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13000 SW CADDY PL MODEL HOME
V� O'Y OF TIGARD ---.ELECTRICAL PERMIT
_ PERMIT#: ELC2004-00422
DEVELOPMENT SEMCES DATE ISSUED. 7/13!2004
13125 SW Hall 91vd., Tigard, OR 97223 1503) 639-4171 PARCEL: 2S104DA-13900
SITE ADDRESS: 13000 SW CADDY PI-MODEL HOME ZONING: R-4.5
SUBDIVISION: QUAIL HOLLOV.1-WEST
BLOCK: LOT : 125 JURISDICTION: 1IG
Project Description: Reconnect only
_ 'RESIDF`tTIAL UNIT_— _ ^�_ TEMP SRVC/FEEDERS" MiSCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
t-IMI1 E0 ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HIA/ SVC/ FUR: 601+arrps - 1000 volts: MINOR LABEL (10):
`T- SERVICE/FEEDER �— �J BRANCH CIRCUITS --_i—� ADD'L INSPEC110NS
0 200 amp: W/SERVIC E OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W10 SRVC OR FDR: PER HOUR:
401 600 amp: EA ADD'I.BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ -- —_ ____PLAN REVIEW SECTION
1U00+ amp volt:
>=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: —` 1 -- -- SVCIFDF!>=225 AMPS:---Y_ _CLASS AREAISPEC OCC: _
Owner: Contractor:
KWO CECIL
13000 S W C ADDY PL
TIGARD.OR 97223
Phone: 503-504-3158 Phone:
Reg #:
_ FEES
Description — Date Amount Required Inspections
cn _ '- n
— — -----
I IJ'FMI] GLlI68 _ _
ElectService
I \xj 80,,,Stale Surcha vc 96.35---- Elect'l
Final
Total $72.2'J `
?rrs Permit is issued subject to the regulations contained in the Ilgard Municipal lode State of OR Sj,aaelty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work 15 not stated within I PC aays cf issuarce or if work is
suspended for mere than 180 days .ATTENTION, Oregon law equires you to follow rules adopted by the Jregon Utility Notification Center Those
rule 5etfotttr o-CI6.R 952-001-0010 ttirougt OAR 952-001-0100 You may obta r copes of these rules or direct questions 10 OUNC at',503)
8699 or 1$00
�
Issued By: �. _� _ Permit Signature:
OWNER INSTALLATION ONLY
The installati,)n is being made on property I own t }ich i� of Intended for sale. lease. �r rent /
OWNER'S SIGNATURE: SS ;C�'J �� — —_---- DATE:_�_L��—M
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N:
LICENSE NU' ------ �- ---- ----- - —---- --_ e_
Call 639-4175 by 7:00pm for an inspection the next business day
omit licatrull r R.U[) �.---
City o Tigard keceived 7 1� �{ �' �
Permit No.
13125 SW Hall Blvd.,Tigard,OR 97223 Pan Re _
B Pian Review Other Permit;
Pyone: 503.639.4171 Fax: 503.596.1960 Date1y1_--
inspection Line: 503.639.4115 Date ke3dyiBy 1 '^ ® See Pogo 2 for
Internet: www rl'igard.orus Notified/Method Y_ /tcJ+ Supplemental Information
TYPI' OF WORX PLAN REVIEW
LJ construction 4ddamon/alteration/replacement - Please check all that apply
ivniolition- _ ❑Other -! �- ❑Service over 225 amps,comm'I [I Hazardous location
❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft.,
CATEGORY 6F CONSTRUC"T.ION of l-and 2-family dwellings 4 or more new residential
1-and 2-tarnily dweding Ct,mrncrcial;industrial J Accessory building [3 System over 600 volts nominal units in one structure
Multi Iamily ❑Building over three stories ❑leer iers,400 amps or mor,
t], ❑ Master builder ❑Other _ ❑Occupant load over 99 persons ❑1vlenufactured structures or
u)It E (NFOR112WIGN ANI) LOCATION V ❑Egress/lighting plan RW psix
--- __-- - -' �- i
01 -care facility ❑dither.
Job no.: Job site address:
( UCS _Q_ev CrW) f t' Submit,2 sets of pfanr with any of the sbovc.
City/State/ZIP f o0eIF&.j-R/ ?72 Z j The above are not ap,rlicable to temporary construction service
Suite/bidg./apt.no.: ` I Project name: M.,( _ — i' __ SEE' SC1iEUULE—_ ..
Description Qty. Fee Told
Cross street/directions to job site: New residertttal singly-or multi-family dwelling unit.
Includes attached garage.
1,000 sq.ft.or less 145.15 4
SuWivision: -- Lot no.: Ea.add'I SCO sq.fl.or portion 3340 l
-- Limited energy,residential 75.00 2
Tax map/parcel no.: Limited energy, 75.00 � 2
AMMOMMOM Each manufactured or modular
dwellinservice and/or feeder 90.90 2
Services or feeders installation,alteration,and/or relocation
----___--_'_---_` 200 amps or less 60.30 2
--PROPERTY OWNER- JT1-_f, ❑ TFNANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: )y��Q �Q C —� — 601 amps to 1,000 amps — 240.60 2
Address: r,act O5� C�(DD`T � Over 1,000 amps or volts 454.65 2
Reconnect only P 2
City/State/ZIP: 61)e Q 7 Z Z j Temporary services or feeders in,.tallation,altersdon,and/or )
relocation
Phone:(6o:3 ) SC y 3/S Fax:( ) 200 amps or less 66.85 l
Owner Installation:This installation is being made on property that I own which is not 201 amps to 400 arms_ 10030 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,67r,,and 701. 401 amps to 600 amps 133 75 2
Owner signature _ __- _ Date Branch circuits-new,alteration,or extension.per panel
❑ AiP"$L ANT ti T —�, "'" A Fee for branch circuits with
-� f] CN7�iCT LrFIt5l)N_. service or feeder fee,each
6.65 2
Busyness name: branch circuit
--- ---- ---- -- - - _- B Fee for branch circuits
Contact name: without service or feeder fee,
- -- ----- --- --- .- 46.$5 2
each branch circuit
Address: Tach add'I branch circuit 6.65_ 2
City/State/ZIP: Miscellaneous(service or feeder not Included)
- --- -- - Pump or irrigation circle 53.40 2
Phone:( ) Pax: ( ) Sign or outline lighting 53.40 2
I mallSignal circuit(s)or limited-
NTEt -
---- -- -'-"'A �T-�. - energy panel,alteration,or
_ l fyC"
�. _I`OR extension.Describe Page 2 2
[Iusuress name: -
-�-
Address: Each additional e
Inspection over allowable in any of the above!
Per inspection 61.50 ---�
City/State/ZIP: Investigation per hour(I hr nun) 62,50
Phone:( ) Fax;( ) - industrial plant per hour 73.75
IAL 1R
CCB Lic., Electrical Lic.. Suprv.Lie.: _—�— Subtotal
Suprv.Electrician signature,required: Plan review(25%of permit fee)
- - �Date:
5tate surchargr(640 of permit fee)Print name: -----
�_ --- ----- TOTAL PERMIT FEE
Authorized signa /,/� _- _ This permit application expires if a permit b not obtained within Iso
days after 1t has been stcepted as complete
Print name: Date:? /3 G`L( Fee methodology set by Tri-County Building Industry Service Board
eC ir '•Number of im!pectiotu per pernut allowed.
,tBuirdingTermm`EI.C.PermitAppdoc IV03 440.46151(1 21(70�4wE9
Electrical Hardt u.)ILL-afion - City of Tigard
Page 2 - Supplemental lnformation
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK C'.—,1,,Y:
Fee for all residential syr-tems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK r INI.Y:
Fee for each commercial system....................... $75.00
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
M Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nursp Calls
L7 Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number ofcommercial systems:
*No licenses are required. Licenses are required
for all other installations
i$uldtn�lParnutfEl.CPamttc.srMc nyv,
CrfY OF
L� � ACj persc+ -)n Line: (503)639-4175N
MST -- - - - - —
INSPECTION DIVISION Butsiness Line: (503)539-4171
BLIP ---- -----
Received Date Requested_ _jL.i.. AM_----- PM BLIP
Location � Suite_-- - ---____-- MEC -_ -
Contact Person Ph -
Contractor— __-_ Ph(n _ ) SWR
ra t
BUILDING Tenand@�Pr �/1't' L.lL� d--' ' ELC;
Footing ELC _.
Foundation I Access:
Ftg Drain ELR
Crawl Drain -
Slab Inspection Notes _ SIT --
Post&Beam
Shear Anchors
Ext Sheath/Shear "- -- --- -
Int Sheath/Shoat
Framing - - - - ---
Insulation
Drywall Nailing ---- ---___.�__-_---
Firewall
Fire Sprinkler - - - -------- - -- ----- ----------_—
Fire Alarm
Susp'd Ceiling - -
Roof
------- ------
Other:
Final
PASS_ PART_ FAIL
PLUM_BINa �.
Post&Beam
Under Slab -- -- - - - -
Rough-In
Water Service -
Sanitary Sewer
Rain Drains
Catch Basin i Manhole
Storm Drain
Shower Pan
Other:
Final
--------------- -- -
- PASS PART-FAIL
------- ---
ME_CHANIC_AL - -- - —
Post& Beam -
Rough-In - - --- --
Gas Line
Smoke Dampers -�
Final
PASS PART_FAIL
ELECTRICAL. _
Service
Rough-In -
UG/Slab
Low Voltage ----
Fire Alarm
Fin Reinspection fee of required before next inspection, Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
- --- �] Unable to inspect-no acc e ss
- � Please call for reinspection RE:�. . -
Fire Supply Line
ADA
Approach/Sidewalk
�et* _ -^ L � n l 1lItBpAolos Ex+
r s='
Othor:
Final DO NOT REMOVE this in%pec lon reroild from the Jub site.
PASS PART FAIL