The URL can be used to link to this page

Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00686 ' v � l �;� DEVELOPMENT SERVICES DATE ISSUED: 11/15/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101DA -00800 SITE ADDRESS: 07105 SW VARNS ST SUBDIVISION: VARNS ACRES ZONING: C -P BLOCK: LOT : 011 JURISDICTION: TIG Project Description: Electrical TI 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: 9 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: • GRANGE MUTUAL INSURANCE RC COSTELLO 7105 SW YARNS ST 1439 SE 12TH LOOP TIGARD, OR 97223 CANBY, OR 97013 Phone: Phone: 266 -8483 Reg #: LIC 87402 ELE 3 -344C SUP 3934S FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 11/15/1999 $85.65 99- 319769 Elect'I Final 5PCT BON 11/15/1999 $6.85 99- 319769 ORIGINAL Total $92.50 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. PERMITTEE'S SIGNATURE , ISSUED BY: 6. �(/ 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: X DATE?( 1/ //s/q7 LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • CITY, OF TIGARD Plan Check # Electrical Permit Application Recd By 1.3125 SW HALL BLVD. Date Recd I1 t - TIGARD OR 97223 Date to P E. Phone (503) 639 -4171, x304 Date to DST Ike Inspection (503) 639 -4175 Print of Type Permit # F ( / -G��0 �W Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address 0 c � , tfru''"�`�) - v A4/1 `' Qr1- � :Complete Fee Schedule Below: Name of Development 70. /S SCv vat/? S Number of Inspections per permit allowed Name (or name of business) ke .s 73/ , • Service included: Items Cost Sum Address 4a. Residential - per unit 1000 sq ft or less $ 117.75 4 City /State /Zip Each additional 500 sq. ft. or portion thereof $ 26.75 1 Commercial n Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data bas /� � >°��U Installation, alteration, or relocation Electrical Contractor C. 200 amps or less $ 64.25 2 Address /L 4 3q S t. `Z 77 4.,o,-) 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 City K State _ oe Zip 20 /j 601 amps to 1000 amps $ 192.50 2 Phone No. / 2.66 - 8 liA3 Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. _3 3 `' / /U OO 4c. Temporary Services or Feeders OR State CCB Reg. No. 87402. Exp.Date / /s /OZ. Installation, alteration, or relocation o � COT Business Tax or Metro No. Exp.Da a 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n ....../ 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, L S / C) / see "b" above. License No. 3q3 _/ Exp.Date / 4d. Branch Circuits Phone No. 81q 1L/ / New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5 35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 3 Each additional branch circuit $ 5.35 �, I The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or imgation circle $ 42 75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):' panel, alteration or extension $ 60 00 Minor Labels bels (10) $ 107 00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59 00 Classified area or structure containing special occupancy as descnbed in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ C o`D IPC * Submit 2 sets of plans with application where any of the above apply. JU O Surcharge (.05 X total fees) $ (p , C65 Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # /l AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ /a 5 i \dsts \forms \electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location 0 cS t✓ vGY►i 3 Suite MEC Contact Person Yes Ph /17 3 y 3 c/ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC /fff - • 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 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 ELECTRICAL Service UG/Slab ' C '�'� ` "" e. Low Voltage Fire Alarm Final 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 / : G q Inspector Date — 0C 9 It Other Ext �i E x Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location 7/ OS 5 w ()al s Suite MEC Contact Person C etss Ph fly 3 Y 3 y PLM Contractor Ph SWR BUILDING Tenant/Owner ELC /tYf - 60 (o /6 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 O r in r n r m a p / D P 1 Firewall - / Fire Sprinkler r= 4 / S'G1'7 CYr> iv Qn C/ re Li I L cho h c4/` Llp/l Fire Alarm —/ .. [[ / Susp'd Ceiling D[ C) es l7 D I Co »2 � D /�/ ‘4, 11 ? pt7Ii C' 4 b Roof l !� Misc: �� • Final PASS PART FAIL I" PLUMBING T � y1G p � � & wo r K / S Q ,3rz v Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam )\ Rough In Gas Line L Smoke Dampers I/- RTC FAIL ELECTRICAL u Service Rough In UG /Slab Low Voltage F' - : arm 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 Approach /Sidewalk f 9 [ / Other Date 2-/3- l Inspector i _ ��/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.