Permit CITY OF TIGARD
A DEVELOPMENT SERVICES ELECTRICAL PERMIT
il PERMIT #: ELC96 -0636
_. „ !+L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/09/96
PARCEL: 15135AD -01900
SITE ADDRESS...: 08818 SW SPRUCE ST
SUBDIVISION - GRAHAM ACRES ZONING:R -4.5
BLOCK LOT •2
Project Description:
- -- 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/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
WESTLAKE ELECTRIC type amount by date recpt
7518 SW MACADAM AVE PRMT $ 35.00 TAT 10/09/96 96- 284930
SPCT $ 1.75 TAT 10/09/96 96- 284930
PORTLAND OR 97223
Phone #: 246 -9838
Contract or:
CONTRACTOR NOT ON FILE $ 36.75 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Elect'I Service
Phone #: Wall Cover Elect' 1 Final
Reg #..
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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. Issued B 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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call for inspection — 639 -4175
' -1r111.r,r
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. .4-e-- � _ a6 3
Tigard, OR 97223 Permit # 5 %
r , . . Date Issued
l - I I Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of 0 y7z2 Development G
op Number of Inspections per permit allowed
Address ? / !� 5 J orzic� 17 Service included: Items Cost(ea) Sum
City /State /Zip ` /G9�r 4a. Residential - per unit
� 1000
Each sq. ft. less $110.00 4
Name (or name of business) // J r J /JE `� A G �/ J .. Each additional l 500 500 0 sq. ft. or
��I// portion thereof $25.00
Commercial ❑ Residential L� Limited Energy $25.00 t
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor ractor �,f f f �� c , I alteration, or relocation 2
/� i 200 amps or less $60.00
Address !' G✓ c cc G' ' -,' , 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City , ATOM' State / Zip Z 601 amps to 1000 amps $180.00 2
Phone No. - - - . `i, 16 -- 3 . 3$5 Over 1000 amps or volts $340.00 2
Job NO. / Z6 003 Reconnect only $50.00 2
contractor's license NO. - " / C 4c. Temporary Services or Feeders
r
Contractor's Board Reg. No. ffi r +' fill� Installation, alteration, or relocation
Signature of SuEr. Elec'n 0111.4 200 amps or less 2
201 amps to 400 amps $50.00 2
License No. /(i Phone No. ZS�S - 3 3�.I- 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit br $ 3
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4o.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 3S-7 N
NOTICE 5% Surcharge (.05 X total fees) $ /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Su6tota $
COMMENCED. wordicomdevldec- Trust Account # 36, 5
6, 7 5 -
$
prm.app
Balance Due $
c4.3
5,426'ita Cgil— .
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o g
o CITY OF TIGARD BUILDING INSPECTION DI ON
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date R uested: ('Q/If/ mi l. Gl A.M. P.M. MST:
Location: g \ 4 W ) JAJP BUP:
Tenant: Suite: Bldg: MEC:
Contractor: ___. r ��' Phone: ,...?„.3/-/5 PLM: 3 //
Owner: Phone: ELC: 76. 3 — a CO
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL EL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Serve Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling 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 Spk1r /Ahn Crawl/Found Dr Heat Pump
Approved Approved Approved Approved D Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ct.,.:, • Not Approved
FINAL FINAL FINAL FINAL' FINAL
/ / ANNOY
-
r -a--ka/
C_e_ ,
O Call for reins. 6A1 1 D Reinspection fe f $ required before next inspection 0 Unable to inspect
Inspector: /c. f... a , C Date: d . V fd" n Page of