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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach, Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out InsulationElec
Post/Beam Struet. Mech. Rough-in Gyp. Bd. -Bldg.
0-an. Sewer Gas Line Appr/Sdwlk Reins.
Other: - —--
Data: q / •A`M. P.M. �c Ent
Address: —f-L-L-� w
f. _`SGS.
Tenant:_�' i'. ' Ste: MST: _
BUP:
Own: �J .� (r 9 q '_��� MEC:
PLM:
ELC: D
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector:��`t -�— --Date-
_APPROVED __DISAPPROVED/CALL FOR REINSP. 0
CITY OF TIGARDELECTRICAL PERMIT
_
PERMIT #: ELC,96—0 .85
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/07/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171
PARCEL: I S 126OC-01 10 7
31TE ADDRESS. . . 19467 SW WASHINGTON SQUARE RD
SUBDIVISION. . . . : ZONI NG:C--G
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
P'r^o.ject Description : Installing two br-anch circ)-lits.
---RESIDENTIAL UNIT----- ---'TEMP SRVC/FEEI)ERS--.-- ------MISCELLANEOUS--.-._---
1000 SF OR LESS. . . . : 0 0 — i2'00 .,mp. . . . . . . : 0 PUMP'/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 — 400 amp. . . . . . . : 1. SIGN/OUT LANE LTG. . : 2
LIMITED ENERGY. . . . . 0 401 -- 600 amp. . . . . . . : 0 SIGNAL/PC',NEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps--1 '00 volts. : 0 MINOR LABEL ( 10) . . . : 0
--. .....BRANCH I RCU I TS----__ —•----ADD' L INSPECTIONS --
0 2
NSP'ECTIONS _.._--
c 0 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . : 0
201. 400 amp. . . . . . : 0 I st W/(1 SRVC OR FDR. : 0 PIER HOUR. . . . . . . . . . . 0
401 — 600 amp. . . . . . : Vi EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
C O1 - 1.017.10 amp. . . . . : 0 --.---.-.__._ ._...________FLAN REVIEW SECT
1000+ amp/volt. . . . . : 0 ) =4 RES UNIT'S. . . . . . . . : > 600 VOLT' NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = _25 AMPS. . : CiLA SS AREA/SPEC OCC. :
Owner: -_._._____._____._.__.____._________.______._._.__._.____.___._.__._-- FEE=S
STARBIJ]KI S COFFEE type amoi_rnt by date recpt
9467 SW WASHINGTON SQUARE RD PRMT $ 80. 00 CJS 05/07/96 96-279078
`PICT $ 4. 00 CJS 05/07/96 96 -2-179078
T I GARD OR 972123
Phone #:
Cont Tact or a
VANC:OUVER SIGN COMPANY, 1NG: E 84. 00 TOTAL
6615 SW HWY 99
_._._.._...__._. REOUIRED INSPECTIONS
VANCOUVER WA 98665 EWlect' 1 Service
Phcne #: 360-693-4773 Elect' l Final
Reg #. . : 06 39 51.
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signatmt-e
applicable laws. All work will be nine 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. Iss�1ed By
INSTALLATION
the installation is being made on property I own which is not intended for-
sale, lease. or, r,vnt.
OWNER' S SIGNATURE: DATE:
__.--_CONTRACTOR INSTALLATION
SIGNATURE OF 5Uf'R. ELEC' N: _Q _,• 1;,- , _____.__ ___ _� �_ DATE: 5-7- 96
LICENSE 1\10:
Call for inspection -- 639•-4175
c•
Commfanity Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # rj6,76
Date ISSUed 5 �-
Phone (503) 639-4171
CITY ®F TIGARD FAX (503) 684-7297
TDD No (503) 684-2772
Inspection (503) 639-4175
1. Job Address: \i\.r clS�%,0 �oc\ St,t-,r{ 4. Complete Fee Schedule Below:
Name of De '�
Development �� 0.cv\ SIL Number of Inspections per permit allowed
(�
Address � t" S ,1JService included Items Cost(ea) Sum
City/State/Zip_-� (' G r _ 4a. Residential -per unit
� 1000 sq. fl. or less $11000
Name (or name I bt-siness)SA 01,r�CEach additional 500 sq ft or
portion(hereof $7500
Commercial Residential l_J Limited Energy _ $2500 1
Each Manufd Home or Modular
Dwelling Service or Feeder $6900 2
2a. Contractor installation only:
/�� C ( /� 4b. Services or Feeders
Electrical Contractor G�� Ov\ Jt� 6\`V Installation,alteration,or relocation $6000
_ V _ 200 amps or less 7
Address 1 '1 201 amps to 400 amps __ $8000
_ 2
\V1 401 amps to 600 amps $12000 2
CO t�ci� CS" S to mac, . Zip 1 _ -- $18000 2
601 amps to 1000 amps _
Phone No. 0 1 LA1_3— Over 1000 amps or volts $34000 2
,Job NO Reconnect only
$5000 2
Contractor's license NO. c L—S _�... 4c. Temporary Services or Feeders
Contractor's Board Reg. S Installation,alteration,or relocation
Signature of Supr. Elec'n4No._ _ 200 amps or less _ z
201 :rips to 400 amps $50.00 2
License No. Ll•�aT�L Ph9ne4 Q• _ 401 amps to 600 amps $75 0n - 2
�3 Over 600 amps to 1000 volts $10000
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name_ _ New,alteration or extension per pane
Address a)The fee for branch circuits with
purchase or service or feeder too.
City _-- __-- State,--- Zip— _ - _ Each branch circuit $500
Phone NO. b)The fee for bunch circuits without
The installation is being made on property I own which is purchase of service or reader lee.
First branch circuit $35 00
not intended for sale, lease or rent. Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump orIrrigationig circle $40.00
Erich sign or outllll
ine lighting < $4000 ;��,)
Signal clrcult(s)or a limited enerry
Please check appropriate item and enter fee in section 58. panel,alteration or extension $40.00
4 or more residential units in one structure Minor Labels(10) $10000 —
0- Service and feeder 225 amps or more
__ 4t. Each additional inspection over
System Over 600 volts nominal
Classified area or structure containing special occupancy the allowable in any of the above
` ) as described in N EC. Chapter 5 Per ho r,coon $ 00
55
ger hour $55.00 _
in Plant $55.00
~ Submit 2 sets of plans with application where any of the above
J apply. Not required for temporary construction services. 5. Fees:
5a. Enrer Ictal of above fees $ S') Oy
NOTICE 5%Surcharge (.05 X total fees! $ 4. 0
w
Subtotal $ C,4 O fJ
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec 3)
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR $
Subtotal $ zcz U
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
�-�
COMMENCED �m ome�n�.= ❑ Trust Account #
inn I
Balance Due $ u J
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