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i:\records\mierolim\largets\building.doc
CITY OF TIGARD BUILDING INSPLCTION DIVISION
2 t-Hour Inspection Linc: 6394175 Business Mime: 639-4171
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Date Requested: �_ .�_ _ _ A.M. P.M. MS'r: _
Location: ,t' _ L �id BUR
Tenant:- --�� 12 •_ _ Suite: Rld : MEC: —
Contractor: _ _ _Phone: _ PI-M.
Q 7�
Owner: ----- _—I'honc: _ �. };LC:
;2,0ep !> r i, jr-e- 4.WjICAclrrS11� ELR:�_^
_ Sir:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SIT::
Site Post/Beanr Post/Pearn Post/Iiewn o 1 Sewer/Storm
Footing Roof Undfl/Slab Rough-In Ceiling Water bine
Slab framing "lop Out Gas Eine Rough-b► UG Sprinkler
Fcumdation Insulation Sewer IloodA)uct Reconnect Vault
Bsmt Damp Drywall Stonn furnace Temp Service MISC.
Masonry Ceiling Rain[kinin A/C [1G Slab
Shear/Sheath fire Spklr/Alm Crawl/Found Dr I lcat Pump Low Volt
Approved Approved Approved ( Approve Approved y
Appr/Sdwlk Not Approved Not Approvea Not Approved 1Q0 rove) Not Approve)
FINAL FINAL FINAL FINAL FINAL
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M('all for reinspection Reinspection fee of S—__ required before next ins tion f 7 Unable to inspect
Inspector -----_..._ Date: �_ � V Page of
CITY OF TIGARD PT L PERMIT
CDEVELOPMENT SERVICES ERMIT It: ELC 98-0 07r
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01,/19/98
PARCEL:
SITE.:: ADDRE•55. . . : 16327 SW 92ND AVE
SUBDIVISION. . . . : ZON T NG:R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG
FIro.jecl Descript ian : Instailation of 1200 app service and 2 branch circuits.
- - -RESIDENTIAL UNIT----- ---TEMP SRVC/FEEDERS------ ------MISCELLANEOUS __._ _....
t000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 17.1 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : N SIGN/OUT LINE LTG. . : 0
L...IMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. .- 0 6011 +amps-1.000 volts. : '*,� MINOR L_AREL ( tQ0 . . . : 0
SERVICE./FEEDER----- --
BRANCH CIRCUITS- --- ADD' L INSPECTIONS-—
_
_ I
0-- 200 crap. . . . . . . 1 W/SERVICE: OR FEEDER: 2 PIER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . . 0 I
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . 0
601 - 1000 elm p. . . . . . 0 ----__--_--__.---.-_PLAN REVIEW SECT I
1000+ amp/volt. . . . . : 0 > =4 RES I.NUITS. . . . . . . . : ) VCLT NOMINAL_. .
RpConnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner __ -____._______.____.______.__.___._.__.__ FEES
(-'TPNLEY R OUINTON type amol.rnt by date ce,pt
16300 SW 93RD PRMT $ 70. 00 r)RA 42)2/19/ 38 98-303451 ,
T'IGARD OR 97224 5PCT $ 3. 50 17 R(1 OP/ t')/` 8 98-30345:' I
Phone #:
,,"ont:rant or^: -_.-_.__.__.---•---_--....___._________.___.._____ ______._______.__
OWNER $ 73. 50 TC fAL.
RE DO I RED INSPECTION""
Rot.tgh-in Elect' 1 Final
Pl1071F #: Elect' ! Service
R e rl #. . : 999999
This pewit is issued subject to the requlations contained in the Tirlard Municipal CAP, State of Dreger Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This periit will Pxpi^e if work is not started r+ithin 180
days of issuance, or if work is suspended for yore tha 80 days. ATTENTION: Oregon law requires you to follow the rules adoptrd by
the Oregon Utility Notification Center. hose rul arP forth in DAR 952-001 (x010 r OAR 952-001-1987. You iay ubtair.. a cipy
of these rules or direct questions to by ca nq 1 31 .46-1987.
rI ermittee Siyna.trrrev _ F-- as�_iPd By - k
— _.... _
INSTALLATION
The installation is being mar_ira on property I nwrr .,: )ir_h is not intended fnr^
.` .ale, 1►aase, or rent/.. i1 %1n I � �
OWNER' S SIGNATURE: >r'- --�-� � :-: �1._-''"`-� DATE
TNSTAI_.I-.AT ION ONL Y---------- --- -- -
T IiNATURE OF SL.1F'R. EL_FC' N: DATE:
i.I CEN aE NO:
++•1.+++++++4-+++++-F++++++-1.+++++f--4-4-+4........H-1..........1-+++++++ .....4............... +
Call 6..39- 4175 by 7+00 p. m. fa* an i.nspecction neederi the next b+isiness; clay
+ +++++ ++ +
CITY OF TIGARD Electrical Permit Application Plan Che T_
13125 SW HALL BLVD. Recd Bklay _
Date Rec'd
TIGARD OR 97223 Date to P.E.
Phone (503)639-4171, x304 Print or Type Date to DST
Inspection (505) 639-4175 Permit
tax (503) 684-7297 Incomplete or illegible will not be accepted called
1. Job Address: ( '� 4. Complete Fee Schedule Below:
%,
Name of Develop 8p(t_ - Number of Inspections per permit allowed
Name(or name of business l- �__ Service included: Items Cost Sum
3Z �'
Addres4a. Residential-per unit
I s_ �,"� � �i �`- � �-n+
1000 sq.It.or less $110.00 - 4
City/State/Zip_ A r �'� � ���' __.___ Each additional 500 sq.ft.or
portion thereof $25.00 1
Commercial ❑ Residential IYJ '_imiled Energy $25.00
Each Manuf d Home or Modular
Dwelling Service or Feeder - $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4Services or Feeders
Electrical Contractor _ r)stallation,alteration,or relocation 1
200 amps or less $6G.00 &C,CL 2
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 _ 2
Job No_ Over 1000 amps ar volts $340.00 -- 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date _
OR State CCB Reg. No Exp.Date_ ac.Temporary Services or Feeders
COT Business Tax or Metro No._ Exp.Date- Installation,alteration,or relocation
200 amps or less $50.00 - 2
Si nature of Su r. Elec'n 201 amps to 400 amps $75.00 2
9 P - - 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. _Exp.Date see"b"above.
Phone No. 4d aranch circuits
Now,alteration or extension per panel
2b. For owner installal.ons: .0 The lee for branch circuits with
purchase of service or
Print Owner's N_arae "'5r � _ 11l�u feeder lee.
Address f l�r�L Each branch circuit $5.00 L`
ty�! �'A / 'b � ' p i b)The lee for branch circuits
Ci c State Zi _ without purchase of
Phone No. •�[) '7�4 b' __ service or feeder fee.
nra branch circuit $35.00 .'
The installation is being male on property I own which is not Lach additional branch circuit_ $5.00
intended for sale, lease or rent. 4e.Miscellttnsous
(Service or feeder not Included)
Owner's Signature Ae Ad j _ Each pump or Irrigation circle $40.00 _
Each sign :r outline lighting $40.00
3. Plan Review section if required):' Signal clrruit(s)or a limited energy -
panel,alteration or extension $40.00 _ -
Minor Labels(10) $100.00
V~ Please check appropriate item and enter fee in section 5B
4 or more residential units In one structure 4f.Each additional Inspection over
Service and feeds!225 amps or more the allowable in any of the above
J System over 600 volts nominal Per Inspection _ $05.00
J Classified area or structure containing special occupancy Per hour $55.00
as descdbed In N E.C.Chapter 5 In Plant - W55.00 _
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Submit 2 sets of plans with application where any of the above apply. S. Fees:
Not required for temporary construction services. 5a.Enter total of above fees $
5%Surcharge(.05 X total fees) $
NOTICE Subtotal $
5b.Enter 25%of line Be for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it reauir (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
TIME AFTER WORK IS COMMENCED. Trust Account A�__
a
Total balanre Due
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