Permit CITY �
DEVELOPMENT ELECTRICAL PERMIT
�~����~�x n�o�n� . SERVICES
PERMIT #: ELC97-0149
--- 13125 S0/ Hall BAvd,7��r����7���� MG���/7/
Tigard, ` DATE ISSUED: 03/13/97
PARCEL: 15135CB-00600
SITE ADDRESS..': 11530 SW TIEDEMAN AVE
SUBDIVISION....: - ' '� ' ' ' 1ONING:I—P
BLOCK..........: LOT.............:
Project. Description: Installing first branch circuit and three add'l 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 O. SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY.....: 0 401.7- 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 0 1st W/O SRVC,OR FDR.: 1 PER HOUR..........^: 0
401 — 600 amp......: 0 EA ADD'L BRNCH CIRCA 3 IN PLANT...........: 0
601 — 1000 amp : 0 PLANREVIEWSECTION
1000+ amp/volt.....: 0 )=4 RES UNITS........: ) 600 VOLT NOMINAL..:
Reconnect _ SVC/FDR >=�225/�MpS.,:����'. REA/SPEC QCC ` /
Owner: ---- ---------------- ---- — FEES ----
MCCALL'PROPE8TIES-INC—� _ type amount ~ by date,, , recpt'y.
808 SW 15TH AVE PRMT $ 50.00 B 03/13/97 97-211668
5PCT $ 2.50 B 03/13/97 97-211668
PORTLAND OR 97205
Phone #:
Contractor: ------ — — ----------
COLEMANS ELECTRIC INC $ 52.50 TOTAL
130 A,MORTONRD/ ^ '
REQUIRED INSPECTIONS
OREGON CITY OR 97045 Ceiling Cover Elect'l Service
Phone 656-5446 '� .__ � Wall Cover ^_.� Elect'lFinal
Reg #..: 005100
/1
14-1-1e1K
'
This permit is issued subject to'the regulations contained in the Tiyard Municipal Code, State of Ore. Specialty Codes and all other Permittee ,Sig
applicable laws. All work will be done in accordance with
approved plans. This permit, will oxpire if work'itnot otarted�. /..
within l8:0• days of issmmco or if work-is' sospemdpd for pmre' '/. 6" �- 'wwx-./��»w�
than 100 days. — _ Issued
------OWNER INSTALLATION ONLY — ' — ----
The installation is being made,: on, prpperty_ L on which is not/ intended for)
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
•
------------CONTRACTOR INSTALLATION ONLY------------------
SIGNATURE OF SUPR. ELEC'N: 0T‘ a�4�\U�u��y �� DATE:
V� ---
LICENSE NO:
Call for inspection — 639-4175.
1
i'
ITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By av r
TIGARD OR 97223 Date Rec'd �S 1
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # GLG9� - f 4�
Fax (503) 684 -7297 Called
1. Job Address: _ I _ 4. Complete Fee Schedule Below:
Name of Development / ' 1 -+- L Number of Inspections per permit allowed
, T-
Name (or name of business) V'' � Service included: Items Cost Sum
I
Address / /536 (A) ) • j t, ( ad 4a. Residential - per unit
e� 1000 sq. ft. or less $110.00 4
City /State /Zip 1 c{ a vc2( �I.c.�.. Each additional 500 sq. ft. or
Commercial ES, \ Residential ❑ 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 aliorrent licenses) r 4b. Services or Feeders
Electrical Contractor Ca to m a I. S i . e GT2 I C Installation, alteration, or relocation
Address 1.3O i4 Y'1/10 v-pp� ea - 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City_QR:-6oN C State 0e Zip q1, S 401 amps to 600 amps $120.00 2
Phone No. (066 5 `"(`'t l0 601 amps to 1000 amps $180.00 2
Job No. •. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3- 7C Exp.Date Ct - q?
Reconnect only $50.00 2
OR State CCB Reg. No. 5 l v o3 Exp.Date Der . q 7 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 3039 acialtA Exp.Date 9P c.. c% 1 Installation, alteration, or relocation
�� 200 a mps or less $50.00 2
Signature of Supr. Elec'n LJr.".... a 201 amps to 400 a mps $75.00 2 -
401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No. 2 0-1 -.S Exp.Daten. -7 98 see "b" above.
Phone No. 64 C - S pit,
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 circuit $5.00 2
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee.
First branch circuit l $35.00 A5,c2.) 2
The installation is being made on property I own which is not Each additional branch circuit 3 $5.00 ya 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irngation 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: ��b
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ 2 -
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 # $ 52 SP
Total balance Due
I: \DSTS \ELC96 APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I
Date: L ( l q 7 A.M. P.M. Entry:
Address: �Q 1 5 -2 ,0 O 1
U
Tenant: ' , m l,/Yei ► Ste: MST:
c BUP:
Con /Own: c i MEC:
_ PLM:
�j p �; ELC:
THE FOLLOWING CORRE TIONNS ARE EOUIRED: ELR:
— dt L 4r T I5c1, D- j9,-
-�� - - 15 cp �ien ei� Wi
C r ie [-eft jr).--r., -e / t N J
--/- z90,4 ,
/Ye s - e e Or-tr/ e .2--• —� 1�
_ckr L,S - 'id, ••tf UPS' f /mil cS
A
Inspector: /, t .„,s de �/ Date: ( -- -3 -- -77
j
_APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Gaye ervice FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins. `
Other: °' � S -
qq I�
Date: .- f c t 'l/ :! a' A.M. P.M. Entry:
-y c 6
Address: r� U C ' t o' : e_ _. ,.,-.4Z,
Tenant: Ste. MST: BUP:
Con /Own: _
Q - - <-, ;;',, .., eJ . MEC:
PLM:< >
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR. - 'T/ rr _ :4sio
77-66‘75
c � n
Pte: - _ - _. /0- i , -' C.)''�
j
5 - c— c 1_, r ,-(- 1 'I .- 7 ( .. t . l(c:Ip'f <
cz
Inspector: 71 [ t -e / / . t D �L� 7 7
j r z ' APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation 4.1130
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: L 7 1 /( 0 /9/
M. P.M. Entry:
Address: / 1 S e
Tenant: Ste: MST:
c BUP:
Con /Own: QWl .- I MEC:
PLM�
3g- U�a ELC. /�/s.
THE FOLLOWING CORRECTIONS ARE EOUIRED: ELR." LMie
r ref)r-e . / - !J® (7L l LA 5
/ In 5 (( .
e."124 !i L rr� G -� / A s-T_S i -e
e /p 4Cr; r 21 1 La - Cio (f $ cec
6 !",h) V e
Inspector: fit 40 e ( 1ei I Date:
4 114 ,
K APPROVED _ DISAPPROVED /CALL FOR REINSP. CO