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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business - 1
-- BLIP ---
Date Requested _L (�: P /_A A >dl-- BLD
Location 1 G � I — — _— ulte l_ MEC —
Contact Person -- — -- Ph (0 -1 PLM ----
Contractor _ __ Ph SWR
BLIILVING Tenant/Owner _ — —_ — EL.0
letaining Wall ELIR —
�',:ooting
Access: FPS
Foundation --
Ftg Drain - SGN
Crawl Drain Inspection Notes: —
Slab -- _� ( G.i / ! .� -- - SIT ----- --
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _- ---- -- ---- --
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _ - - --a-AV - - -
Final —
PASS PART -FAIL. -- '-�- -- ----
P LI.i irl a 11V b
Post&Beam -
`, Under SlabTop Out
Out ------ --- ---- —
Water Service
Sanitary Sewer
'ain Drains --- - - -- -- --- - - -- -
i- ;al
PASS PART FAIL
MECHANICAL _
Post& Beam --- - ---- - -- - - -- --
Rough In
Gas Line --.-.-- - - --- --- ---- --- -
Smoke Dampers -
Final -------_ _ - ---- ___--------------- --
PA 3S PART FAIL
XffdTRICA
a Servic_) - -_ ------ -- --- -- - - --
Rough In
`n UG/Slab - - - ------ — - -----
Low
-Low Voltage
Fire Alarm -- -- ------- - ----- ------
J
i
:CIOFSS PART FAIL __ ------ -- -- -
LD
Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reirispection fee of$- required before next inspection. Pay at City Hall. 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE _ [ ]Linable to inspect-no access
Fire Supply Line --
ADA
Approach/Sidewalk pate , �/� Inspector - Ext
Other -
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
ELECTRICAL PERMIT
CITY
OF
T I G A R D _
PERMIT#: ELC1999-00374
DEVELOPMENT SERVICES DATE ISSUED: 6/23/99
13125 SW Hall Blvd.,Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S111BB-01200
JITE ADDRE:S: 14230 SW 103RD AVE
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R-3.5
BLOCK: LOT : 015 JURISDICTION: TIG
Proiect Description: 200 amp sery ce or feeder
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EAGH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10)•
SERVICE/FEEDER BRANCH CIRCUITS
---- ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 st W/O SRVC OR FDR: FIER HOUR:
401 - 600 amp: EA ADD'L BRNGH CIRC: IN PLANT-.
601 - '000 amp: PLAN REVIEW SEC'F'ION _
100()4 amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >=225 AMPS: _-� CLASS AREA/SPEC OCC:
Owner- Contractor:
ROB FABER GEORGE + SONS ELECTRIC CORP
14230 S1,'V 103RD AVE PO BOX 339
TIGARC, OR 9722.3 CLACKAMAS, OR 97015
Phone: Phone: 654-8634
Reg#f: LIC 00035600
ELE 3117C:
SUP 31855
FEES R,3nuired Inspections_
Type By Date Amount Receipt Elect'I Service
— — I Elect'I Final
PRMT BON 6/23/99 $64.25 99-316344
5PCT BON 6/23/1.9 $3.22 99-316344
Total $67.47 ORIGINAL
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 accordance with approved pians This permit will expire if work is not started within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules 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)
_ 246-1987
Permit Signature: 1CN1vyc Issued By: L)
III OWNER INSTALLATION ONLY
JThe installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ___ DATE: —
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: O �l� t�7 __—. DATE:_
LICENSE NO: __—
Call 639-4175 by 7'00pm for an inspection the next business day
� awe
RECEIVE,
N 1 c, jpCommUlnity Development ELECTRICAL PERMIT APPLICATION
13125 S'VV Hall Blvd,
C� MUN Y DEVELOPMENT Tigard, OR 97223 Permit #
Date Issued - 11
Phone (503) 639-4171
FAX (503) 684-7297
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4'Complete Fee Schedule Below:
Name of development Y� Number of Inspections per permit aliuwed
Address-1 tQ /s f d J Service included: Items Cost(ea) Sum
City/State/Zip �•qA 4a Residential -per unit
1000 sq. ft or less $11000 4
Name (or name of business)RO4_ �
- � Each additional 500 sq.It or
B pertion thereof $25.00 _
Commercial ❑ Residential IY Limited Energy $2500 1
Each Manurd Home or Modular
Dwelling Service or Feeder 4— $68.00 2
2a. Contractor installation only: /
J 14b. Services or Feeders fOL ,�
, /C� LCL` Installation,amp or l etion,or relocation
Electrical Contractor �t: N� N L 200 amps or less / S60 00 2
Address k D DOS' 3 j 201 amps to 400 arnps ^` $80.00 _ 2
City CI L, e State ZI�1���5 401 amps to 600 amps $12000 _ 2
601 amps to 1000 amps $180.00 __ 2
Phone No. S'11fover 1000 amps or volts $34000 i 2
Job NO. Reconnect only WOO _ 2
contractor's license NO. 3 -// 4c. Temporary Services or Feeders
Contractor's Board Reg. Nn. -S S a a -Z D Installation,alteration,or relocation
S'gnature of Supr. EIe_c'n —�- t4tsi 200 amps or less _ 2
License No._�J� -5 Pone No.6'S�+` `f� 201 amps to 400 amps $so 00 2
401 amps to 600 amps $75.00 2
() I" 01 ',)ver 600 amps to 1000 volts $100 00 — —
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Nartle New,alteration or extension per pane
Address i)The fee for branch circuits with ,
1 City _ .Stela Zlp _ purchase of service or feeder fee.
Each branch circuit _ $500
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is rurrrhase of service or feeder fee.
not intended for sal lease or rent. First branch circuit __ $35 00
Each additional branch clrcult $5 00
Owner's Signature _ _ ._, 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or:rrlgation circle $40 0n 2
Each mien or outline lighting $4000
Signal circult(s)or a limited energy 2
Please check appropriate Item and enter fee In Qection 5B. panel,alteration or eMenslon $4000
4 or more residential units In one structure Minor Labels(10) $10000
F Service and feeder 225 amps or more
N
System over 600 volts nominal
14f. Each additional Inspection over
_ Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 re inspection $3500
Per hour _ $55 00
In rlanl � $55 00
m Submit 2 sets of plans with application where any of the above
apply. Not required Inc telnperary ,nnstruction services. 5. Fees-
t_.,
__j 5a. Enter total u' above I es $ _
NOTICE 5%Surcharge ( 5 X ,otal fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AU1-HORIZED IS NOT f:OMMENCED WITHIN 180 DAYS, OR II- 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. El Trust Account #
$
Balance Due