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CITY OF TIGARD BUILDING INSPECTION NOTICE
InspectionLine (Rec-O� Phone): 639-4175 Business Phone: 639-4171
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Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underiloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr, Insul. Shear Wall Gyp, Bd. Elec
Date Requested: ��� �,`i_Time: AM PM
Address:
Builder: Permit #tZ0
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TNE FOLLOWING C RRECTIONS ARE REQUIRED:
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Inspector: Dater
APPROVED DISAPPROVED P'.'ROVED SUBJECT TO ABOVE
_Call For Reinsp.x�� `7l
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection-
Footing
Footing Susp.
/Ceiling rink. Rou h in
p 9 �ApprlSclwl!
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. 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.
Undertlr. Insul. Shear Wall
Gyp, Bd. -Elect.
Date Requested:_ s
' — Time: n AM PM
Address: l Ln 3(J
Builder:
Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE.
—Call For Reinsp.
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Community Development ELECTRICAL PERMIT APPLICATION
t 13125 SW Hall Blvd.
a Tigard. OR 97223 Planck/.�ec. #
Permit # rL% y.5-
Phone (503) 639-4171 Date Issued 0- ._?/ -9,.5
! CITY OF TIGARD FAX (503) 684-7297 Issued by L' /'• scHn,1e17
TDD No. (503) 684-2772
Inspection (503) 639-41.15 _
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Number'of Inspections per permit allowed —
Address � #Q2>CA.) Service included: Items Cost(ea) Sum
City,'State/Zip_ /¢ _ 4a. Residential- per unit 4
1000 sq II or lase -__ $110 00
Each additional 500 sq It or
Name (or name of business)
portior thereof $2500 '
Commercial❑ ResidentialLimited Energy —_ $2500
2
�_�.1 '% Each Manurd Home or Modular
�(L�JeI► pwalAng Service or Feeder $fW 00
2a. Contractor Installation only: 4b.Services or Feeders
Inslallalion,akaration,or relocation 2
Electrical Contractor zoo amps or Isea $60 00 2
Address .3 4i s 201 ar,ps to 400 amps $8000 2
401 an pa to 800 amps $12000 2
City State,_ lip q�bj� 001 amps to 1000 amps -- $18000 2
Phone No. ?$$ S/Ce j Over 1000 amps or volts $34000 i _ 2
Contractor's License No. a&,, %: t C Reconnect only $5000
Contractor's Board Reg. /329 4c.Temporary Servicee or Feeders
Installation,alteration,or relocatmn 2 F
Signature of Supr. Elec n 200 amps or lose $5000 2
Licensp No. /�S Phone o _ _S 201 amps to 400 amps ^� 1 00 —_
401 amps to 800 amps $10000 00
Over 800 amps to 1000 volts e
2b. For owner installations: see•b•above m
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4d. Branch Circuits 4
Print Owner's Name Jew,alteration or extension per panel
Address n)The lee for branch circuits with
purchase of servke or feeder fes. 2
City_ State Zip Each branch circuit $5 00
Phone N0. _ b)The lee for branch drams without
The installation is being made on property I own which is purchase of aavke or feeder fee. 2 q
First branch circuit / $1,00 3 2
not intended for sale, lease Or rent. Each additional branch araril 1` $5 DO •s–��
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review sec,tioa (i/ required): Each pump or ungeliar aide $40 00 2
Ead,sign or outline lighting _ $4000
Signal amuit(s)or a limited energy 2
Please check appropriate Rom and enter fee In section 5B. panel alteration or extena,on "o 00 _
4 or more residential units in one structure Minor Labels(10) $10000 _
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E.0 Chapter 5 Per irnl�+cuon $3500
For hour $5ri 00
In pram oo --
Submit 2 sets of plans with application where any of the above
apply. Nr,t required for temporary construction services. 5, Fees:
NOTICE So. Enter total of above fees $ yy
5%Surcharge(.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter vi of e A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review iff required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. El Trust Account At
Balance Due $
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