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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00457 , �� i � DEVELOPMENT SERVICES DATE ISSUED: 9/14/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133CD -13200 SITE ADDRESS: 11818 SW TALLWOOD DR SUBDIVISION: PEBBLECREEK II ZONING: R -25 BLOCK: LOT : 023 JURISDICTION: TIG Project Description: One (1) branch circuit. 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: 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: MEYER, CHRISTIAN & CARIN OWNER 11818 SW TALLWOOD DR TIGARD, OR 97223 Phone: 503- 590 -8516 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 9/14/01 $46.85 2720010000( Elea! Final 5PCT CTR 9/14/01 $3.75 2720010000( Total $50.60 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 OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to Permit Signature: 74,4 Issued By: X/ 7 OWNER INSTALLATION ONLY The installation is being made . ' I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: • _ !�• --- DATE //WO q /WD CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day 4 Electrical Permit Application '. -,. " ' 4 ' w r ° ,. • , A IR Date received: /g✓ Q,/ Permit no. ---/D 5 1,` ilti City of Tigard (r) Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 92223 Date issued: By " %/ Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: " ° ; � # r d. '- , � , t: TYPEr /OF PERMIT 7 ', .);‹ , , v , : : , , ,f :0 0 , - ".' "' '15 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial ^' a F ' 5 J011 SITE, INFORMATION ' ■' � : t � , / ; , p , '',.*.:12:e.,,,' ' A`,; ., Job address: , 1r Sta 'T,Ii.4.-4-.0:.: p balky-L. T er g,0 In z.3 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: , b e.G 1 f.... Project name: De cription and location of work on premises: Estimated date of completion/inspection: ' 7 - o D d CONTRACTOR s "� ¢. Efi " � „� a r .r: .' � _ ;� � � , . � , ', FEE . SCHEDUI: aT .� : r . Job no: Fee Max Business name: Description Qty. (ea.) Total no. insp New residential - single or multi- family per Address: dwelling unit. Includes attached garage. City: State: ZIP: " Service included: Phone: Fax: E -mail: 1000 sq. ft. or less 4 CCB n0.: Elec. h lic. n0: Each additional 500 sq. ft. or portion thereof __ Limited energy, residential ___ 2 City /metro lic. no.: Limited energy, non- residential ___ 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder ■ 2 Services or Sup. elect. name (print): License no: alteration or relocation: feeders installation, llatto , PROPERT Y'OWNER a ' ' . n ` ' 200 amps or less In 2 Name (print): r i S 7h a •• V a 201 amps to 400 amps ___ 2 401 amps to 600 amps ___ 2 Mailing address: (i I !; 543 ljt.Ltvcs,,,L biz_. 601 amps to 1000 amps 2 City: - I) frito State: OK ZIP: q 71 Over 1000 amps or volts ___ 2 Phone: S03 5 *SI(o Fax: E -mail: Reconnect only ��� i 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 ORS 447, 455, 479 ID '0, 701. 200 amps or less 2 201 amps to 400 amps ___ 2 Owner's signature: e. Date: 9 / 40 1 401 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: State: ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: ■ 2 Phone: Fax: E __ Each additional branch circuit: `PLAN REW chec all. apply) ' EVIPlease k, fh Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle ME • 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* Mill ❑ Building over three stories ❑ Feeders, 400 amps or more * Descri ption: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ 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 $ ❑ 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 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6 /00 /COM) ELECTRICAL PERMIT FEES: ,. LIMITED ENERGY PERMIT FEES:e' , y Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY (� Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total si, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems* Each additional 500 sq. ft. or portion thereof $33.40 1 l l Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Dwelling Service or Feeder $90.90 2 Garage Door Opener Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 n Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 I f I 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 Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, l �� I see "b" above. I I 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 n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service pi or feeder fee. Fire Alarm Installation First branch circuit / $46.85 1 /4 • "s ❑ Each additional branch circuit $6.65 HVAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 I I Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over F Medical the allowable in any of the above Per inspection $62.50 Nurse Calls Per hour $62.50 In Plant $73.75 I I Outdoor Landscape Lighting Fees: �i ❑ Protective Signaling Enter total of above fees $ /� , 0 S El Other 8% State Surcharge $ 3,25 Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $mod , to Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\elc-fees.doc 08/30/01 CITY OF TIGARD BUII DING INSPECTION DIVISION MST 24 -Hour Inspection Line: 63! .75 Business Line: 639 -4. , BUP • Date Requested // � AM PM BLD iO Location / I f) - �t,c�- - )\--- Suite MEC Contact Person (// Ph 5`k) Fs PLM Contractor - Ph SWR BUILDING Tenant/Owner ELC ,15e / - D D t i , c7 Retaining Wall ELR Foong � Foundation Access: �� � i% U -vim) FPS Ftg Drain ;) t Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear 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 Top Out Water Service Sanitary Sewer Rain Drains . U Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PA _ FAIL Rough UG/Slab In n Low Voltage �lJ�' Fi,ce Alarm (Fine?) ART 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 / Q 1 4{ () i Inspector ( Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.