Permit CITY OF TIGARD ELECTRICAL PERMIT
r PERMIT #: ELC99 -0120
,����;� D�EVEH OPMENO SERV6CES DATE ISSUED: 03/02/99
25 SW PARCEL: 1S133DA -00800
SITE ADDRESS...:11O7O SW SUMMER LAKE DR
SUBDIVISION •AMART SUMMERLAKE ZONING:R -7
BLOCK LOT •030 JURISDICTION: TIG
Project Description : Add one branch circuit.
- -- 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
STEVE SLABAUGH type amount by date recpt
11070 SW SUMMER LAKE DRIVE PRMT $ 35.00 GEO 03/02/99 99- 313359
TIGARD OR 97224 5PCT $ 1.75 GEO 03/02/99 99- 313359
Phone #:
Contractor:
GRF ELECTRIC $ 36.75 TOTAL
15460 SE PARADISE LN
REQUI RED INSPECTIONS
MULINO OR 97042 Elect'1 Service
Phone #: 503 -829 -4146 Elect' 1 Final
Reg #..: 001015
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 1:
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0014010 through OAR 952 -001 -1987. You say obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987. / /
Permittee 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: , G� DATE: 3 - - a -F9
LICENSE NO: 3003-5'
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
03/01/1999 14:08 5038295747 GRF ELECTRIC PAGE 01
RECEIVED
1
CITY OF TIGARD MAR 11999 Electrical Permit Application Pion Chats
13125 SW HALL BLy%MUNITY DEVELOPMENT Reed By
TIGARD OR 97223 Data Rarq
Date to P.E.
Phone (503) 839 -4171, x304 Print or T e V74-7. Data to DST
Inspection () 6,39-4
503) or Illegible w ill not be accepted porn*, �9 �o i�d
Fax (503) 684 -7297 Caned
1 1. Job Address:
4. Complete Fes Schedule Below:
Name of Development Number of Inspections pr permit allowed •
Name (or name of bushtess) C IJ e S 1 O� �., a re p1 !UMW Included: Items Cost Stan
Address ! / D 7 0 SI i) 65 '+ rte er /A- Le ra. Raeldmt ' - per unit
7 h t000 ea, It or leas $110.00 4
City/State/Bp A /� Pr I Each adds n& 500 sq. ft. or
Commercial ❑ ✓ Reaiden l
dai ( Energy $25•0:1 00 -- 1
Each Mafhfd Moyne or Modular
Dweging Swipe or Feeder $80
2a. Contractor Installation only: 2
• (AS•ct copy at an current Iiceneas lb. Sorvloa or Pescara
Electrical Contractor 6 it.F lI -- Ci Imo, alteration. or relocation
Address 200 amps or lass 000.00 2
201 sires 10 400
City state Zip 401 one to sot � mama � 2
Phone No • q 2V- — iiC. t sot amps to loon amps $ta000 2
Job NO. Over 1000 amps or volts $340.00 2
—
Elec. Cont. Lice. No. / a , k7 re., Exp.Date Reconnect only $50.00 - 2
OR State CCB Reg. No. O Exp,Date ea Temporary Servloes or Feeders
COT Business Tax or Metro No. Exp.Date I natadaion, alteration, or relocation
200 amps or Ws $50•00 2
Signature of Supt. i:lecen 47c 201 amps to 400 amps $7.6.00 2
401 amps to too amps 5100.00 2
001 000 angry to tam volts.
Licence No.
3 -S E xp.Date see "b" shove.
Phone No. " i�4' 4 -41 IV
44. month Circuits
New. alteration or extension sear panel
26. For owner installations: e) The f« for branch Omits with
pwiebaao of Nola* or
Print Owner's Name_ folder Its.
Address Each branch circuit $5.00 2
City State b) The lee for branch circuits
N p bfehout panther of
Phone No. - works or trade wee.
First brand, circuit $35.00 3 2
The installation is being made on properly I own which la not Each eddnlonel bream circuit $5.00 2
intended for sale, lease or rent 4e. Ml•o.usnawrs
(Bents or feeder not atd+det*
Owners Signature Each pump or Irrigation circle - $40.00 2
Lethally or outline lighting $40•00 2
3. Plan Review section (if required):' . °110 e) era 1 iltse
r
panel. alteration or estensket $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 slide If. Each additional Inspection over
Service end feeder 225 amps or more • the allowable In any of the above
System over 800 who nominal Per {nspeatlon $36.00 _
Classified area or structure oordaining special a:cupanay. Per hour $56.00
as described In N.E.C. Chapter 6 In Plant 036.00
Submit 2 sees of plans with application where any of the above apply. S. Fees:
Not required for temporary oenstetic ion se lea. Si. Enter total of above fees
6% Surcharge (.06 X total Neel • $ ---1-6
7 S
NOTICE Subtotal $
50. Ernst 25% of Ina $a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ AT ANY
_
TIME AFTER WORK IS COMMENCED. A PERIOD OP ISO DAYS AT Aim • / l Po j 74._ 7s
Total ba a e sew
5/17/99 Activities for Case #: ELC99 -00120
4:46:36 PM
Assigned Hold Updated
. Activity Description Date 1 . Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 APPlication received 3/1/99 GEO FAX GEO 3/2/99
ELCA003 Permit created 3/2/99 GEO DONE GEO 3/2/99
ELCA730 Elect'I Service GEO 3/2/99
ELCA799 Elect'I Final GEO 3/2/99
ELCA500 (F) Issue permit. - 3/2/99 GEO PASS GEO 3/2/99
ELCA920 Miscellaneous action _ 3/19/99 CD FAIL CD 3/19/99 no one home
ELCA799 Elect'I Final 3/23/99 CD • PASS CD 3/24/99 wiring of a /c/unit
ELCA800 Case finaled 3/24/99 AKJ PASS • AKJ 3/24/99
•
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• Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
-2:415.- BUP
Date Requested 3/2-3/q7 AM PM BLD
Location ///) 70 Su Awl ,yl c -f &lee aeSuite MEC ( fe - Ce)Q qc,
Contact Person )o . (- )1/1- - k9. -/ Ph ..,� ?. -- 4 7/90/ �� PLM
Contractor Ph S2 t - 4/1479- SWR
BUILDING Tenant/Owner ELC 0/00
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain PO/Z, cJ 4 G1 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing 4/ r _ r/ /� �j• E C 99 C% d
Firewall
Sprinkler 7
Fire Alarm .� 99 i
Susp'd Ceiling � `' -, j `/ 40/ /
Roof
Misc:
Final -
PASS PART FAIL �
PLUMBING (co.
Post & Beam � 'S'
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PAS$ _E,AT FAIL
ELECTRICAJ)
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
a D PART FAIL
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
Approach /Sidewalk l�
Other Date 3 z C� Inspector � lip �;f_,F% ‘ z Ext
Final
PASS. PART ' FAIL DO NOT REMOVE this inspection record from the job site.