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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: /�r � A.M. ` P.M. MST:
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Location:^�� 0 SO— BUY:
Tenant: 4)ao Suite: Bldg: MEC:
Con'ractor:_ �. p _ P!ione: S5(- r'�l
_ 3 S PLM:
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Owner. C/// Phone: _ ELC:
ELR: r
_ STI': _
BUILDING BLDG(coni) PLUMBING MECHANICAL LECTRiCAL SITE
Site Post/Beam Post/Bcam Post/Beam Cover crv.ce Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top(hal (las Line Rough-In 1JG Sprinkler
Foumletion Insulation Scwe.r Ilood/Duct Recomiect Vault
lismt Damp Drywall S!onn Fumme 'Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spkh/Alm Crawl/Found Ih I feat Pw.ap I _
Approved _._ Approved Approved Approved-' �� Approved
Appr/Sdwl�c Not Approved Not Approved Not Approved roved Not Approved
FINAL FINAL FINAL AL FINAL
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O Call for reinspection ` 0 Rejnspection ree or required before next inspection D Unable to in t
Inspector: / / Mte:— 7- Page of
CITY OF TELECTRICAL PERMIT
DEVELOPMENT SERVII"ES PERMIT #: ELC97-0631
13125 SW Hall Blvd., Tigard,OR 97223 j303)639-4171 DATE ISSUED: o'3/25/97
PARCEL: 1S136CA-03700
SITE ADDRESS. . . : 1126O SW 79TH AVE
SUBDIVISION. . . . :FRIENDLY ACRES ZONING: R-4. 5
BLOCK,. . . . . . . . LOT. . . . . . . . . . . . . :O11 ,JURISDICTION: TIG
Project De seri ptiori : Install a 200 AMP service/feeder and two (2) additional
branch circuits to and existing single family dwelling.
---------------------------------------------------------------
----RESIDENTIAL UNIT-- ---TEMP SRVC/F=EEDERS---•- ------MISCELLrrNEOUS---•----
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L. 5O0SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITF_D ENERGY. . . . . : 0 401 - 6O0 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : D
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SERVICE/FEEDER---- ----8 RANCH CIRCUITS------ ----ADD' L INSPECTIONS---
0
NSPECTIONS----
0 - 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 2 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/0 SRVC OR FDR. : 0 PER HOUK. . . . . . . . . . . : 0
401 -- 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ------------------PLAN REVIEW SECTION----------------
1000+ amp/volt. . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 6O0 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ----------------------------------------------------- FEES -----------------
MARC:Y CRAUGHAN type amount by date recpt
11260 SW 79TH AVE PRMT $ 70. 00 GEO O9/25/97 97-299540
TIGARD OR 97223 SPCT $ 3. 50 GED 09/25/97 97-299540
Phone #: 624-9387
Co n t r act o,•: ----------•--------•-------- ---- -----------------------------------
JPC ELECTRICAL SERVICES INC f 73. 50 TOTAL
4120 SE INTERNATIONAL WY
STE A-107 ------- REQUIRED INSPECTIONS -----
MILWAUKIE OR 97222 Rough-in Elect' 1 Service
Phone #: 654- 325 Underground Cove Elect' 1 Final
Reg #. ,, : 093774
This permit is issued subject to the regula+;ons contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. A1l work will be done in accordance voith 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. ATTENT!ON: Oregon law requires you to follow the rules adopted by
the Oregon IJtility Notification Center. Those rules are set 'orth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy
of these rules or direct questions to OLK by calling 15e3) -1987. �� /�
i
Permittee Signature : Issued By - _
------------------------------OWNER INSTALLATION ONLY-------------------------•--------
The installation is being made on property I own which is not intended for
sale, lease, or rent.
DWNr:.R' S S T l?NATURE: DATE:
J
-_. ---- ----- -- ------- ---CONTRACTOR INSTALLATION ONLY----------------------------
SIGNATURE UI- SLIPR. ELEC' N: �'J ' DATE: 9 .S
LiCPN5E NO:
++++++++++++.++++++++++++++++i+++++++++ ' ++++++++++++++++++++++++++++++++++++++++
— i 15 hW A:Q p_ m_ fnr an ingpprt inn n
+.+.++++++++++++ L+++++•f++++++++++i +++++++++++++++++++++++++++4-+++++++++++++++++ti
CITY OF TIGARD Electrical Permit Application plan Check u _
13125 SW HALL BLVD. Reo'd By_
cd
TIGARD OR 97223 Date ReDate to c'd
Phone(503)539-4171, x304
Print or Type Dale to DST o y
Inspection (503) 639-4175 Permit u
Fax (503) 684-7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 4, Number of Inspections per permit allowerr
Name(or nameof
�business)�� L ti) Service included: Items Cost Sum
Address dotyJy `W 1-1 `1 V C 4a. Residential•per unit
'''��n �/ �1 � 1000 sq.f1.or less $11000 4
City/State/Zip TTt PQv-CI L/�� C� ��` Each additional 500 sq.ft.or
Commercial ❑ Residential ® portion thereof $25.00 1
Limited Energy _, $25.00 _
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00 _ 2
(Attach copy of all current licenses)• 4b.Services or Feeders
Electrical Contractor ., pG E 1 C Ltf I LCA1-:Se1- I Qs Z tic Installation,alteration,or relocation
Address q1.20 q/ 200 amps or lest ! $60.00 2
201 amps to 400 amps __ $80.00 2
City Or Zip Ck% 401 amps to 600 amps $120.00 _ 2
Phone Is - `3'j�5 601 amps to 1000 amps $180.00 _ .
Job No. M-;l-7 Over 1000 amps or volts $340.00 2
Elec.Cont Lice. No. _3��Exp.Date_,i) Reconnect only $50.00 2
OR State CCB Reg. No. )9 7 7 YExp.Date 4c,Temporary Services or Feeders
COT Business Tax or Metro No.
�Exp.Dat / installation,alteration,or relocation
200 amps or less $5C.00 2
Signature of Su r. Elec'n v 201 amps to 400 amps $15.00 2
g Supr. amps to 600 amps $100.00 2
over 600 amps to 1000 volts,
License No.�� Exp.Date IC)- " r/8 see"b"above.
Phone No.
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Namefeeder fee.
Address _ Each branch circuli $5.00 __ 2
CI State Zi b)The tee for branch circuits
city P - without purchase of
Phone No. service or feeder lee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch clrcu* $5.00 2
intended for sale,lease or rent. 4e.Miscellaneov-
(Service or feeder not Included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) Signal circult(s)or a limited energy
panel,alteration or extension $40.00 - 2
Please check appropriate Item and enter fee in section 513. Minor Labels(10) $10).00
4 or more residential units in one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
~, System over 600 volts nominal Per inspection T $35.00
Classified area or structure containing special occupancy per hour $55.00
as descrlbed In N.E.C.Chapter 5 In Plant $55.00
"Submit 2 sets of plans with applicntlon where any of the above apply. 5. Fees:
`J Not required for temporary construction services. So.Enter total of above fees $
5%Surcharge(.05 X total fees) $ 3
NOTICE Subtotal $
5b.Enter 25%of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if r2guired(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 El Trust Account u
73e o
TIME AFTER WORK IS COMMENCED.
Total balance Due
$
I Q)%T91ELC99 11PPh Rev 9199
INSPECTION NOTICE
e tp of Tigard Building Department
13125 SW gall Blvd. Tigard, Oregon 97223
Inspection Line (Rer-O-Phone): 1-39-4175 Business Phone: 639-4171
I nsp-ciion s i`
Footing MY;. Undst:lab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL
?oat/Beam struct San. Sewer Framing -Bldg.
Pod,-/Beam rsech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lineej Gyp. Bd. -Meeh.
Date Requested: A" / - I _ imes AM PM
Address: (Q /T_ 7 (//�" /
Permit s ' U
Builders (7 )
n THE FOLLOWIN4: CORRECTIONS ARE REQUIRED:
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Inspectors
APPUMD DISAPPROVED — APPROVED SUBJECT TO AWNR
_`Call For Rainsp.
INSPECTION NOTICE
City of Tigard Building Departsr_nt
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection tine (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _
Footing Plbg. Underalab Much. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lina FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -h/Ch.
Date Requested:_ Times AH�.
Address: O 1 Permit
Builders
THE FOLLOWING CORRECTIONS ARE UI}tEUs
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Inspector Dates
APPAOVtD bISAPPROVED APPROVED SusiscT TO ADM
Call For Reinap. '
CITY C►1` T I'GARL, RC:C E I P T O . PF;Y*,ME--NT' REC'E•:.I FST NO, 264
CHIA.,I-( AMOUNT i26. 85
NAML7 a SPECIALTY NEAT I NG CASH AMOUNT x 0. 00
A1)i1RL'.S x E`ABRICAT IUiJ, ING. PAYMENT VA'TF a IP/27/91
15ES SW 'I TGARE.) g7411 FT SUBDIVISION
TI(i(4RT), 04E GON c)7F2•._.
1URPOSE: OF P,OYME;NT 014OUNT VIA I D PURPOSE OF PAYMENT AM;"►UNT PPI D
P5. 00 ST. BUILD PK R 25
TOTAL AMOUNT 1-'I110 i:`15
MECHAN I CAL
4
C'TYOF TIGAWD PERM IT: IYIEC910311-3
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cn E R 1Y1 I
COMMUNITY DEVELOPMENT DEPARTMENT RD)
13126SWHWIBlvd. P.O.Box 23397,TOW,Oregon 972M(603)8304175 DATE ISSUED: 12/27/91
SITE ADDRESS. . . : 11260 SW t'9TH AV PARCEL: IS136CA-03700
SUBDIVISION. . . . : FRIENDLY ACRES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . : 11
------------------------------
CLASS OF WORK. . :ADD FLOOR FURN. . . . EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRE'. . : R3 VENTS WIC) APPL: VENT SYSTEMS:
sTo <I ES. . . . . . . . : BOTLERG/COMPRESSORS HOODS. . . . . . . :
FUEL V.1-3 HP. DOMES. INCIN:
3—15 COMML. INCIN:
MAX 1NPU1 BTU 15-30 HP. REPAIR UNITS:
0-50 HP.
F1 RE DAMPEPS?. . : 3j WOODSTOVES.
GAS PRESSURE. . . : 50+ HP. CLO DRYERS. . -
NO. OF AIR HANDLING U1\11 1 OTHER UNITE .
FURN ( 100K BTU. 1 (= 10000 cfm: GAS ouTLETS. : 1
FURN > =100K DTU.- > 10000 cfm :
Remar-ks : installinq 1—air conditioner-
Owner- : FEES
MARK si-OLABER type amount by date reept
11260 S. W. 7'3TH P )ENUE P R M I- $ 25. 00 PLL 12/24/91 *22
;PCT $ 1. 25 PILL 12/24/91 22
1* IGARD OR 97221-
Phone #:
Contr-autor-: -------------------------------
SPECIOLTY HEAT ING/FABRI CAT IOr'
9448 GW TIGARD ST
TIGARD OR 97223 --------------
Phone #: 620-5643 $ 26. 25 1'01 AL
Req 66578
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the F . nal Inspection
Tigard Municipal Code, State of Ore. Soecialty Codes and 211 other
applicable laws. All work will be done in accordance with
approved pans, This permit will expire if work is not carted
within 180 days of issuance, or if work is sue ended for more
than 160 days.
tA
Permittee Sign-
at Ll ata
C811 In,, inspection 639-4115