600 volts nominal Per inspection $35.00
-
Classified area or structure containing special occupancy Per hour
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: . /
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ 17 0
NOTICE Subtotal $ mote
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TrustAccount fl ������� / `�2
TIME AFTER WORK IS COMMENCED. /��
S
Total balance Due
InDS rS \eLC96.Ar'V nay 9/88
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
\ / BUP
Date Requested 4-t!(p -91 A �C PM BLD
Location g l h V r i VY ]• Suite MEC
Contact Person (TO Ph OVP300 PLM
Contractor Ph 20q SWR G� q
BUILDING Tenant/Owner `e- / h D ►� q, ELC f -! q ! d x)Z /S
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: C� . 36 ` M SGT
Slab / [ SIT
Post & Beam .
Ext Sheath /Shear GyVIC 'e Cho ) A e-
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 44 el ( CI y i,�j (, —
Top Out l/
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough
UG /Slab In
Low Voltage
Fire Alarm
%Iii
PASS 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 4-i 6 — Inspector E
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.