11570 SW 69TH AVENUE 4
ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DNISION MST
24-Hour Inspection Line: 639-4175 Business Line: 633-4171
BLIP
Date Requested AM PM BLD
Location Jr ( ' " z-t--i " - Suite —_ MEC
Contact Person _ Ph _. PLM
Contrz7 otor 44 e— Tf C c. � Ph &Z Y -36,3/ SWR
BUILDING Tenant/Owner ELC -
Retaining Wall ELR
Footinge
Foundation Acc..s R &� ,c, �LL e#F S4z.{ )CC.., f_:;t. Fx C,C1C'X_ =PS
Fig Drain NO"I'7t11,lL� S f'N
p FOUND DURING RESEAR('11 'GN
Crawl Drain InSec
Slab NO INSPECTION(s) IN FILE irT _-
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation _
Drywall Nailing
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling —
Roof l�
Misc: --
Fina
PASS PART FAIL ---
PLUMBING
Post& Beam —
Under Slab _
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART_ FAIL_ _
MECHANICAL
Post R lien n --- - - ---- --
Roo�h In
r-as Line - — — --
Smoke Dampers
Final - �-
P S_-'PA-RT, FAIL
ELEC RICAL
UG/Slab
- Low Voltage -
i- Fire AIL40 -- - -- --
v
ASS PART FAIL - - --- — -
J
c� Backfill/Grading - -
Sanitary Sewer
Storm Drain [ J Reinspection fes of$ —_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( )Please call for reinspection RF ( j Unable to Inspect no access
Fire Supply Line
ADA a
Appronch/Sidewalk Date ��' �/' ' Y,� Inspector �`' -� __. Ext
Other
Final
PASS PART PAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL- PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97-0470
11
13125 SIN Hall Blvd., Tigard,OR 97222 (5Z)639.4171 DATE ISSUED: 07/17/9-
P,ARCEL: 1S136DD-01100
SITE ADDRESS. . . : 11570 SW 69TH AVE
SUBC I V I S I 01\1. . . . :WEST PORTLAND HE I GHTS Z 0 N11 NG:M U E
BLOCK. . . . . . . LOT. . . . . " . . . . . . JURISDICTION. TIG
Project Descr-iption : installataion, alteration, or re oration of services or
feeders
--------------------------------------
UNIT------ -.--TEMPI SRVC/FEEDERS---- --- ---------
1000 SF OR LESS. . . . 0 0 200 amp. . . . . . . : 0 PUMP'/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . 0 2'12).1. 400 amp. . . .— . : 0 SIGN/OUT LINE I-TG. . : 0
LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . : 0
MANE. I-AM/ 5VC/FDR. . : 0 610J .4-amps-1000 vOILS. 0 MTNOR LABEL (10) . . . : 0
SERVICE/FEEDER ---- -- ------- --BRANCH CIRCUITS----_._._.-.. -.---ADDIL INSPECTIONS---
0 *200 amp. . . . . . : I W/SERVICE OR FEEDER: 0 FIER INSIZIECTION. . . . . : 0
201 400 amp. . . . . . : 0 1 :5t W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 G00 .amp. . . . . . : 0 1::-'A ADD" L_ LARIOCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . . 0 REVIEW SECTION--------
1000+ amp,/Volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: FEES
SAM CRAIG type amount by date t-eept
11,570 SW 69TH AVE. PRMT $ G0. 00 GEO 07/ 17/97 37 -297244
TIGARD OR 972'23 5 P,CT $ 3. 00 GEe 07/17/97 97-E:1.97244
Phone #:
CnIltr-actor':
WILLAME,rTE ELECTRIC INC $ 63. 00 TOTAL
V,O BOX 230547
---- REQUIRED INSF,ECTIONS
-TIGARD OR 97281 R o 1-t g h--i n Elect' I Set-vice
Phone #: (-,24- 3631 tJndev-gv,o1.tnd Cove Elect' l Final
Reg #. . : 000750
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicab!c laws. All work will be do,�z in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. AT'04TTON: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy
of these rules or direct questions to OUNIC by calling (503)246-1987.
rpt,mittee Signature : I s s i.t e d B
INSTALLATION
The installation is being made on property I ov)n which is not intended for,
sale, lease, or rent.
OWNER' S r:)I GNATURE: DATE:
INSTALLATION ONLY-----__--__---_.________
OF SUP,P. ELECIN: DATE
LICENSE NO: Y9910
4,.++++++++++-+++•+++++++++++;-+++++++++++++++++++++++++++++++++++++++++++-F+++++•++++
1 16 2a"1 k4 00 F1 IN i"SpRipkieft aw-0494d 6-Im "0006 kolosilq@%is "my
1 4 t-4 -v-I..,.-#--V444-+444--++-t- F-J-t+A-+++4+44-+++-+-++4++44++-f-+-F4--t -f4-4-+4-1-4+-+4......4-+4+1-4+++44 1
CITY OF TIGARD Electrical Permit Application Plan Check q
1315 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Date to P.E _
Phone (503)639-4171, x304 Date to DST
Inspection (503) 639-4175 Print Or Tyne Permit a�LC°��-C
Fax (503)684-7297 Incomplete or illegible will not be accepted Called
1. Job Address: { 4. Complete Fee Schedule Belo,►:
Name of Development �. Number of Inspections per permit allow3d -
Name(or name of business) <,a.,. 1f n < <t Service included: Items Cost Sum
Address_ l/5 C) c,J L• 4a. Residential.par unit
1000 sq.ft.or less $110.00 4
City/State/Zip, I c t'1 rt tj d,1 Z Z 3 Each additional 500 sq.It.or
f portion thereof $25.00 _ 1
Commercial ❑ Residentiai ❑ Limited Energy $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00
(Attach copy ut all current licenses) t 4b.Services or Feeders
EI2CtrIC81 Contractor t- /!a,., ,N♦ C/+c Tn c ��� Installation,alteration,or relocation ^ r
Address Pa F4 e t Z 36 �' 7- 200 amps or less ! $60.00 _1c.SL__ 2
201 amps to 400 gimps $80.00 2
ciry_�r State l).ti Zip 9 i'7i{ f _ 401 amps to 600 amps $120.00 _ 2
Phone Nd. (ot ki 3(.'; i 6n1 amps to 1000 amps $180.00 2
Job No. 9-9 ? `'1 Over 1000 amps or volts $340.00 _ 2
Elec.Cont. Licr-. No. 3,1- 7 V 3 C Exp.Date o /y 7 neconnec•t only $50.00
OR State CCB Reg. No. ? I Exp.Date_ 4c.Temporary Services or Feeders
COT Business Tax or Metro No. ,5'y 4 Exp.Dat� Installation,alteration,or relocation
41 200 amps or less $50.00 2
i l/ 201 amps to 400 amps $75.00 -_� 2
Signature of Supr. Elec'n ��� �` 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License No. 7 - r EYp.Date_ 14 see"b"above.
Phone No. b 74 - 3a '3 t
-- - 4d.Branch Circuits
N(-i,alteration or extension per panel
2b. For owner installations: a)The foe for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00
h)The fee for branch circuits
City_ State, Zip _.. without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00
The installation is being made on property I own which is not Each addilional branch circuit $5.00 2
intended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not ncluded)
Owner's Signature _ Each pump or irrigation circle $40.00
Each sign or outline lighting $40.00
3, Plan Review section if required):* Signal circult(s)or a limi:3d energy
panel,alteration or extension $40.00 2
_
Please check appropriate Item and enter fee in section 5B. Minor Labels(10) $100.00
4 or more residential units in one structure 41'.Each additional Inspection over
CX
CX Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00
Classified area or structure containing special t :cupancy Per how _ $55.00
as described In N.E.C.Chapter 5 In Plant $55.00
"Submit 2 sets of pians with application where any of the above apply. Jam. Fees:
Not required for temporary construction services. 5a.Enter total of above Was q• ---
5%Surcharge(.05 X total fees) $ '
11' ( NOTICE Subtotal $
-� Sb.Enter 25% of line Be for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It regulre (Sec.3) $ -
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account M
TIME AFTER WORK IS COMMENCED. $ G
Total balance Due
I MSTSIRC86 APr nev age
z,.
RECEIVED
JUL 17 1997
COMMUNITY DEVELOPMEN,