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13675 SW FEIRING LANE (2) ADDRESS: i:\record.s\micrcrlm\targets\bu;:ding.doc CITY OF TIGARD BUILDING INSPECTION NOTICE I �s InsF ection Line (Rec-O-Phone): 63i-4175 Business Phone: 639.4171 Inspection:_ Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. - lect, Date Requested:_ [�b /� Time: X_AM PM Address: 3(` Builder: _ Perrru # THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: — ,)�PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE _Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 6394175 Business Phone: 639-4171 Inspection:. Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. Elect. Date Requested: _ f �' / 1, Time: AM PM Address: :� (o -�->'+�i�✓i;'�� r4c % Builer: rt. _ ��t�' Permit #: ==Li_ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector. Date:2— 1 APPROVED __DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. F Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # Et.:� qS-0111 Z Phone (503) 639-4171 Date Issued --fv IS- CITY OF TIOARD FAX (503) 684-7297 Issued by TDD No. (503) 684-2772 - Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Namo Development _ _ Number of Inspections per permit allowed Address 9)\I� IS `.r��f \ V Service included' Items Cost(ea) Sum City/State/Zip \ 4a. Residential-per unit 4 1000sci it or 10166 111111000 Name (or name of business)_ Each o n or E25 00 portion 1 _ on lhersol Commercial❑ Residential Limited Energy $2500 Each Would Home or Modular 2 Dwelling Service or Feeder _ $80 00 2a. Contractor Installation only: 4u.Services or Feeders In-dallatiun,alteration,or rolocal-on 2 Electrical Contractor _ 200 amps or leas Sao 0o 2 Address 201 amps to 400 trmps $8000 2 �,.' 401 amps to 800 amps $12000 _ 2 City 5.ateZip 601 amps to 1000 amps $18000 2 Phone No. Over 1000 amps or volts $34000 2 Contractor's License No. Reconnect only E5000 — Contractor's Board Reg. No. 4c.Temporary Servicer+or Feaders Ini,allahen,alteration,or relocation 2 Signature of Supr. Elec'n ^_ 200 amps or leas $5000 — 2 201 amps to 400 amps $7500 2 License No. Phone No. 401 amps to 800 amps $10000 Over 600 amps to 1000 volts 2b. For owner Installations: above 4d. Branch Circuits Print Owner's Name Novi, alteration or extension per panel Address C a)The lee for branch c rcuNe With City_�\ [[� _ State Zip_ purchase o/eavice or lewder M6. 2 Each branch circuit 86.00 Phone N0. h)The lee for branch cna,ita wirhold The installation is being made on property I own which is ( purchase cd service or Moder ice. 2 First branch crena not intended for sale, lease or rent. Each add4iona $ l Wrench circus $5.95 0 000 Owner's Signature_r �, t a�(1 � 4e. Miscellaneous (Service or feeder not included) 2 3. Irrigation mote $40 0 2 Plan ev ew section (16 required): Each pump or IEach sign or oulline lighting $4000 Signal cimud(s)or a limited energy 2 Please check appropriate Item and enter fee in section 5B. panel,alteration or extension $4000 4 or more residential units in one structure Minor Labels(10) $10000 _ Service and feeder 225 amps or more Systom over 600 volts nominal 411. 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 Per ser io cl on __ $35 On Per how $5500 Submit 2 sets of plans with application where any of the above In('lent E55 00 apply. Not required for temporary oomtruction services. S. Fees: rr NOTICE 5s. Enter total of above fees $ ( l 5%Surcharge(05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Flan Review if required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtorsl $ COMMENCED ❑ Trust Account N Balance Due s raeldwnLNMK-pm xpp CITY OF TI©ARD RECEIPT OF PAYMENT RECEIPT NO. :95—e68328 CHECK AMOUNT a 42. 00 NnME (,'U9WORTHj HEIDI CASH AMOUNT a 0. 00 ADDRESS a 11895 SW 9TH PAYMENT DATE 0 07/PO/95 BEAVERTON, OR SUBDIVISION 97 0 ft— PURPOSE OF PAYMENT' AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID ELECTRICAL PERMIT 40. 00 ST. BUILD rER c. 00 13675 SW FEIRINCS L.N. ELC 99--0192 miint- PWAINT PAID 42. 00