11100 SW 82ND AVENUE ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
• Inspection Line (Rec-O-Phone): 639-417«5 Business Phone: 639-4171
Inspection:
Footing �jsusp- Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
` Post/Beam Struct. Plbg. Top Out El-ac. Rough-in FINAL:
Post/Beare Mech. San. Sewer Gastine -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall ! Gyp. Bd. D 0 ct.
Date Requested. / ( -] TimAM PM
Address:_ ✓�`��-
Builder: 7 g Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspe tor: _ Daterf ;
PPROVED —DISAPPROVED —APPROVED SUBJECT TO ABOVE
_Cali For Reinsp.
•� WASHINGTON COUNTY
i0 - ELECTRICAL PERMIT
Department of Land Use & TransF:,rlation
Electrical Inspection Section
155 North First Avenue, 4350-12 APPLICATION
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
Permit
0 __VM1141
Number (-(. `�5_Uf� Date" lete all 4. Complete Fee Schedule below
1. Location of Installation _ Number of Inspections per pr.mit allowed
Address : A Service included: Items Cost(ea.) Sum
Building A. Residentt::!-per unit
City I�/��,1.� Suite No.
1000 sq.tt,or less $110.00 4
Tenant Name Each additional 500 sq,ft
of commercial) or portion thereof $25.00
I 1 )' Limited Energy $25.00 1
Map No.�.�1-' �Tax Lott-P 0 Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
Thomas ;�1ap Book: Page: ____ Section:
Directions_ _______ _. B. Services or Feeders
Installation,alterations or relocation
Comrnercial 200 amps or less $60.00 - 2
Residential❑ 201 amps to 400 amps $80.00
401 amps.o 600 amps $120.00 2
tae Contractor installatt n onl : 601 amps to 1000 amps $180.00 - 2
Q Y Over 1000 amps or volts $340.00 - 2
Electrical Contractor j' �-� • /'1-P. -)r., -i y-e Reconnect only $50.00 2
Address Ac,I ' lA I t -c b ,.
City at _ State-LiL,. ZIP, 7 C. Temporary Services or Feeders
Date_ .ZJ-`t Job Number Installation,alteration or relocation
Property Owner I t 'Li f, 1^ •" 200 amps or less $50.00 2
Contractor's license No. -,--3K-1- C_ 201 amps to 400 amps $75.00 2
Contractor's Board Reg. No. ,[ l 7. 1 G 401 amps to 600 amps _., $100.00 2
Over 600 amps to 1000 volts see W above
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Signature of Supr. Eiec'n,: , ' . -��,.. D. Branch Circuits
License No. Phone No. ' "
Now,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder lee.
Each branch circuit $5.00 2
b) The fee for branch circuits without
Print Owner's Name one o, purchase of service or feeder lee. z`
Adi3ress --- First branch circuit __ $35.00 2
Each add'nl branch circuit $5.00 _ 2
State _71-p -� E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle $40.00 2
The installarion is being made on property 1 own Each sign or outline lighting $40.00 _ 2
which is not intended for sale, lease or rent, signal circulus)or a limited
energy panel,alteration
Owner's Signature ,__ or extension $40.00 2
F. Each additional in5.pection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection $35.00
Per hour $55.00
_ Please check appropriate Rem and enter fee in sec•.ron 5B. In Plant $55.00 _
C.
_4 or nu,te resist ntial units in one structure 5. Fees
___Servir�e and feeder, 800 amps or more
_System ever 600 volts nominal A. Enter total of above fees $
Clas;sified Area or structure containing special 5% Surcharge (.05 X total fees) $ i
occupancy as described in N.E.C. Chapter 5 Subtotal $ _..
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ ---
above apply. Not required for temporary construction Subtotal $
services. ❑ Trust Account $
Balance Due $
For inspections call ihls potmit becomes null end void it the work authorirod 6 Iha
h p.rmn is not commenced
640-3561 or 693-4415
wihln ISO days tram dale o1 bsuance M such permit or if IM work authorized Is
s:apendsd or abandoned at any time eller work Is commenced for•period of Ito days.
24-hour recorder, one working day in advance of need Elsirical Permits are nen-ralundable and non transferable.
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