Permit CITY OF T I G A R D ELECTRICAL PERMIT '
PERMIT #: ELC2000 -00398
A 1 ; 4 ; DEVELOPMENT SERVICES DATE ISSUED: 7/19/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1026C -02006
SITE ADDRESS: 10610 SW WALNUT ST
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R -4.5
BLOCK: LOT : 024 JURISDICTION: TIG
Project Description: Installation of one branch circuit for new a/c unit. Job No. R14500
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:
EDWARDS, ANNE D + HARVEY 0 SHARPE ELECTRIC INC
10610 SW WALNUT ST 22605 SW RIGGS
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
•
PRMT DEB 7/19/00 $37.50 0003825 Elect'l Final
5PCT DEB 7/19/00 $3.00 0003825
Total $40.50
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 k �/ - / , ISSUED :Y: /I
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: 2 / '� / C=i :0 -- DATE:
LICENSE NO: 3 c `1` 4` 6
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan C ck
;131 HALL BLVD. Rec'd
TIGARD OR 97223 Date Rec'd 7 - 0 - 'i
Date to P E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit # ei_e -6 - o ---- 3 --- 9 7g
Fax (503) 598 -1960 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 busines 4,1 /I eza/L 0 6 Service included: Items Cost Sum
Address / ( / s
0 lO . (L 4t l/ �4't n n / / 4a. Residential - per unit
City /State /Zip CV!. � O /e_ [ ,-' .. 3
. 1000 sq ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial ❑ Residentiak Limited Energy $ 60.00
Each Manuf'd 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 p). Installation, alteration, or relocation
Electrical Contractor ; .4/) r , 62 c.'�'��
T 200 amps or less $ 64.25 2
Address -2.2 lc f1 S tv I �S
Rce 201 amps to 400 amps $ 85.50 . 2
401 amps to 600 amps $ 128.50 2
City jg,.,eh /21' - er 1 1 State 0 Zip q 7G0 7 601 amps to 1000 amps $ 192.50 2
Phone No. rJ0S I �4 , T , - 793 7 Over 1000 amps or volts • $ 363.75 2
I
Job No. ) / `� Se'" - Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 V- ? /7G Exp.Date ID /D //& • 4c. Temporary. Services or Feeders
OR State CCB Reg. No. b Exp.Date 5`4 /O / Installation, alteration, or relocation
COT Business Tax or Metro No. , 5, ?[ Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'nA lL T `� 401 amps to 600 amps $ 100.00 2 •
/ Over 600 amps to 1000 volts,
License No.
3 3q / 4 � 79 3 7 5 Exp.Date / / see "b" above.
Phone No. 5 3/ 4 New, Branch ech Circuits
/' 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 V b) The fee for branch circuits
without purchase of service -
City State , 'Zip , or feeder fee. 0 ' . 570 Phone No. First,branch circuit 1 $ 37.50
Each additional branch circuit $ 5.35
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 irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy -
• section (if required):* panL alteration or extension $ 60.00
3. Plan Review.
�. Minor Labels (10) $ 100.00
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
described in N.E.C. Chapter 5 5. Fees: QSd
5a. Enter total of above fees $ d
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (08 X total fees) $ 4, OC)
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 #
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ X0 - 5.°
i. \dsts \forms \electric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
, 744-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
BUP
Date Requested AM PM BLD
Location to t ./ 0 .5 w 1v0-64 ki 5 r Suite MEC
Contact Person Ph (' 7� /.. `! 3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC 0 - 0 v J4
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 e
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL " �
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
ppcc ART FAIL
LELE
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
in
�I SART 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 Date •►i/ Inspector
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.