Permit _ _ _ _
CITY OF TIGARD ELECTRICAL PERMIT
&N DEVELOPMENT SERVICES PERMIT #: ELC99 -0146
�� DATE ISSUED: 03/17/99
13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S102BA -00500
SITE ADDRESS... :09760 SW TIGARD ST
SUBDIVISION •NO.TIGARDVILLE ADDITION AMEND. ZONING:I —P
BLOCK LOT •060 JURISDICTION: TIG
Project Description : Installation of 200 amp or less service or feeder and 10
branch circuits.
- -- 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 : 1 W /SERVICE OR FEEDER: 10 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 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
JIM CASTILE type amount by date recpt
9760 SW TIGARD ST PRMT $ 110.00 DEB 03/17/99 99- 313783
TIGARD OR 97223 5PCT $ 5.50 DEB 03/17/99 99- 313783
Phone #:
Contractor:
A BETTER ELECTRIC CO, INC $ 115.50 TOTAL
8192 SW DURHAM RD
-• REQUIRED INSPECTIONS
TIGARD OR 97224 -4190 Rough —in Elect'l Final
Phone #: 670 -7575 Elect'l Service
Reg #.. : 127438
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 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Ore''' - -!uires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 'x40 through F' 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: ��d 2,x_____ Issue• By: A 4/. A
OWNER INSTALLATION ONLY
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : � / : - DATE: ,l/ 7 / � y
LICENSE NO: y/ 3 � S
+++++ + + +++++ +++++ ++ + + ++ +++++++ ++ +++ +++ + + +++ + + +++++ +++++ ++++ + ++ + + ++++++ + + + +++ ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CFTY OF.TIGARD Electrical Permit Application .
C
13125 SW HALL BLVD. Rec'd i___,
Date Rec'd /7 7
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # Li.C.79 -0l go
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) "Ti' re, tc.cteei Service included: Items Cost Sum
I
Address y76 6 f w • T," c S� • 4a. Residential - per unit
City /State/Zip Ti 9 cu-t( 0 Q 97ZZc/ Ea additional 500 sq. ft. or $110.00 4
Commercial El Residential portion thereof $25.00 1
Li mited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) ,. l 4b. Services or Feeders
Electrical Contractor A B e.1 -k)- Gle.c.irrf- •:"1"c„ . Installation, alteration, or relocation 66
Address �6l92 5 . pc w , .r{ (Z • 200 amps or less / $60.00 2
201 amps to 400 amps $80.00 2
City 1 y c� et State O dL Zip 9 Z Z y 401 amps to 600 amps $120.00 2
Phone No. • 6 7 6 - 7 5 7 S 601 amps to 1000 amps $180.00 2
Job No. /3 , Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3 -1 - Exp.Date III Reconnect only $50.00 2
OR State CCB Reg. No. /Z 7 Exp.Date I f % 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n / 17: D +Rue,e 201 amps to 400 amps $75.00 2 -
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. yy3c( - 5" Exp.Date /o /do / see "b" above.
Phone No. 67o- 75 CAI. ,'s Xsy -6/311 <E1c•
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee. SO
Address Each branch circuit /d $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) :* Signal circuit(s) or a limited energy
panel, alteration or extension $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 structure 4f. 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 $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. S. Fees: 1/6,0°
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
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 # / /5e$0
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
•
6/1/99 Activities for Case #: ELC99 -00146
2:42:19 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 3/17/99 DEB RECD DRA 3/17/99
ELCA003 Permit created 3/17/99 DEB DONE DRA 3/17/99
ELCA700 Rough -in 3/23/99 BRP PASS AKJ 3/25/99
ELCA730 Elect'I Service • 3/23/99 BRP • PASS AKJ 3/25/99 Heater boxes to be secured
both sides Insure that outlet
• boxes are flush with finished
wall surfaces Panel to.be flush
• with wall finish. To be checked
at final.
• . ELCA799 Elect!' Final 5/3/99 CD FAIL AKJ 5/3/99 No access
ELCA500 (F) Issue permit 3/17/99 DEB DONE DRA 3/17/99 -
ELCA799 Elect'I Final 5/5/99 5/5/99 5/5/99 BRP PASS No Hold AKJ 5/5/99
ELCA800 Case finaled 5/5/99 AKJ DONE No Hold AKJ 5/5/99
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
5-5-99 BUD
Date AM PM Requested BLD
Location e 1 0 - 7`9 G't JI c-� • Suite MEC
Contact Person (A A °A Ph (0--2O-757s PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC c(q-o/ q6
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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final /
l
PASS 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
<ELETRI
Service
Rough In
UG /Slab
Low Voltage r
Fir: • larm
t ier )
PASS PART FAIL
S
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 t
I
Date v � ( Inspector Other QiL, Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.