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CITY
��� o� TIGARD
����� ELECTRICAL PERMIT
PERMIT#: ELC1999-00392
DEVELOPMENT SERVICES DATE ISSUED: 6/30/99
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S114A0••01100
SITE ADDRESS: 16285 5W 85TH AVE 408
SUBDIVISION: ZONING: I-P
BLOCK: LOT : JURISDICTION: TIG
Protect Description: Installation of a 200 AMP service/feeder and eight (8) b,anch circuits for TI.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMRIIRRIGATION.-
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 60C amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
_ _ ADD'L INSPECTIONS _
0 200 amp: 1 W/SERVICE OR FEEDER: 8 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reronnect only: _ SVC/FDR >=225 AMPS: i, CLASS AREAISPEC OCC:
Owner: Contractor:
BIRKEMEIER, BRENT T/JANET D TR MT HOOD ELECTRIC INC
BY THE BIRKEMEIER FAMILY TRUST 8900 SW BURNHAM RD
10573 SW NAEVE ST UNIT F-27
TIGARD, OR 97224 TIGARD, OR 9723
Phone: Phon6: 639-5833
Reg#: LIC 000011
SUP 3801S
ELE 34-425C
FEES _ Required_Inspections
Type By Date Amount Receipt
_ Ceiling Cover
PRMT GEO 6/30/99 $107.05 99/316t)21 Wall Cover
5PCT GEO 6/30/99 $5.35 99/316521 Elect'I Service
_ Elect'I Final
�— Total $112.40 ORIGINAL
L�
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 aca)rdance with approved plans This permit will expire if work is not started within 180 days of issuance,or I work is
cL uspended for mop than 180 days. ATTENTrON Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
s are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at(503)
h
k46-1987
10
-' Permit Signature: (�- ) Issued By:
L OWNER INSTALLATION ONLY
-J The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ _ DATE:
1 CONTRACTOR INSTALLATION ONLY
--------- - J -C7 C�'1
SIGNATURE OF SUPR. ELEC'N: c��zJ rZ`� DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application P!anCheck#
13125 SW HALL BLVD. Recd By
Date Recd
TIGARD OR 137223
Date to P.E.
Phone(503)639-4171, x304 Date to DST_
Inspection (503)6'9-4175 Print of Type Permit 414C lfl?f"ed V
Fax (503) 598-1960 Incomplete or illegible will not be accepted Called _
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1)0 Im,rW , Number of Inspections per permit allowed
Name(or name of business) Service included: Items Cost Sum
Address_ (��-�, Su) f S __ 4a. Residential-per unit
1000 sq.h.or less _ $ 117.75 _ 4
City/State/'Zip_fin r--a P _ Z_-��_—__- Each additional 500 sq ft.or
portion thereof $ 26.25 _ 1
Commercial Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor Installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
inforriation for COT data base). Installation,alteration,or relocation �
Electrical Contractor 1" U�� 200 amps or less $ 64.25 �� J q2
Address_ qoc) . 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City�l� State_ —Zip Z� 601 amps to 1000 amps _ $ 192.50 2
Phone No3 _ Over 1000 amps or volts $ 363.75 _ 2
Job No. Reconnect only $ 53.50 2
Elec Cont. Lice. No. `t 'VS CExp.Date 4c.Temporary services or Feeders
OR State CCB Reg. No. f 1 6c,4 t Exp.Date Installation,alleration,or relocation
COT Business Tax or Metro _Exp.Date_ 200 amps or less $ 53.50 2
201 amps to 400 amps $ 8025 2
401 amps to 600 amps $ 107.00 _ 2
Signah,re of Supr. Elec'n Over 600 amps to 1000 volts,
see"b"above.
License No._ � � Exp.Date
4d.Branch Circuits
Phone No �' «
-6c -- New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee. QQ
Print Owne�s Name Each branch circuit $ 5.35 4 � ?10 2
Address R b)The fee for branch circuits
--- ----- ----------- w.'thow purchase of service
City _-_—� State __--- Ip --_-- _-_--_ or feeder fee.
Phone No. First branch circuit $ 37.50
- _ J 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 _
Owner's Signature -_^ Each sign or outline lighting $ 42 75 — -
Signal circuit(s)or a limited energy
panel,alteration or extension $ 6000
3. Plan Review section (if required):* Minor Labels(10) - $ 10700 --- -
Please check appropriate itern and enter fee in section 5B. 4f.Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
--- Per inspection $ 5000 _
J Service and feeder 225 amps or more Per hour $ 5000
System over 600 volts nominal In Plant $ 5900
Classified area or structure containing special occupancy as
W described in N E C Chapter 5 5. Fees:
5a.Enter total of above fees $ ! 6 r• O
Submit 2 sets of plans with application where any of the above apply. 5%Surcharge 105 x total fees) $
Not required for temporary construction services. Subtotal $ ✓i J
5b.Enter 25%of line 6a for
NOTICE Plan Review If re ulred(Sec 3)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Suhtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ I rust Account#_ L�
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ ,!
I\dsts\rnmu\electric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 6394175 Business Line: 639-4171
BUP _ —
Date Requested e- v _AM _/PM/I- BLD
Location Suite MEC -
Contact Person _ Ph 6-3 -5"?_73 PLM
Contractor � od _ Ph _ _ SWR
BUILDING — Tenant/Owner ELC ?179' - U'O ?2--
Retaining Wall ELR _
Footing Access:
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab _-_ �— SIT
Post&Beam —
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -_-- —_-- -------- --_-_..-_--
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _ ------
Rc of
fAisc. - --- -
Final ---- -
PASS PART FAIL - -- ----- -- - --
PLUMBING 7
Post& Beam -------- —
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final ------------ - -------
PASS PART FAIL
MECHANICAL _ ----_-_�—
Post& Beam
Rough
----- - - -- - -- - -- - ---
Rough In
Gas Line _--
Smoke Dampers
Final --- -------- - - ----- -- -- -
PASS PART FAIL
._
N ough In
UG/Slab
Low Voltage
,7-' Fire Alarm
FiOSE
al
LD PART FAIL
Backfill/Grading - - -- —� _
Sanitary Sewer
Storm Drain I Reinspectior fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: . [ )Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Ext
Inspector_Date L� �� '
Other - —
Final
PASS PART FAIL DO NOT REMOVE this inspection rec%,rd from the joh site.