Permit '� 'C I TY OF TIGARD ELECTRICAL PERMIT
�_ PERMIT #: ELC1999 -00701
• ll DEVELOPMENT SERVICES DATE ISSUED: 11/19/1999
13125 SW Hall Blvd.. Tisaard, OR 97223 (503) 639 -4171 PARCEL: 2S111 CD -08900
SITE ADDRESS: 15910 SW SERENA CT
SUBDIVISION: KERWOOD ESTATES ZONING: R -4.5
BLOCK: LOT : 037 JURISDICTION: TIG
Project Description: Add two (2) 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
TOWLE, JANET C WEST SIDE ELECTRIC CO INC
15910 SW SERENA CT 1834 SE 8TH AVE
• TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
231 -1548
• Reg #: LIC 13306
SUP 1556s
• ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 11/19/199£ $42.85 99- 319878 Elect'I Final •
5PCT GEO 11/19/1995 $3.42 99- 319878 •
Total $46.27 ORIGINAL
...„ .
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 -0 through OAR 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY:AZA / • . .....
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: 1F 19-1- 9
LICENSE NO: 15 Slv - 5
Call 639 -4175 by 7:00pm for an inspection the next business day
NOV -18 - 9 9 03:12 PM WEST SIDE ELECTRIC 503 736 0677 P.01
cf -•SIT • F TIGARD E1ectrical Permit Application Plan Check 0
131 5 SW HALL BLVD. Rec'd By
TIG • RD OR 97223 Date Rec'd
Pho ., (503) 839 -4171, x304 Date to P.E.
Insp Ction (503) 839175 Date to DST
Print of Type °V 4 Permit #8 ! if91 - c 7
Fax 03) 598 -1960 Incomplete or Illegible will not be accepted CalIed
i
i.1. • b Address: 4. Complete Fee Schedule Below:
Name 1 Development P Number of Ins alone per permit allowed
~tdame : • name of busIness)rae.r' YrwLE Service Included: Items Cost Sum
Addres , 1Sq 1 C) S w •ga.F C. as. Residential - per unit
Pity /S ' te/Zip 1000 eq, fl. or lass $ 117.75 4
t� Each additional 500 sq. ft. or
Comm = rclal 0 Residential pQ �^bn •root $ 26,25 1
Limited Energy $ 60.00
' Each Manufd Home or Modular
a. • • ntractor installation only: Dwelling Service or Feeder 5 72.75 2
(Prior to .. rmit Issuance, aDpllcanta must provide contractor license 4b. Services or Feeders
Ihfonne • on for COT deal base). Installation, alteration, or relocation
IeCtri I Contractor / ♦ e C - .14-1C._ 200 amps or less • $ 64.25 2
ddres • r Allingairrf t.e 201 amps to 400 amps 1 65.50 2
Ity ri
•
/ Orr - late �' zip 7 401 amps to 800 amps E 126.50 2
hone ' O. 23 / y 601 amps to 1000 amps $ 192.50 2
Over 1000 amps or volts $ 363.76 2
Job No. 11 1 "1 - eo Q ' Reconnect only $ 63.50 ' 2
Elec. C • nt. Lice. No, 1 / - Exp.Date 4c. Temporary Services or Feeders
C R Sta , CCB Reg. No. / 3 Exp.Date _ Inatellatlen, alteration, or relocation
OT B iness Tax or Metro No. Exp.Date 200 amps or lees 8 53.60 2
201 amps to 400 amps 8 80.25 2
ignatu : of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 _d;?..,,__,-----,
r// Over 000 amps to 1000 volts,
License o. /�T b J Exp.Date ••• °b" above.
Phone a. 2 3/- /� 4/..4 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
b . F. r owner installations: with purchase of service or
i feeder fee,
Print • . ere Name Each branch circuit $ 8.35 2
Alddres8 b) The fee for branch circuits
without purchase of service
City • State Zip or feeder fee.
Phone • . First branch circuit ' 1 5 37.50
Each additional branch circuit _ i $ 6.36
•
-
The inst Ilatlon is being made on property I own which Is not 4e. Miscellaneous i ende •; for sale, lease or rent. (Service or feeder not Included)
Each pump Or Irrigation circle $ 42.75 _
O - Ignature Each sign or outline lighting $ 42.76
Signal circuits) or a limited energy
(If required):"
3, PI n Review section panel, alteration or extension $ 50.00
Minor Labels (10) $ 107.00
;Pleas ,. check appropriate Item and enter fee In section 6B. 4f. Each additional inspection over
I- • or more residential units in one structure the allowable In any of the above
•- - rvice and feeder 225 amps or more Per inspection $ 50.00
ystem over 600 volts nominal Per hour $ 50.00
I In Plant S 69.00
lassified area or structure containing special occupancy se '
i described in N.E.C. Chapter 5 5. Fees:
8s. Enter total of (bore fees tt
• �ubmlt - Bete of plans with application where any of the above apply. 6% 8Surcharge e (.05 X total fees) • s
!iii:
Sot req • Ired for temporary construction services, Subtotal S
8b. Enter 25% of line 6a for
NOTICE, • Plan Review If reauireo (Sec. 3) S
PERMITS : ECOME VOID IF YORK OR CONSTRUCTION AUTHORIZED Sy fl
IS NOT C' MENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR a
RK IS USPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account p l 3 366, •
A , ANY TI E AFTER WORK IS COMMENCED. Total balance Due $ 46 '� -1
i N'sis\Mrm cicciric (Inc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST Alift
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP Mr
Date Requeste �� AM PM BLD ��
Location /5 /d . ir Suite P f.9 2a 3
Contact Person Ph PLM
Contractor Ph SWR
• - c
BUILDING Tenant/ e LIP 1 9 ` C)70
Retaining Wall 6 — 76,342 ELR
Footing Access:
Foundation
0-4W1.6--e FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab n l / ' SIT
Post & Beam C�.�t�t .�' g ' 3 6) -/ 0 .'o 6 � ,
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm /Y f j y=
Susp'd Ceiling
Roof
Misc:
Final
jiggimmiik
PASS PART FAIL `^-
PLUMBING /'� 5 a/c( w
Post & Beam
Under Slab
Top Out di ‘J/Y dX_
Water Service -__-_
Sanitary Sewer
Rain Drains
Final t____ P T FAIL � � )�
rHe am 2
Post & Bea
Rough In
Gas Line
e illit
k ` S •• - e Damper
ART FAIL
J
Service l .... /L►zi� lb
Rough In gittiO.W1 "
UG /Slab
Low Voltage
F• - Alarm •
4M PART FAIL 4 6-• . 5 /
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 oach /Sidewalk Date / 2 // 3 / Inspector 0 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.