Permit CITY F T I ELECTRICAL PERMIT
PERMIT #: ELC1999 -00314
iii DEVELOPMENT SERVICES DATE ISSUED: 5/25/99
13125 SW Hall Blvd.. Tiaard. OR 97223 (503) 639 -4171
PARCEL: 1S133CD-14500
SITE ADDRESS: 11855 SW TALLWOOD DR
SUBDIVISION: PEBBLECREEK II ZONING: R -
BLOCK: LOT : 036 JURISDICTION: TIG
Project Description: Adda first branch circuit to an existing dwelling.
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:
•
TRUDY SULLIVAN . GRF ELECTRIC
11855 SW TALLWOOD DR 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: Phone: 503 - 829 - 4146
Reg #: LIC 001015
SUP 3003S
ELE 26 -878C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Final
PRMT GEO 5/25/99 $35.00 99- 315662
5PCT GEO 5/25/99 $1.75 99- 315662
Total $36.75 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 -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 By:
//—
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: ca7 DATE: 5-- a
LICENSE NO: 3003-5'
Call 639 -4175 by 7:00pm for an inspection the next business day
05/25/1999 14:15 5038295747 GRF ELECTRIC PAGE 01
° RECEIVED
CITY OF TIGARD Electrical Permit Application Plan Cherck a
13125 SW HALL BLVD. MAY 2 199 Recd By
TIGARD OR 97223 COMMUNITY DEVELOPMENT Date Recd
Phone (503) 639 -4171, x304 Date to P.E.
Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or Illegible will not be accepted Permit dgGe / j�- oo s/V
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name me of business or name f " r(�f !' .r
t ) �� ✓ L4 1i Service Included: Items Cost Sum
Address S (,) T l / e4 4e. Residential - per unit 7
City► /State/Zlp 2 Z -3 1000 sq. it. or less $110.00 4
�ry Each additional 500 sq, ft. or
Commercial ❑ sldential f �l / portion thereof $25,00 _ 1
Limited Energy $25,00
Each Melted Home or Modular
2a. Contractor installation only:
Dwelling Service or Feeder ;68.00 2
(Attach copy of ell current licenses) 4b. Services or Feeders
Electrical O tractor a� installation, alteration, or relocation
Address � Q f7 , A gi3� ,d,P 200 amps or less $80.00 _ 2
' 201 amps to 400 amps $80.00 2
City , f w::-. a State are- Zip 4'7n t f e, . 401 amps to 600 amps $120.00 2
Phone No. S 2A - (f-t , 601 amps to 1000 amps • $180,00 2
Job 1110, Over 1000 amps or v olts $3,40 2
Elec. Cont. Lice, No. 31y - 7A� Cr. Exp.Date Reconnect only 450.00 2
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. r Z- Exp.Date Installation, alteration, or relocation
J / 200 amps or less $50.00 2
Signature of Supr. Elec'n ? _ ; . / 201 amps to 400 amps $75.00 2
jj 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 3 a s Exp.Date see "b" above.
Phone No. 8251 - `t 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits wife
Pchaaa of Print Owner's Name f ee. ebder f �,t ice or
Address Each branch circuit 55,00 2
b) The lee for branch circuits
City - State , Zip without purchase of
Phone No morales or feeds! flee. 3
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. ae, Miscellaneous
OgR1ef S Signature (Service or feeder not Included)
g Each pump or Irrigation circle $40 -00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (f required):* Signal circult(s) or a limited energy
panel, alteration or extension $40.00 2
Please check appropriate {fete and enter tee in section 6B. Minor Labels (to) 11100.00 - _!
4 or more residential units in one structure 41. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00 _
Classified area or structure containing special occupancy Per hour $56,00
as described in N.E.C. Chapter 5 - In Plant $55.00
e Submit 2 aegis of plans with application where any of the above apply. 5. Fees: .
Not requited for temporary construction services. 6a. Enter total of above fees $ )
6% Surcharge (.05 X total fees) $ ._/_ S
NOTICE Subtotal s -
Sb. Enter 25% of Ilne Se for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If rartuirad (Sec.3) S
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account p / ^^�
Total balance Due 16/ ` q-3 $ - ,��
6/30/99 Activities for Case #: ELC1999 -00314
1:42:57 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 5/25/99 GEO FAX No Hold GEO 5/25/99
ELCA003 Permit created 5/25/99 GEO DONE No Hold GEO 5/25/99
ELCA799 Elect'I Final 5/25/99 5/25/99 6/11/99 CD PASS No Hold AKJ 6/13/99
ELCA500 (F) Issue permit 5/25/99 GEO DONE No Hold GEO 5/25/99
ELCA800 Case finaled 6/13/99 AKJ DONE No Hold AKJ 6/13/99
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
ii C� BUP
Date Requested ' I AM X PM BLD
Location 1 SS 1 I1 cAD Suite MEC
Contact Person Ph 2,g 1/ I PLM
Contractor Ph 41(44. SWR
BUILDING Tenant/Owner ELC ) q C ! -0031 L
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /t
Drywall Nailing . .• ���. /`T
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer •
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
LE CTRIC`L
Service
Rough In
UG /Slab
Low Voltage
Fire larm
AS 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
Other oach /Sidewalk Date — t( ? Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.