Permit CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0012
* DATE ISSUED: 01 / 08 / 98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S134DC -08500
SITE ADDRESS...:11549 SW TWIN PARK PL
SUBDIVISION •TIGARD PARK ZONING:R -4.5
BLOCK LOT °001 JURISDICTION: TIG
Project Description: Beckman
- -- 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
TED BECKMAN type amount by date recpt
11549 SW TWIN PARK PL PRMT $ 35.00 JSD 01/08/98 98- 302358
TIGARD OR 5PCT $ 1.75 JSD 01/08/98 98- 302358
Phone #:
Contractor:
PORTLAND METRO AIRE $ 36.75 TOTAL
10010 SW BEAVERTON— HILLSDALE HWY
REQUIRED INSPECTIONS
BEAVERTON OR 97005 Rough —in Elect'1 Final
Phone #: Elect' 1 Service
Reg #.. : 000612
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: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952 -001 -1987. - say obtain a copy
of these rules or direct questions to OUNC by calling (5031246 -1987.
Permittee Signature: AD.1 [304 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: DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
id
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd OI
Date to P.E.
Phone (503) 639 -4171, x304
Print or Type Date to DST
Inspection (503) 639 -4175 Permit # F.. ere)/ z
Fax (503) 684 7297 Incomplete or illegible will not be acce Called ���
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address i i .1 1 , 7 S 11 ( s) uwj]t fCO` � - f,v.L,' 4a. Residential - per unit
City/State/Zip J �
ty
' f j (,7 � L Each or less q $110.00 4
P .J Each a addit tional 500 s . ft. or
Commercial El Residential Z portion thereof $25 00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all urrent icens s)^ + 4b. Services or Feeders
Electrical Contractor ) • , 1 1 ? l 1 ,s Installation, alteration, or relocation
Address DO/ - 6 J L) •� A `r ^ / 7 S' T ' 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City State ZipT� 401 amps to 600 amps $120.00 2
Phone No. #( 7 -, - 1 g t �����' ///??? 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Y 1-5 Exp.Date / 3(2) -9
OR State CCB Reg. N. Exp.Date /6-7d-- 7f-Y 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec 'n 4eit1Z_ , 2Q1 401 amps to 600 amps $100.00 2
"2. Over 600 amps to 1000 volts,
License N� `� �� Exp.Date /c-3 : /� see °b" above.
Phone Nr
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.
Address Each branch circui $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. 5
First branch circuit I $35.00 3 2
The installation is being made on property I own which is not Each additional branch circuit $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 descnbed in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: S
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 $ -&--1
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due
I \DSTS \ELC96 APP Rev 9/96
) 4S7 CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 9 `_ �� 1 (•i7L/ / - / - 7' A.M. P.M. MST:
Location: 1 1,5 l MJ741 / lj1.0 7 ,A.ce� BUP:
Tenant: Suite: G p Bldg: MEC:
Contractor: , AO /111 A l / ' / ' a 91 -P-Z �, A Phone: tip - 70 1 J PLM:
Owner: - ��� ✓/L (JJ■ Phone: ELC: / q Q -QO 1
/, ELR:
l Chi/ l V SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam o ce 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 Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved • . • ... ved Not Approved
FINAL FINAL FINAL FINAL FINAL
A //Z CD4/ 7
3° A Cie IN Pc? VI J
3 D A/ N'C m.6 1 Ale4
. - - / /-)-4: l — A .5 t
K C__
D Call for reinspection 0 1 s • io ee of $ / ;wired before next inspection 0 Unable to inspect
Inspector: / Date: — Page of