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13530 SW 121ST AVENUE i .:i J t i:lrecordsimicrolimklnrgelsllwiiding.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Pusiness Line: 639-4171 -- _ BLIP �� Date Requested 1 - 9,� AM PM BLD Location )W V Suite MEC Contact Personti> U� Ph r?C G- 7' I PLM Contractor Ph - 7 3 31 SWR BUILDINGTenant/Owner ) `7?1,��Q,ya-. - ELC Retaining Wail_ ELR Footing Access: �W Foundation � 'C.2� A FPS Ftg Drain SGN Crawl Drain Inspection Notes: -- — – Slab SIT Post&Beam A Ext Sheath/Shear _ Int Sheath/Shear Q o p Framing ---�'�?L�e C m"v�p _ Pc— Insulation - Drywall Nailing - _ -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ ` -- /-- Roof Final PASS PART FAIL ---- �_ ,FL1IMB;NG Post& Seam --- --- -- Under Slab Top Out —.— — --- Water Service Sanitary Sewer Rain Drains Final PASS PART._. FAIL MECHANICAL i a L�- :' ------ -- -- —_ S=he Dampers PP ,SS PART FAIL ELECTRICAL _..------- _— -._------ ,__-- _-- Service _ Rough In -- cL UG/Slab Low Voltage -- -------_.__ _---__.--- — ,` ~ Fire Alarm y Final — �- PASS PART FAIL SITE Backfill/Grading — Sanitary Sewer w -r Storm Drain J J Reinspection fee of$, ,required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( i Please call for reins ection RE: _ [ J Unable to inspect• no access ADA Approach/Sidewalk Other Date ZL Inspector Ext Final / PASS PART `FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 G v BUP _Date Requested.0�/� / AM O PM BLD Location /35,30 (N � / S A!/e.— _ Suite -7� MEC _-- — Contact Person �/ , �4 u1r� Ph �� 1 PLM _ Contractor PhL 5 ;'Zr- 7 s" 3 ./ SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: -- Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing -- ---------- -- Insu,ation Drywall Nailing - Firewall Fire Sprinkler _ ° — ----- --- Fire Alarm — Susp'd Ceiling Roof Final — PASS PART FAIL — -- -- PLUMBING Post& Beam -- — Under Slab Top Out — Water Service Sanitary Sewer Y— Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam - -------- ----------- — Rough In Gas Line ---.- - — - - — Smokc Dampeis Fi:ial -- — - — — - -- — P PARI FAIL ELE LAL ---- -- -—---- ---- — - Rough In UG/Slab Low Voltage _ v~i Fire Alarm At i ASS ART FAIL SITE _ BackfillIGrading LLJ Sanitary Sewer Storm Drain j j Reinspection fee of$ _ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Si-Fply Line I J Please call for reinspection RE'—_ � [ J Unable to inspect-no access ADA Approach/Sidewalk {� Inspector � Ext Other Date _ Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — /� �y --- —_— — Date Requested BLIP � 1 r� b AM PM BLD _ Location_ p s(N 12— Suite MEC Contact Person — M I ke 9,ro Ph PLM _ Contractor Ph,_ -3 y— �/ SWR ELC 9$ -� 7 �pc1 - �— _. BUILDING Tenant/Owner —_ Retaining Wall ELR Footing Access: Foundation 3 _ (l�G FPS — Ftg Drain Crawl Drain inspection Notes: Slab — -- SIT Post& Beam --- Ext Sheath/Shear Int Sheath/Shear — Framing _ _ — Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Su,p'd Ceiling —.-_— �� — — — — — ----- -- --- Roof Misc: -- -------- — — —.__. _. Final PASS PART FAIL --- - - __— — -- _—__ PLUMBING Post& Beam ----.T.------- --------- --- -- Under Slab Top Oui - -- Water Service Sanitary Sewer — — Rain Drains Final ---�.�_._---------- — - PASS PART FAIL_ MECHANICAL Post& Beam ------ -- -- Rough In Gas Line - - — -- — — Smoke Dampers Final — MSS PAF FAIL - ----- __-- LEC C - - 1n UG/Slab Low Voltage cc r- Fire Alarm Final PASS PART FAIL _-- _, SITE Backfill/Grading — ---_— — — i� Sanitary Sewer LU Storm Drain ( ) Reinspection fee of$._ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ) Please call for reincpectior. RE:—_-__— — ( )Unable to inspect no access Fire Supply Line ADA Approach/Sit'-walk Other Date _1L) Inspecior. Ext _ - Final L PASS PART FAIL DO NO1' REMOVE this Inspection record front the job site. CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC98-0510 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DnTF ISSUED: 08/_'..6/98 PARCEL: _,--,S103CD--04400 SITE ADDRESS., 1.33531-A SW 121ST AVE SURD I V I S I ON. . . . . Z ON I NC77:R--4. 5 BLOCK* . . . . . . . LOT. . . . . . . . . . . . . JURISDICTI N: TIG Proj ect D;set,i pt i on: Addition of electrical service to residence. ----RESIDENTIAL UNIT---- SRVC/FEEDERS---- 1000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . ;: 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 500SF— . : 0 201. 400 -.Amp. . . . . .. . 0 SIGN/0L1T LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 600 i2mp. . . . . . . o SIGNAL/PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR. . : 0 6014-AMPS-1000 volts. : 0 MINOR LABEL. ( 10) . . . : 0 -----SERVICE/FEEDER----- -----BRANCH CIRCUITS--.---- ---ADD" L. INSPECTIONS-.._...__. 200 amp. . . . . . : I W/SERVICE OR FEEDER: 1. PIER INSPECTION. . . ., . : 0 201 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . . 0 401 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 0 1N PLAN-)'. . . . . . . . . . . . V, 601 1000 amp. . . . . : 0 ----------------_-PLAN REVIEW SECTION--- _—_---.—_—_---.... 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOL..T NOMINAL. . - Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS- - CLASS AREA/SPEC OCC. : Owner: FEES DROWN, MICHAEL, it JUANITA REIS type a m 0 1_(n t by date recpt 13530 SW 121ST AVE PRMT $ 65. 00 B 08/26/98 98-3086.12, TIGARD OP 97�?23 5PCT $ 3. 25 B 08/26/98 98-308612 Phone #: Contractor: -------------------------------- ELECTRIC GROUP, INC, THE $ 68. 25 TOTAL. 47C2*(:') SE MII.-WAUKT.E AVE REOUIRED INSPECTIONS PORTLAND OR 9720 ' Rai.igh- in Elect, I Final Phone #: 23.7­2499 Elect' l Service Reg 4. . : 000438 This permit is issued subject to thp regulations contained in the Tigard Municipal Code, State of Oregon Specialty Coc ; and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 160 days of issuance, or if work is suspended for more than 180 days, ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You say obtain a ropy of these rules or direct questions to OK by calling (90246-1987. Pet-mittee Signati.tre: fA+.&JA0_0 -4V k(14,s,"t P d 1)Y . A INSTALLATION ONLY— The installation is being made, an property I own which is not intended for sale, I e a s e, at, rent. OWNER' S SIGNATURE: DATE: INSTALLATION ONLY----------------._—_—_—_. - 5IGNATURE OF SUPR. ELECI N ZD/I //I DATE: 1..ICENSE NO: +++++++++i..........1--+++4.....................................4.......4-+++........... Call 639-4175 by 7:00 p. m. for an inspection needed the next bi-isiness day .........................F-4f........................4-+++4....4.................... CITY OF TIGARD Electrical Permit Application Plan Check If 13125 SW HALL BLVD. Recd By TIGARD OR 97223 ADD TO L�X/SgTli�le . � 1 r Data Recd )4- � Phone (503) 639-4171, x304 G"L c /�--l�-16 7 AUG 2 0 1996 Date to P.E. Print or Type • Date to DST Inspection (503) 539-4175 Incomplete or illegible will`not be accepted Permit#eLC q --0:5(p Fax (503) 684-7297 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _ Number of It ^pections per permit allowed Name )CaEN1 T-ra Re13`M r l4: 3, Service included: Items Cost Sum [� /'� �r Address�3 ) 4a. Residential-per unit City/State/Zip- '� ©fr�-a?- 7Lz�� E�n sq. or le s sq.ft.or $110.00 _ 4 Commercial ❑ Residential Rrportion thereof $25.00 Lit mited Energy $25.00 _ Each Manuf'd Hosie or Modular Dwelling Service or Feeder __ $68.00 2 2a. Contractor installation only: (Attach copy of all c rrent licenses) 4b.Services or Feeders .� _ Installation,alteration,or relocation Electrical Contractor / h cam_ r!Lr t r; � -�� Add r s,y ,a I 1= /t-/mi l r.:.�f� 'f _ 200 amps or less $60.00 -- 2 201 amps to 400 amps $80.00 2 City State Zip_ !7, 401 amps to 601 ampsto600 amps $120.00 00 mss $180.00 2 Phone No. .�+a- ��� --- Over 1000 amps or volts $340.00 2 JobNo. � _ �� Reconnect only $50.00 _ 2 Elec.Cont. Lice. No. Exp.Date OR State CCB Reg. No.- Y j;�3 / Exp.Date _ 4c.Temporary Services or Feeders COT Business Tax or Metro o. Ex Date Installation.alteration,or relocation 200 amps or less $50.00 __ - 2 Signature of Supr. Elec , - 201 amps to 400 amps $75.0 _ 2 401 amps to 600 amps $100.00 _ ?_ 2� Over 600 amps to 100 volts, License No. __Exp. see"b"above. Phone No. Z 3 z Z y 9 A 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 Name feeder fee. Addrr-ss Each branch circuit $5.0 City— _ State_ Zip b)Tcircuits purrhssel of Phone No. _ _ service or feeder fee. First branch circuit $35.00 _ The installation is being made on property I own which is not Each additional branch circuit- $5.00 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature _ Each pump or Irrigation circle $40.0 Each sign or outline lighting $40.00 3. Plan Review section !if required):* Signal circult(s)or a limited energy panel,alteration or extension $40.0 --_ Please check appropriate item and enter fee in section 5B. Minor Labels(10) -- $100.0 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 abcve System over 600 volts nominal Per Inspection $35.00 > Classified area or structure containing special occupancy Per hour $55.00 _ as described In N.E.C.Chapter 5 In Plant $55.00 J r *Submit 2 sets of plans with application where any of the above apply 5. Fees: 65 Not required for temporary construction services. 5a.Enter total of above fees w 5%Surcharge(.05 X total foes) $ -� NOTICE Subtotal $ � - 5b.Enter 25%of line Be for -ERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It require (Sec:1) $ NOT COMMENCED Wr i HIN 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 N $ Total balance balance Due --I i�osrs%ELCAr.APP Revrise - CITY O F T I G,A►R ® MECHANICAL DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard,OR 972,13 (503)639-4171 PERMIT #. . . . . . . : MEC98-0337 DATE ISSUED: 08/11/98 PARCEL: 2SI03CD-04400 SITE ADDRESS. . . : 135.30 SW 1.21ST AVE SUBDIVISION. . . . : ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG ---------------------------------------------------------------------------------------- CLASS OF WORK. . :OTR FLOOR FURN. . . . : 12) EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP'. . :R:3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL- 0-3 HP. . . . : I DOMES. INCIN: 0 :GAS 3-15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPE;2S?. . : 30-50 HP. - . . - 0 WOODSTOVES. . : 0 GAS PRESSI!RE. . . : 50+ HP. . . . -. 0 CLO DRYERS. . - 0 NO OF UNITS------------, AIR HANDLING UN I TS OTHER UNITS. : 0 FURN k 100K BTU: 0 1.0000 ofin : 0 GAS OUTLETS. : I FURN ) =100K BTU: 0 > 10000 cfm: 0 Remarks : Installation of a/c unit, oust cooply with standard setbacks. Owner: -------------------------------------------------------- FEES -------------- MICHAEL BROWN type amol..tnt by date rec-pt 13530 SW 121ST AVE PIRMT $ 25. 00 DEB OB/ 11/98 98-308191 ITICARD OR 97223 5PCT $ 1. 25 DEB 08/11/98 98-308191 Phone #: 590--6879 Contractor-,: JACOBS HEATING & A/C 4474 SE MILWAUKIE AVE ------------------------------------------ $ 26. 25 TOTAL PORTLAND OR 97202 Phone #: 503--234-7331 Reg #. . : 000014 REQUIRED INSPECTIONS ------- This pervit is issued subject to the regulations contained in the Gas I- ine I n s p Tigard Municipal Code, State of Ore. Specialty Codes and all other Mpchani(-al Ins l, applicable laws. All work will be done in accordance with Cooling Unt Insp approved plans. This pewit will expire if work is not started Final Inspection within 180 days of issuance, or if stork is suspended for @are than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Orevon Utility Notification Center. Those rules are - set forth in OAR Fai-001-010 through OAR 952-00I-0W. You eay obtain copies of these rules or direr' questions to (Kt.L by calling 1503)246-9187. /7 eA/ I S S 1.1e Permittee Signator .............4•..... .................... ...................4 ++.+..++-f.... ......... Call 639-4175 by 7:00 p. m. for inspections needed the next bLisioess day 4..........4..............4-++-J++--+f•++++++++++++++++++I...................... CITY OF TIGARD Mechanical Permit Application Plan Ch RecdB ,4 13125 SW HALL BLVD. Commercial and Residential Date Recd -// % _ TIGARD, Or: 97223 Date to P E.^^ (503) 639-4171, x304) /1� Ddte to DST Print or Type Permit#� '�? Incomplete or illegible applications will not be accepted Called — ---- Name of Development/Project Description �~ r7 "—"--q��`) -,7— Table 1A Mechanical Code Qty Price Ami job Street Address Y Suite# A) "irmil Fee __ 1000 Address 1) Furnace to 100,000 BTU including ducts&vents Fiidga CdylState 21p 2) Furnace 100,000 BTU+ including ducts&vents 7.50 Ne ( r name of business) 3) Floor Purnace Owner V 16II Including vent 6.00 Mailing Address 4) Suspended heater,wall heater or floor mounted healer _ 600 5) Vent not included in appliance permit Cilyislale Zip V Phone 3.00 O ' CHECK ALL Boiler Heat Air Name(or name of business) THAT APPLY. or Pump Cond Qty Price Amt Comp 6)<3HP;absorb unit to Occupant Malling Addres / � 100K BTU _ 600 7)3-15 HP;absorb unit GdyiState I J I Phone i 100k to 500k BTU 11.00 V`� 8) 15.30 HP,absorb Contractor Nam unit.5-1 mil BTU 15.00 . ��5 9)30-50 HP;absorb — unit 1-1.75 mil BTU 22.50 Prior to permit dress 10)>50HP;absorb unit issuance,a copy L� >1.75 mil BTU _ 37.50 of all licenses ciryi e p o e 11)Air handling unit to 10,000 CFM are required if na, L 4.50 expired in COT ores Punsi C n and is Exp Date 12)Air handling unit 10,000 CFM+ database 7.50 Architect Name 13)Non-portable evaporate cooler 4.50 or Halling Add 14)Vent fan connected to a single duct 3.00 15)Ventilation system not included in Engineer cdyfState Zi Phone appliance permit 4.50 16)Hood served by mechanical exhaust Describe woo to be done: _ 4.50 17)Domestic incinerators New O Repair O Replace with like kind: Yes• No U 7.50 Residential• Commercial O 18)Commercial or industrial type incinerator _ 3000 Additional Information or description of work: 19)Repair units 4.50 'I`I �//L/ "4— �j v/ yqq � 20)Wood stove I Y 4.50 21)Clothes dryer,etc. 450 j` Type of fuel O natur as LPG O electric O 22)Other units _ 4.50 I hereby ackWe I read his application,this the Information 23)Gas piping one to four outlets ~ given is con t,th a the o authorized agent 2.00 the owner,th Ian ted at compliance w4gr tale laws 24)More then 4-per outlet(each) L .50 Signature of Owner ent Da I� J 'SUBTOTAL -J I "� ,UA1,,�ILnA45%SURCHARGE Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL Required for ALL commercial ermits onl TOTAL 1210. L-7 'Minimum permit fee Is$25+5%surcharge "Residential A/C requires site plan showing placement of unit 1.lmechprm3 doc rev 06/2 j/g8 J 16 (2. n(/(/o, ` S Al vr DiCal)dnJ taauSE P/:oni t s-nzEET" M AK E -e J rr J �acb3s Nry t ��c FORT. OR 503 - Z3,1- 733/ �'Ax 503 2351- 6,B5Z- CITY OF TIGARD ELECTRICAL. PERMIT DEVELOPMENT SERVICES PERMIT #: ELC98--0467 13125 SW Nall Blvd., Tigard,OR 97223(503)639.4171 DATE ISSUED: 08/26/98, � PAREuEL: ESIO3CD--O44O0 SITEADDRESS. . . : 1.35`•:x0 SW 121aT AVE SUBDIVISION. . . . : Z ON I NG:R--4. 5 BLOCK. . . . . . . . . . . LOT. . , . . . . . . . . . . . JURISDICTION: TIG Project De scr i.pt i an: Addition of electrical service to residence. -----RESIDENTIAL. UNIT___-- --------TEMP SRVC/FEEDERS------- ._____..MISCELLANEOUS--- -- 1000 SF OR LESS— . - 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L... 500SF. . . : 0 201 -- 400 :.imp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : 51GNAL../PANEL. . . . . . . . 0 MANF. HM/ SVC/I`DR. . : 0 601+Amps--1000 volts. : 0 MINOR LABEL_ i 1.01 . . . : 0 ---SERV I CE/FEEDER---- -----NRAhICH CIRCUITS—— -----ADD' L I NSPECT IONS--- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 Amp. . . . . . : r7+ i st W/0 SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401. — 600 amp,. . . . . . : 0 EA ADD' l_ BRNCH CIRC: I IN PI._.ANT. . . . . . . . . . . : 0 601 — 1000 amp. . . . . : 0 --------------------PI-AN RFV T EW SECTION----------------- 1000.1- amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > - c.'2 5 AMP'S. . : CLASS AREA/SPEC OCC:. : Owner: --------------------------------------------------------- FEES MICHAEL J BROWN & JUNITA M. REIS type amor.tnt by date ret-pt 13530 SW 121ST AVE PRMT $ 40. 00 DI._H 08/1.0/98 `: 3081229 TIGARD OR 9722:3 5P'CT $ 2. 00 DLH 08/10/98 98--3081.29 Phone 4: Contracrto* : ELECTRIC GROUP INC, THE $ 42. 00 TOTAL 47 :6 SE MIl_WAUKIE AVE —_--- - REQUIRED INSPECTIONS -- - PORTLAND OR 972O;--: Roi.rgh--in Elect' l Final Phone #: 232-2499 Elect' I Service Reg #. . - 000438 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. III work will be done in accordance with approved plans. This permit will expire if work is not started within 100 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thrse rules are sst forth in DAR 952.001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to C by calling (5'63)246-1987. Permittwe Signati.rre: 11'x_ Issi.red By '_____ 2 -----------------------------OWNER INSTALLATION ONLY---___—___-----_.__._______.. Thp installation is being made on property I own which is not intended for sale, lease, at, rent. _r OWNER' S S T GNATURE: DATE: INSTALLATION U-1 J SIGNATURE OF SUP'R. ELEC' N: DATE t LICENSE NO: ........................... .............+f•+•F i•i•i-i•i..4.... .....4A........4-+++ Call 1739--4175 by 7:00 p. m. for an inspection needed the next bi_rsiness day +++++++++++++++++++++ 1+++++++-I+i-+++++++++++++++++++++++++++++i ++++++++++++++-F ' ► CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC98-0467 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 08/10/98 PARCEL: 2SI03CD-04500 SITE ADDRESS. . . . 1'13500 S1,4 121ST AVE SUBDIVISION. . . . : ZONING: R­4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . JURISDICTION: TIG Pro.i ect De scr i pt i on: Addition of electrical service to residence. -----------------------------------UNIT---- ---TEMP SRVC/FEEDERS----- ------MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION....: 0 EACH ADDIL 500SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 I-IMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . : 13 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . : 0 ----SERV I CE/FEEDER---.._ --_—BRANCH CIRCUITS----- ----ADD' L INSF'ECT'IONS---- izi — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER HOUR. . . . . . . . . . . : 0 401 — 600 amp. . . . . . : 0 EO ADDIL BRNCH CIRC- 1 IN P11_ANT. . . . . . . . . . . . 0 601 — 1000 amp. . . . . : 0 ------------- -----P[...AN REVIEW SECTION----------------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FI)R ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner. FEES --------------- MICHAEL J BROWN & JUNITA M. REIS type amoL(nt; by date reept 1.3530 SW 121ST AVE PRMT $ 40. 00 DLH 08/10/98 98-308129 TIGARD OR 972'3 5PCT $ 2. 00 DLH 08/10/98 98-3081.29 Phone #: Contractor: ----------------------------- ELECTRT-C GROUP INC, THE $ 42. 00 TOTAL 4726 SE MILWAUKIE AVE REQUIRED INSPECTIONS PORTLAND OR 97202 Roi-tgh—in Elect' l Final Phone #: 232-2499 Elect' ]. Set-vice Reg #. . : 000438 This persit is issupd subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other appliz:ablp laws. All work will be done in accordance with approved plans. This peroit will expire if work is not started within 180 days of issuance, or if work is suspended for #ore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00I0 through OAR 952-08I-1987. You eay obtain a copy of these rules or direct questions to GUNC by calling (503)246-1987. Permittee Signati-tre: A===, Issi-ted By n. -----------_---.--------------OWNER INSTALLATION ONLY--------------_--------------.__.. The installation is being made on property I own which is not intended for, >_ sale, ] ease, or rent. OWNER' S SIGNAT URE: DATE: _._.___.___—._---__—__.-__—__CONTRACTOR INSTALLATION SIGNATURE OF SUPR. ELECIN: QA_ 19 1_119L z�17 0 w - / DATE: 7r-- LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++++4++i+++ '; ! 4 1-1........#.. . .....4 Call 639-4175 by 7:00 p. m. for an inspection needed the next b((siness day .........................4-+++-4..........................................4+++++4 CIY V OF TIGARD Electrical Permit Application Plan Check# -- 13125 SW BALL BLVD. Recd By Z:� L/� '?Tr^f"I�L/r r Date Rec'd� ?o TIGAtRD OR 97223 Date to P.E. Phone (;303) 639-41'71, x304 �� Date toST inspection (503) 639-4175 AUG `' 1�q Print Or Type Permit DELCy p'0,16 7 Fax (503) 684-7297 Incomplete or illegible Wi!) not be accepted Caned _ 1, Job Address: 111. Complete Fee Schedule Below: lame of Development ff!A r J rr,6 Number of Inspections per permit allowed Name ) �t�5 2o�c�KJ Service included: Items Cost Sum Address 5 UrJ�-CJ �� �A��` 4a. Residential-per unit City/State/Zip=T'iG�d��- �J -7 2 2?' E�n a additional 500 sq.it.or ft.or less $110.00 4 Commercial ❑ Residentialportion thereof $25.00 Limitedt Energy $25.00 Each Manuf'd Home or f,oourar Dwelling Service or reader �. $68.00 �___ 2 2a. Contractor installation only: (Attach copy of all went licenses) 4b.Services or Feeders Electrical Contractor �r �r, ' Inst.alation,alteration,or relocation Addr SS ! 200 amps or less $60.00 2 201 amps to 400 amps $80.00 2 City State Zip );1G 401 amps to 600 amps $120.00 _ 2 Phone No. - 601 amps to 1000 amps $180.00 2 Job No. - Over 1000 amps or volts $340.00 2 P Elec. Cont. Lice. No. Ex Date t� Reconnect only $50.00 2 -�L�YY�, OR State CCB Reg. No. 1�/ Exp.Date h _ 4c.Temporary Services or Feeders COT Business Tax or Metro N / '),A Exp.D Installation,alteration,or relocation ?00 amps or less $50.00 Signature of Supr. Elec'n ---- 201 amps to 400 amps $75.00 401 amps to 600 amps $100.00 � Over 600 amps to 1000 volts, License No. 2L= l Exp.Date_ 101-1112f- see"b"above. Phone No. �2 7 z 2'f�f 7 4d.Branch Circuits New,alteration or extension per panel 2b. For owrer Installations: a)The lee for branch circuits with purchase of aervlce or Print Owner's Name _ feeder fee. Address -' Lach branch circuit $5.00 _ 2 hl Tho fee for branoi circuits City_ _ State _ Zip without purrhnse of Phone No. service or feeder fee. 2 First branch circuit / $35.00 3r 2 The instah.'bn is being made on property I own which is not Each additional branch circuit�_ $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or;seder 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 cfrcuit(s)or a limited energy panel,alteration or extension $40.00 T ,, Please check appropriate Item and enter fee In section 58. Minor Labels(10) $100.00 4 or more residential units in one structure 0.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 _ $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described In N E.C.ChP„, In Plant $55.170 +Submit 2 sets of plans with opptien0on where any of the above apply. S. Fees: Not required for temporary construction services. 5a.Enter total of above fees $ 5ei6 Surcharge(,05 X total fees) $ z NOTICE Subtotal $ 'may 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if[gguIrqg(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#. 7 Z S Total balance Due I U0STRTLC96 APP Rev 9196