Case File ADDRESS.
113 3z) 5(-u A Ce, Plea ea.
i:Vecord s\microflm\targets\building.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection ine (Rec•O•Phgne): 6 Business Phone: 639-4171
Inspection: '�1J
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. P(bg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. lett.
Date Requested: `'� 2 Time: AM PM
Address: 1.Q�--y_ �
Builder: ' Permit#:,E-7 S —C)SW
THE FOLLOWING CORF,_CTIONS ARE REQUIRED:
r
Inspector:4,4 fL4 _ Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
ELECTRICAL PERMIT lj
CITY OF TiGARD DATEIISSUED: 11/29/595
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Orogen 87223.8109 (503)630.4171 PARCEL.: 2S 103DB-06500
SITE ADDRESS. . . ? !.. ; cti `._)W AMBIANCE PL_
SUBDIVISION. . . . s GENESIS NO. 2 ZONING.R-4. 5
13LOCL1.. . . . . . . . . . : LOT. . . . . . . . . . . . . :E1
Project Description: Two branch circo_oits for irstalling a hot tLob and 120v circ-1-1
it
for pltins.
-----RESIDENTIAL UNIT-,--.- ----TEMP SRVC/FEEDERS-•- --- -------M I SCELL.ANEOl1S-----
1000 Sr:' OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT I.._.INE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MONF. 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/O SRVC OR FUR. : 1 PER HOUR. . . . . . . . . , . : 0
401 - 600 amp. . . . . . : 0 FA ADD' L SRNCH CIRC- 1, IN PLANT. . . . . . . . . . . : 0
601 - 1.000 am�j. . . . . : 0 --------------- -PLAN REVIEW SECTION-_.--_-.----.__----
1.@00+- aMp/vott . . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. .
Reconnect only. . . . . : 0 SVC/FDR >= 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: -___._.________._._.____._._______....__ FEES
CHEROKEE ELECTRIC type amok_ont by date recpt
PO BOX 230230 PRMT 4 40. 00 CJS 11 /29/9.5-, 35 '73309
SF'CT $ 2. 00 CJS 11/29/95) 95-273309
TIGARD OR 97281-0230 i
Phone #: 503-508--7744
Contractor-
CHEROKEE ELECTRIC CO 42. 00 TOTAL
PO BOX 230230
------- REOU I RED INSPECTIONS
-----
11f ARD OR 97P61 Ceiling Cover Elect' 1 Service
Phone #: Wall Cove"- Elect' l Final
Reg
This permit is issued subject to the regulations contained in the
Tigard 011inicipal Code, State of Ore. Specialty Codee and all other Permittee Signati.lre
applicable .laws. All worm will ba done in accordance with
approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended for more �7Gi�1lot- ,C �
than 188 days. I s s i.o ed By
INSTALLATION ONLY-----_--_--------------__-.--_
The instal laltion is being made on property I own which is not intended fo,-
aale, lease, or rent.
OWNER' r, SIGNATURE: _... _._ U►; rE:
INSTALLATION ONLY-- _ .___.___._.__----..____.._-nn__-----_-.- _.
-)IGNATURE OF SUPR. ELEC' N: ��? ._— i _ HATE: _� ?7�_�
LICENCE NO:
Call for inspection - 639-4175
r.orrimuniq D;:vr;^pment ELECTRICAL PERMIT APPLICATION
n 13125 SW HaH Blvd.
igard, OR 97223 Permit # 4:2y-.Q 587_
L
Date Issued 1� a4 9S-Fhone (503) ti39-4171
FAX (503) 684-',297
TM i'O. ( 03', :i84-2772
In�,pecHun (`Mr 839-4175 _
1. Job P V,ess: 4. Complete Fee Schedule Below:
Name of UE�t.�pmf: rtfj.,�1 osis __— Number of Inspections per permit allowed
Address--fl 330 Service included Items Cost(ea) Sum
City/State/Zip_T-i�,L,,(--,-O-r. 4a. Residential -per unit
1000 sq ft or less _ $11000
Name (or name of buslness).�l /j 1 Lr Each additional et sq ft.or — —
portion
thereof
$25.00
r $25.00
Commercir.; Li Residential Each
h Energy
J Each Manurd Home or Modular
re til ✓ , i Wars(f 41— D(w'5 Dwelling Service or Feeder --_ $68.00
2a. Contractor installation only:l
4b. Services or Feeders
Installation,alteration,or relocation
Elect,v,al Contractor > 200 ampu or less $60.00 --
Address '+0,,_$ ���ZOO 201 amps to 400 amps _— $80.00
401 amps to 600 amps $120.00
City_ T}.,ar_� State 49c, Zip 9? f£� 601 amps to 1000 amps $18000
Phone No. Over 1000 amps or volts $340.00 _
---
Job h0 Reconnect only $50.(X)
__
contractor's license NO-3—WC- 4c, Temporary Services or Feeders
Contractor's Board Reg, No. 6_ Installation,alteration,or relocation
Signature of Supr. Elec'n_, -tee _ 200 amps or less
_� 401 amps to 600 amps $7500
�b 5 __ Phone No., Y-77Y'/ zo1 sopa l0 4(10 amps
License No -- 350.00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see"W above
4d. Branch Circuits
Print Owner's Name__ _ NnH,aheiation or extension per pane
Address s)The fee for branch circuls with
purchase of service or feeder fee. 2
City _— State Zip_--- Ench branch circuit $500
Phone No. _____ hi The fee for branch circuits without
purchase of service or feeder fee. 2
The installation i being made an property I own which is First brain-In circuit _ 1 $1500 2
not intended for Sale„ lease Or tent Each additional branch circuit A_ $5.00
Ownei's Signature __. _ 4e. Miscellaneous
(Service or feeder not Included)
3. Plan Review section (if required): Each pump or Irrigation flingJrc $4000
Each sign or nutllne Its ding $4000
Signa'clrcult(s)o a Ib iMed en iy 2
Please check appropriate Item and enter fee in section 50 pant' alteration or atension $4000
_4 or more residential units in one structure Minor L..ler.(10) $10000
Service and feeder 225 amps or more 4f. Each m.AlUrnal inspection over
— System over 600 volts nominal
C assified area or structure contai.ling special occupancy P allo"b.* 1 any of the :above
-- er nspedkl $3500
as described in t4 . Chapter 5 Per hxjr $5500
In L:r.: -- $5500
Submit 2 sets of plans with appiiration where any of the above f�
apply. Not required for temporary construction services. 5. Fees.
5a. Enter total of above fees $
NOTICE 5%Surcharge (05 X total fees) $
PCF.MITS BECOME VOID IF WORK OR CONSTRUCTION subtotal $
5b. Enter 25% of line A for
AU'HORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required (Sec 3) $
CONSTRUCTION OR WORK.IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS —_ -
COMMENCEDm mma�w. �_� Trust Account f
BAIARCp, Oue a ,__
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A 0 CJt*Y OF TIARD HVCF`IPT OV PAYME-M RE I'l- '1111 Ml I.
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ADDRF136 r Pu BOX 2,30"'130 PAY MI- 1`41 DHTV
T I SARD OR `SUN.D I V I S I CIN
4729A—M130
PLIRVIOSF OF' PAYMENT Amutir4l W411) PURI.101-A, 1•x(014"4 01401-IN 1 1-4111)
LLFCTRICIAL PF.R1411 40. 00 Hl. lillil I 1 00
11 ,'31A SW NMN j#-lNCf- PL
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