11985 SW NORTH DAKOTA STREET-1 i
1S dl0)ldfl HiHON MS 59661
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11 965 SW NORTH DAKOTA ST
CITY J w T I C A R D ELECTRICAL PEftMn
PERMIT 0: ELC2000-00072
4—a DEVELOPMENT SERVICES DATE ISSUED: 02/23/2000
13125 SW Hall Blvd.,Tlaard, OR 97223 (503)639-4171 PARCEL: 1S134CH-00603
SITE:ADDRESS: 11985 SW NORTH DAKOTA ST
SUBDIVISION: PANORAMA ZONINQ,: R-4.5
BLOCK: LOT: 002 JURISDICT;ON: TIG
Prosect Deacription: Service or feeder to 200 amps
RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISrELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/SVC/FDR: 601+amps-1000 volts: MINOR LABEL (19):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 100,j amp: __PLAN REVIEW SECTION
1000+ amplvolt: a=4 RES UNITS: r >600 VOLT NOMINAL:
Reconnect only: SV(;/FDR>=225 AMPS: CLA -,ARE&SPEC OCG:
Owner: Contractor:
FRANZWA, PE) .2 A OREGON ELECT CONSTRCTN/GRP INC
DIANE C 1010 SE 11TH
4903 GLORIA GAYLE WAY PORTLAND,OR 97214
FLORENCE, OR 97439
Phone: Phone: 234-9900
Reg 0: SUP 2841S
LIC 0026-9
ELE 001302-S
FEES Y _ Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 02/23/200( $64.25 00-321809 _ Elect'I Final
5PCT BON 02/23/200( $5.14 00-321809
Total $69.39 ORR" '
This Permit is issued subject to the regulations contained in tha Tgard Municipal Code,State of OR. :;p?dalty Codes and all other applicable laws.
All wotc will be done in accordance with approved plans. This permit will axire if work is not started Nit,* 180 days of issuance,or If work is
0. suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by th-e Oregon Utility Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordirect questions to OUNC at(503)
N 246-1987.
PERMITTEE'S SIGNATURE OXI a 1ZA1M_ ISSUED BY:
m t__..
0 __ OWNER INSTALLATION ONLY _
J The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _____ DATE:---
_ CONTRACTORINSTALLATION ONLY
SIGNATURE OF SUPR. ELFC'N: 1 -41
� DATE:, -
LICENSE NO:
Call 639-4175 by 7:O0pm for an Inspection the next business day
CITY OF TIGARD Plan C
13125 SW HALL BLVD. RECEI�ctrical Permit Application Recd ByW
TIGARD OR 97223Date Recd
FEB 9 ?00@ Date to P.E.
Phone(503)639 4171, x304 Date to DST_
Inspection(503)639-4175 OWMUNHY 10TIAPM141 Print of Type Permit N tt L�'J�
Fax (503) 598-1960 Incomplete or illegible will not be accepted Caned
t. Jab Address: 4. Complete Fee Schedule Below:
SName of Development New Service Number of InspecOons per permit allowed
Name(or name of business) Service included: Items Cost Sum
Address 11985 SW North Dakota 4a. Residential-per unit
City/State/Zip Tigard, OR 97223 1000 sq.it or less s 117.75 _ 4
Each additional 500 sq.it or
portion thereof $ 25.95 1
Commercial ❑ Residential 0 Limited Energy _ $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 7275 - 2
(Prior to permit Issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). Installation,alteration,or relocation
Electrical Contractor Oregon Electric oLp- 200 amps or less -_ 1 $ 64.25 64.25 2
Address 1 635 SE Enterprise Circles #A 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City H i 11 sbc:r,�State A�_Zip_9 71 2'1 801 amps to 1000 amps _ v S 192.50 _ 2
Phone No. r` Over 1000 amps or volts _ S 383.75 _ 2
Job No. r Reconnect only S 53.50 2
Elec. Cont. Lice. No. 2 v_-9 5C Exp.Date 7-01-00 4c.Temporary Services or Feeders
OR State CCB Reg. No. 2 0 Exp.Date 10-DI-OD Installation,alteration,or relocation
COT Business Tax or Metro No. 003 9SExp.Date 04-01 0 200 amps or less _ $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n_ 2 401 amps to 600 amps - S 107.00 2
Over 600 amps to 1000 volts.
L'conse Na._ 1302-S eon"b"above.Exp. �� ! n _
Phune No. 4d.Branch Circuits
�-��- New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owners Name Each brand,circuit _ $ 5.35 2
Address b)The fee for branch circuits
without purchase of service
City State Zip or►ceder he.
Phone No. First branch circuit S 37.50
Each additional branch circuit S 5.35 _
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or rent. (Service or feeder not Included)
Each pump or Irrigation circle $ 42.75
Owner's Signature_ Each sign or outline lighting $ 42.75
- Signal circult(s)or a limned energy
* panel,alteration or extension $ 60.00
Q. 3. Pian Review section (%f required):* Minor Labels(10) $ 107.00
of -
NPlease check appropriate Item and enter fee in section 58. 4f.Each additional Inspection over
_4 or more residential units in one structure the allowable In any of the above - -
eJG Service and feeder 225 amps or more Per inspection $ 50.00
_System over 600 volts nominal Per hour $ 50.00In Plant _ _
$ 59.00
Classified area or structure crnntaining special occupancy as
W described in N.E.0 Chapter 5 5. Fees:
J Be.Enter total of above to $ 64. 25
* Submit 2 sets of plans with application where any of the above apply. 7 p,59G'Surcharge(.05 X!otal fees) $ I�
Not required for temporary cox:traction services. I Subtotal $
6b.Enter 25%of line is for
NOTICE Plan Review If reWired(Sec.3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal S
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account 0
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
i\dsts\forms\cicctric.doc
AA-
CITY OF TIGARD BUILDING INSPE,,:TION DIVISION MST
24-Hour Inspection Line: 638-4175 Business Line: 6384171
BUP
DateRequested_ 00 AP9_____PM BID _
Location 0 5 _ Suite MBC
Contact Person Ph PLU
Contractor QPh SWR
BUILIJING Tenant/Owner `ELC _
Retaining Wall ,ELR _
Footing Access-
Foundation FPS
Ft Drain 'r
rewl Drain Inspection Notes,BIZ! SGN
scab e S�i SIT
Post&Beam v...
Ext Sheath/Shear ryt+s+
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall - r
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL — —
PLUMBING
Post&Beam —
Under Slab
Top Out
Water Service
Sanitary Sewer - -- `— —'
Rain Drains
Final
PASS PART PART FAIL
MECHANICAL
Post&Beam —
Rough In
Gas Line
Smoke Dampers
Final ——
PASS PART FAIL
IL Service _
Rough In
F.. UG/Slab
N Low Voltage -
Fire Alarm
ma
m SS PART FAIL
SITE
W Backfill/Grading - --- --
Sanitary Sewer
Storm Drain [ J Reinspection fee of$_ required betore next inspection. Pay at City Hell, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE: [ ]Unable to Inspect-no access
ADA
Approach/Sidewalk
Other Dalt@ Inspector Ext
Final
PASS PART F?qi,.j DO NOT REMOVE this inspection record from the job site.