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P.M. MST: _ Location: �7(p�a L V �j t BLIP: _ Tenant: (.. � - �' Suite: Bldg: NEC: _ Contrac Phone: PLM: Owner: _--Phone: ELC: ELR: _ facO✓� _ SIT: _ BUILDING BLDG(con'o ^ PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Post/Bum Cover/Service Sewer/Stone Footing Roof tiidFI/Slab Rough-In Ceiling Water Line S'.ab Framing Top Out Gas Line Rough In/�� UG Sprinkler dlD Foundation Insulation Sewer Iloouct Reconnect Vault Bsmt Damp Drywall Storm Furnace 'Temp Service ' MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I leat Pump Low Volt Approved Approved Approved Approved – Appr/Sdwlk Not Approved Not Approved Not Approved No1�,,roved Not Approved FINAL FINAL FINAL TFINAL j FINAL _ i.✓a/.Gly�_�.✓ s�� . �aL�L�-��_ l— F— C t�J 0 Call ror rcinsl>eV.Pn i O Reins tion fee of S __required before next in.Vection C7 I friable to inspect Inspector—-- �-- Date_ l'aRe of — CITY O F TI GAR D ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC98-0278 13125 SW Hall Blvd., Tigard,OR 91223 (503)639-4171 DATE ISSUED: 05/27/98 PARCEL: 1S126C0­01107 SITE ADDRESS. . ,, :09675 SW WASHINGTON SDUARE RD SUBDIVISION. . . . : ZONING:C—G BLOCK,. . . . . . LOT. . . . . . . . . . . .. . . JURISDICTION: TIG Project Description: add outline lighting _._.._RESIDENTIAL UNIT----- ----TEMP SRVC/FEEDERS ---- ---- ---MISCELLANEOUS—_--_.._- 1000 SF OR LESS. . . . : 0 0 — 2,00 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 500SF. . . - 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : I LIMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. ! 0 MINOR LABEL ( 10) . . . : 0 - ---SERVICE/FEEDER---- ----BRONCH CIRCUITS---— ---ADD' L. INSPECTIONG—­ 0 — 200 amp. . . . . . : 0 41 'SERVICE OR FEEDEP: 0 PER INSPECTION. . . . . : 0 201 — 400 amp. . . . . . : 0 1. W/O SRVOR FD.R. : 0 PER HOUR. . . . . . . . . . . : 0 401 — 600 amp. . . . . . : 0 EA t!')DIL BRNCH CIRC- 0 IN PLANT. . . . . . . . . . . : 0 601 — 1000 amp. . . . . : 0 ------------•--------FLAN REVIEW SECTION---------------- 1000+ amp/volt. . . . . 2 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: FEES ---------------- JUST SPORTS type amok-Int by date recpt 9675 WHSHINGTON SQUARE PRMT $ 40. 00 DST 05/27/98 98-306045 TIGARD OR 97223 5PCT $ 2. 00 GEO 05/27/98 98-306045 Phone #: Contractor: ----------------------------- MULTI—LIGHT SIGN CO. $ 42. 06A TOTAL 3255 NE BROADWAY REQUIRED INSPECTIONS J-DORTLAND OR 97213 Elect ' l Set-vice Phone #: 2'81-13083 Elec,-.11 Final. Reg #. . : 001641 This permit is issued subject to the requlations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will he done in accordance with approv?d plans. This permit kill expire if work is not started within 180 days of issuance, or if work is suspended for more than 190 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952-001-0010 through OAR 952-%1-1987 nu may obtain a copy of these rules or direct questions to OX by calling (503)24 .98 7) lulermitteE- Signatt-tre- d 8y : ---------------------------OWNER INSTALLATION ONLY-------_______--_--._------_--_ J The NLY------------------------------- The installation is being made on or-operty I own which is not intended for sale, lease, or, rent. F)WNER' S SIGNATURE.- DATE.- --------------------------fONTRnCTOR INSTALLATION ONLY--------- w SIGNATURE NLY--------SIGNATURE OF c5UPR. ELECIN: DATE: 12dr, LICENSE NOI >� +++++++++4_++++•M++++++++- .+++++++++++++++++++++++++++++-4-++++++++++.++++++++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next bLisiness day ............................................................................... dn*iDF TIGARD Electrical Permit Application Plan Check#_ 0125 SW HALL BLVD. Recd By_ Date Recd TIGARD OR 97223 _ Date to P.E. Phone (503) 639-4171, x304 Date to DST Print or Type c Inspection (503) 639-4175 Permit Fax (503) 684-7297 Incomplete or illegible will not be accepted Called_ 1. Job Address: 4. Complete Fee Schedule Below. Name of Development_W p�n�4, _o G.l Ar. �_ Number of Inspections per permit allowed ` Name(orname of business) $ �f ARTS Service included: Items Cost Sum Address %g 15- (.i "__f�, 4a. Residential-per unit 1000 sq.ft.or less $110-00 4 City/State/Zip _. Each additional 500 sq.If.or Commercial Residential portion thereof $25.00 1 Limited Energy $25.00 _ Each Manut'd Home ur Modular _- ;_ 2a. Contractor installation only: Dwelling Service or Feeder $68 00 (Attach copy of all current tic ngas) ` 4b.Services or Feeders Electrical Contra0oryy_\LLInstallation,alteration,or relocation -; 200 amps or less $60.00 2 Ad e 201 amps to 400 amps $80.00 2 Ciry Stat riv7 ' Zip q92-12 401 amps to 600 amps $120.00 _. 2 Phone No. 601 arnp!!:c.000 amps $180.00 2 Job N0. Over 1000 amps of volts $.340.00 2 Elec. Cont. Lice. No. ti ds L_ .Exp.Date bU Reconnect only $50.00 2 OR State CCB Reg. [,�KIcY) _Exp.Date g�y 4c.Temporary Services or Feeders COT Business Tax or Metro No._ Exp.Date� Installation,alteration,or relocation' - ��_� 200 amps or lase $50.00 7 201 amps to 4amps $75.00 2 Signature of Supr. Elec'n -- 401 amps to 600 amps $100.00 _ 2 Over 600 amps to 1000 volts, License No. 'a43 Sl \11p.Date. 110 see"b"above. Phone No.�g_I_�7c�1r 4d.Branch Circuits Now,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase or service or Print Owner's Name feeder tee. Address_ v Each branch circuit $5.00 Cit State Zip_-- b)The fee for branch circuits City- - without purchase of Phone No. _ a*I vice or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 intended for sale,lease or rent. 4e.Miscelleneous (Service or feeder not Included) Owner's Signature Each pump or!rrigation circle $40.00 -r r�s�- 2 Each sign or outline lighting $40.00 +_. 2 3. Plan Review section (if required):* Signal circuit(s)or a limited energy $40.CJ -_! panel,alteration or extension 2 Minor Labels(10) $100.00 _ Please check appropriate item and en'.3r fee in Section 51B. 4 or more residential units in one struch.re 4f.Each additional Inspection over `Y Service and feeder 225 amps or more tt•.e allowable In any or the above V) System over 000 volts nominal Per Inspection Classified area or stucture containing special occupancy Per hour $55.00 ►- as depcdbed in N.E.C.Chapter 5 In Plant $55.00 J X Submit 2 sets of plains with appllcati-,r where any of'he above apply. S. Fees: 0 Not required for temporary construction services. 5a.Enter total of above fees $ ���!� - W 5%Surcharge(.05 X total fees) $ --- -� NOTICE Subtotal $ --- - 5b.Enter 25%of line Fa for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Dian Review If reQuiryd(Sec.3) $ --NOT COMMENCED WITHIN 180 r)AYS,CR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A FERIOD OF 180 DAYS AT ANY t� TIME AFTER WORK IS COMMENCED. Trust Account F Total balance nue I�osMErrc96 Apr, nm ass