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11720 SW BULL MOUNTAIN ROAD
121
CFF' OF TIGARD BUILDING INSPECTION DIVISIGN
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: 3 - 30� ` /j A.M. P.M. M:'T:
Lowtion. __ 0 S tV� ,(� ,cU r -, — — BUR
Tenant: A. Suite: Bldg: MEC. _
Consactor:_ _ �_ _Phone: 6 3 q �0 PLM:Ldjp ��
Owner: T � Phone: 9 ELC.
f�_ u C SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL r� SITE
Site Post/Beam PostiBcam Post/Beam Cov ervtce Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In tIG Sprinkler
Fowldation Insulation Sewer Hoodiihtct Reconnect Vault
Bmw Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab ', ll ,," " -
IV
Shcar/Sheath Fire Spklr/Alm CrawlMound Dr Heat Pump Low Volt 014 t /(XU r{"—
Approved Approved Approved A rov Approved
Appr/Sdwik Not Approved Not Approved Not Approved of A roved Not Approved
FINAL FINAL FINAL INA FINAL
Jew
O Call for reinspection nspection fee of Srcyui before next inspection 171 Unable to in.lv.i
Inspector: — _---- bate:--- �[1 Page
CTRICAL PERMIT
CITY OF' TIGARD ply
Z111IT 0: El C, 8-0:1. 2
DEVELOPMENT SERVICES DOTE 11.3)SUED: 0.3/1.6/98
12�_'5 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
S 1:TE ADDRESS. 1.1'120 Sw P(R.A... HOUNTOIN RD
SUBD IVT S)ION. ZONING:R-4.5
1`11 OCK.. .. .. ., .. .1 .. .. .. .. N IATT. JURISDICTION: TIG
Project Descriptions Miscellaneous: move overhead service to underground.
........................................_........................................................... ......................
UNIT---- ---TEMP SRV(: /FEEDERS---- -----MISCELLANEOUS——-
1000 SF OR LESS. . . . i 0 0 --- F?00 anip., 0 PUMP/I RR I GATT ON. .. . .. :1
li,-'r)(1A ADD'I ;:0013F'. .. .. -1 0 r'!01 400 amp., 0 SIGA/OUT LINE 1-11-4. .. » 0
LIMITED ENERGY. . . . . s 0 401 6WO anqw . . . . . . .. 0 SIGNAL/PANEL. . . . . . . 0
IIANF. HITI/ 1133VC/FDR., .. - 0 601.+am1-.)s---1000 v(:)J.tl:',. " 0 MINOR LABI-.1. 0(d) . . . 0
----SERVICE/FEEDER---------- ------BRANCH CIRCUITS----- _....__ADD'I... INSPECTIONS------
0 E00 tamp. . . . .. . 1 0 W/SERVICE OR FEEDERs 0 PER INSPECTION. . . . . v 0
201 400 aunt.,. . .. . .. .. s 0 Ist W/O SRVC OR FDR. : W PER HOUR. .. . . . . . . .. „ „ n 0
401 6NO amp. . .. . . . 1 0 EA ADD'I_. BRNUH CIkCs 0 IN PLANT— . .. . . . . - - : 0
601 :1 RIM amp. . ., . 1 0 -----------------PLAN REVIEW SECTION-----------------
1(%J001 ramp/volt.. . . . . 1 0 )-4 RES UNITS. . . . . . . . :: ) 600 VOLT NOMINAL. .. -.
Reconnect only. . . . . s 0 SVC/FDR )- 225 AMPS. . : CLAS)S OREA/.SPEC OC,C'.. #
Ow"er: -------------------------------------------------- FEES ..........................-- -....................._....-
DERE:K L COL BY typv amount by date reept
1.1720 SW BULL MOUNT011-4 ROAD PRMT $ 40.00 ( EO 03/16/98 983041'51
1100RD OR 97224 5f:,(:,*T* $ 2.00 GE O 0.3/16/98 98-3041t5l.
Phone Us
Contractorn
42.00 TOTAL
REOUIRED INSPECTIONS ----
Underground Cove Elect' I Final
Phone No Elect' I Service .......................................
Reg ". . I
This pervit is issuLA sub?-,0- to the regulations contained in the Tigard Municipal Code, State of "on Specialty Codes and all other
applicable laws. All h.vrk will be done in aCCOTdaire with approved plans. This pp-sit will expire if wort: is not started within 180
day,, of issuance, nr if work i� suspended for more than 180 days. ATTENTION- Oregon law requires you to follow the rules adopted by
the "on Utility Notification Center. Those rules are set forth in OAR W881-WO through OAR 952-01-1987. Yqu may obtain a copy
of these rules or direct questions to OX by calling (563)246-1987.
4, 6-tA-.
nX By.
Permittee Signatureggl; I ssued B q .......... .......
---------------------------OWNER INSTALLATION
rhe installation is being made on property I own which is not intended -For
gale, lease, or rent.
OWNER'S SIGNATURE: ........... ........ ....................... DOTE::-. ...-...................
INSTALLATION ONLY.......................................
SIGNOTURE OF SUPR. El E C-I N: ............................_......................... .......... DATEn --V'......0�...........................
LICENSE NO: ................ .........
r.+. +++++4-ffffffffffffffffffffffffffffffffofffffff++++++4.. ..1•i•+•1•
Call 639-4175 by Q@@ p.m. for an Inspection needed the next business da),
ffffffffffffffffffffffffffffffffffffffffffffffff+4+fffffffffffffffffffffffff++f
CITY OF YIGARJ Plecirical Permit Application Plan Check ft
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Date to P.E.Recd_
Phone (503) 639-4171, x304 Date to DST
Inspection (503) 639-4175 Print or Type
Incomplete or illegible will not be accepted Permit
Fax (503) 684-7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of inspections per permit allowed
Name(or name of business)DE2LIL Cot-8If S� ervice included: Items cost Sum
Address 1 11 Z-O s'tn/ B(U L-t-AA-r-� �� i_ 4a. Residential-per unit
City/State/Zip T_14 Ar 1*-D Q 1000 sq.ft.or less $110.00 _ 4
Each additional 500 sq ft.or
Commercial ❑ Residential portion thereof $25.00
Limited Energy $25.00
Each Manuf'd Home or ModL'at
Dwelling Service or Feeder $68.00
2a. Contractor installation only: -
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor---------- Installation,alteration,or relocation
200 amps or less
_ $60.00
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $1P0.00
Phone No. 601 amps to 1000 amps A_ $180.00 2
Job No. - Over 1000 amps or volts $34000 2
Elec.Cont. Lice. No. Exp.Date - Reconnect only $50.00
OR State CCB Reg. No. _Exp.Date 4c.Temporary Services or Feeders
COT Business Tax or Metro IVo._ Exp.DateInstallation,alteration,or relocation
200 amps or less $50.00
Signature of Supr. Elec'n 201 amps to 400 amps $75.00
--- 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License Nr Exp.Date_ see"b•'above.
Phone N, _ _
-- 4d.Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a)The lee for branch circuits with
Print Owner's Name CD L-5 Y _ eede fee, service or
Address (1 7 Zo S c.J 0;W L_ A4 TnJ ft 0 Each branch circuit $5.00 2
-- b)The lee for branch circuits
r�ItY�4 � State &r? Zip_ c�7Z: `� _ without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I owr which is not Each additional branch circuit_ $5.00 2
intended for sale, lease or rent. 4e.Miscellaneous
Owner's Signature Signature (Service or feedar riot Included)
Each pump or irrigation circle $40.00
Each sign or outline lighting __ $40.00 _
3. Plan Review section (If required):� Signal circuit(s)or a limited rnergy
panel,alteration or extension $40.00
Please check appropriate item and enter fee in section 58. Minor Labels(10) $100.00 -
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
% em 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 s is of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a.Enter total of above fees $
591.Surcharge(.05 X total fees) $
--
NOTICE Subtotel $
5b.Enter 25%of line fie for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reaulred(Sec.3) $ -
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 JAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Accot, ,0
Total balance Due s
t MSMELCN APP Rev W96
CITY OF TIGARD
OREGON
\ s
PROPERTY OWNERIOPERATOR APPROVAL FORM
{_\ CC L-6Y_ being the true legal owner of the
(Piease Print,
property located at U Lt til ny (t7 Tigard Oregon give my
approval for the current tenant, _ _ ,�� � � residing at the
above mentioned property, my permission to operate a busines; at this location in
accordance with the City of Tigard's home occupation permit ordinance.
Owner/Authorized ReprerentatiA s Signature
Owner/Authorized Representatives Phone Number
Date Signed
H 1LOGIMOSTS\HOPOWNER
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2712 ----- ---