12190 SW 69TH AVENUE J
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Huui Inspection Line: 639-4175 Busin�!s3 Line: 639-4171 -
BUP _
Date Requested_ 0 I AM PM _ BLD
Location /'? G(f-�' /"�� i — Suite MEC
Contact Person ��-��.f!U� C �`ldh(( (h) l$h Lv 3 `I`�,J 7 PLM
Contractor Ph _ SNIR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: �^ 1
Foundation I PS
Ftg Drain
Crawl DrainInspection Note,: SGN _
Slab -- - - — SIT
Post&Beam -A
Ext Sheath/Shear
Int Sheath/Shear �—
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -_
Roof
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final - - —
PASS PART FAIL _
MECHANICAL
Post&Beam - —
Rough In
Gas Line - - -
Smoke Dampers
Final - - -
PASS PART FAIL
ELECTRICAL
Servic --
UG/Slab _
Low Vcltage — --
�- Fire Alai m
Final - - -
PASS PART i All_ --.
Backfill/Grading ---
Sanitary Sewer
S!orm Drain [ ]Reinspection fee of$ required uefure next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin i
ll f
Please call rens prtinn RF
Fire Supply Line [ ] p _ [ ]Unable to Inspect-no access
ADA / 7
Approach/Sidewalk. /
Date
Usher ae `�--� Inspector Ext
Final
PASS PART FAIL DO ►:OT RIEMOVE this inspection record from the job site.
CELECTRICAL PERMIT
CITY O F TIGARD G A R D
PERMIT#: ELC1999-00723
DEVELOPMENT SERVICES GATE ISSUED: 12/03/1999
u 13125 SVV Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S101AA-02300
SITE ADDRESS: 12190 SW 69TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT : 019 JURISDICTION: TIG
Proiect Descriotion: Re-conn;ct only
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: I
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 600 amp: SIGNAL/PANEL:
MANF HM/SVC! FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNC`i CIRC: IN PLANT:
601 - 1000 amp: _ _ _ PLAN REVIEW SECTION
1000+ amp/volt: �T >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only. 1 SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JONES, CECIL E DONNA RAE FRAHLER ELECTRIC CO
12190 SW 69TH 1E 11860 SW GREENBURG RD
TIGARD, OR 97,_3 TIGARD, OR 97223
Phone: Phone: 639-4627
Reg #: LIC 00037410
SUP 1816S
ELE 34-1'
FEES Required Inspections
Type By Date Amount Receipt Elect" Service
PRMT BON 12/03/199E $53.50 99-320162 Elect'I Final
5PCT BON 12/0?!l99E $4.28 99-320162
Total $57.78 0 I \ G I NA,
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not startea w,t',,in 160 days of issuance,ur 11 .-.,irk is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted ,)y the 0(ennn Utility Notification Center. Those
rule;are set forth in OAR 952-001-0010 through OAR 952-001.0080. Y-i may obtain copies of these rules ordirect questions to OUNC at(503)
246.1987
PERMITTEE'S SIGNATURE I \ i ` ��.� ��t�[\�;t ISSUED BY:f
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
c
LL OWNER'S SIGNATURE: __ __ ____._ DATE:
_J
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: i i '
._.__�-__^__�__ DATE:----
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OaF TIGARD Electrical Permit Application Plan Check,
13 25 SW HALL BLVD. Recd By n�
Date Recd J7_-71 �]
TIGARD OR 97223 Date to P E.
Phone(503)635-4171, x304 Date to DST
Inspection (503) 639-4175 Print of Type Perini t#
Fax (503) 598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ 69th STREET IMPROVEMENTS Number of Inspections per permit allowed
Name(or name of business)^ C. JONES Servi,;e included: Items Cost Sum
Address_ 12190 SW 69th _ 4a. Residential-per unit
City/State/Zip TIGARD, OR 97224 _ 1000 sq ft.or less _ $ 117.75 4
Each additional 500 sq.It,or
portion thereof $ 26.25 _ 1
Commercial ❑ Residential ® Limited Energy $ 60.00
Each Manurd Home or Modular
2a. Contractor installation {,)nly: Dwelling Service or Feeder $ 72.75 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 FA LER ELLt rk1C C0111PIM 200 amps or less $ 6425 2
Address 11860 SW GREENBURG ROAD 201 amps to 400 amps $ 65.50 2
Cit TIGARD tate OR Zi 97223 401 amps to 600 amps $ 128.50 2
City p 601 amps to 1000 amps $ 192.50 2
Phone No. (503) 639-4627 Over 1000 amps or vett$ $ 363.75 i 2
,lob No. 59679 Reconnect only -- $ 53.50 -T5 5U_ 2
Elec. Cont. Lice. No 34-13C Exp Date 10/01/00 4c.Temporary Services or Feeders
OR State CCB Reg. No. 37410 Exp.Date 07102101 Installation,alteration,or relocation
COT Business Tax or Metro W. 1987 E---xp.Date 12 01 00 200 amps or less $ 53.50 2
2.01 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n l/ _ 401 amps to 600 amps $ 107.00 _ ._
Over 600 amps to 1000 volts,
see"b"above.
License No. 18165 ,Exp.Date 10/01/01 4d.Branch Circuits
Phone N0. New,alteration or extension per panel
M The fee for branch circuits
2b. For owner installations: with purchase of service or
I feeder fee.
Print Owner's NameEach branch circuit $ 5.35 2
Address b)The fee for branch circuits
- without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 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 _
Fach sign or outline lighting $ 42.75
Owner's Signature- -_ _ _ - - Signal circuit(s)or a mited energy
If required):* panel, els(flan or extension $ 60.00
3. Plan Review section
Minor Labels(10) $ 107.00
Please check appropriate item and enter fee in section 58. 4f.Each additional Inspection over
cam`, 4 or more residential units in one structure the allowable In any of the above
r Service and feeder 225 amps or more Per inspection $ 50.00
LA
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
-Classified area or structure containing specie!occupancy as
J described in N.c.C.Chapter 5 5. Fees:
., 5a.Entet total of above fees s 53.50
* Submit 2 sets of plans with application where any of the above apply. Surcharge(I#x total fees) $
4_28
Not required for temporary construction services. Subtotal $
5b.Enter 25%of line as for
NOTICE Plan Review If required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS FIT rust Account#
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $
i dslsAl,rm-000 tric doc