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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 e5
r��i�rpt �j,�P�1�4•��a i t s�:av � j u ri �� d� r�ill r
Footing Rain Drain Cover/Service FINAL: S*
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Foundation Water Line Ceiling -Plumb.
r � Post/Beam Mech. Shear/Sheath Framing -Mech. '
F i 1 P da'1 `Yk
Plbg.Und/Flr/Slab Plbg.Top Out Insulation E"Ie c . "j,
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
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Other. J A
Date: A.M.�._P.M. Entry;
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Address:
Tenant:---- - _. Ste:----- MST: .
BUP:
Con/Own: _ �_�—_� MEC: ry'
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: f Date:k��
APPROVED -DISAPPROVED/CALL FOR REINSP. (elF CO
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OF TIGARD
CITY ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT
#ISSUED-1C95� 7E�7
13125 SW Hall Blvd.,Pgard,OR 97223 (503)6394171
PARCEL- c S 102AE3--O36017)
SITE'. ADDRESS. . . 1226,5 SW MAIN
SURD I V I S'[ON. . :
1aI..CJC;I;. . . . . . . . . � LOT. . . . . . . . . . . . .
^r-OCK. . Description: Install, one br-anch circr_�it _.._.__.__....._._..__....__.__._____-_-__.__...
MISCEI_.LANEOUS____.._
—RESIDENTIAL -__ --TEMP SRVC/FEEDERS- ---
_ 2,00 amp PUMC>/I RR T GAT I ON. .
1 Vr00 SF OR LESS. . . . ; 0 f�1 - 1
Qf SIGN/OUT LINE L.TG. . : 0 ■
F:ACH ADD' L `"17605F. . .. ; 0 ;;'rm 1. _.. 4O0 a m n. . . . . . . . Ia
4�1, r,00 ?ml1. . . . . . .
LIMITED ENERGY. . . . . . 0 MINOR'. LABEL (1.0) . . . : 0
6Oi.+��m 5 ].►�Q► volts. 0 - r�u. I TiI
MANE. MIM/ SVC/FDR. . : 0 P rr+ q I-- :C;T'[ONS
__.S'1-RV ICEz!FEEDER- _._..._
__....__-F3RAhdCH CTRCLJITS-•-_-._.
Qr W/SERVICE OR FEEDER: F'ER [hlt�F'ECTION. . . . . ; ■
Qi - x_'00 amp. . . . . . r 1.,t W/L7 SRVC OR FDR. . 1 PE:R Hf1!JR. . . . . . . . . . . . 0
`.V_r1 - 400 .gym[). . . . . . : 71 � I,N PILANT. . . . . . . . . . . : 0
���1 - Fair amp . . , , , : V, EA ADD' L BRNCH CIRC: i
f"I_.AN REVIEW SECT _.._._.._...._._..
01 1,000 amp. . . . . ) C-,00 VOLT NOMINAL.. : :
1001A.* amp/volt. . . . . : 0 ) =4 RFS UNITS. . . . . . . . w CLASS AREA/SPEC OCC. :
)
Rer_onnect only. „ . . . 'VC/rDR 21P15 AMPS..__�_________________..____.-• FEES
9viner : -__ __._.._._._._..--------___.______.___.___ r type amor_int by 'date recrit
YAN' '"3 RE STURANT typeRMT $ 35- 00 JSD 11/1.7/9
5 95-273040
1,2 :'65 SW MAIN 1) �� SPCT 'I 1. 7!5 ..7SD 11/17/95 95-273040
T I CSA RT) OR (� LA�.�1
Phone s,'�
cont r^ac^t or ?(;. 75 TOTAt.
A E, E'. SAF AND ALARM CC?
PO 130X 1.
,.._____-_-_ REQUIRED INSPECTIONS
.. _._..__._--- •
MCMIN II_1_F OR 9'71;::18 Ceiling Cover Underground Cave
Wall Cover^
Phone #: 503-472-6439Fl.ect' 1 Ser-vi.ce
P e rl #. . 000651
u
This permit is issued subject to the regulations contained in the Perm *
Si.gnat ure``
Tigard Municipal Code, State of Ore. Specialty Codes and all other ; R
a licable laws. All work will be done in accordance with
PP
approved plans. This permit will expire if work is not started / C Gtc }� L
within 188 days of issuance, or if work is suspended for more 1 s 5�a ei d B y
than 188 days.
_ . OWNER INSTALLATION ONLY_ --_._..__..
The installzztioni.s being made on prr^operty T. own which is not intended for
;ale, 1(ease, at rent. DATE;
OWNER' S SIGNATURE:
fNS'Tf-rl_.L.ATICIhIONLY________________..._...______.
1 SIGNATURE OF SUPR. Fl. EC' N: _ ------ —_
DATE: —
Call far inspection F.,39-41.75
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' Community Development' ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. �' �' �jL, 0ti
Tigard, OR 97223 Permit #
Date Issued _
Phone (E33) 639-4171
FAX (503) 684-7297
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
P
1. Job Address: 4•
Complete Fee Schedule Below:
Name of Development __ Number of Inspections per permit allowed
, / d
Address-f�(5 �� fi�'v Service included. Items�Cost(ea) Sum ,
City/State/Zip1 Cr rt Cf 4a. Residential -per unit V-- 4 6
1000 sq- ft or less $11000
,q�� ,,q,' Each additional 500 Sri It or
Name (or name of business) 1J^' Ps L=� � poniorthereof $2500
Limited Energy $25.00 1
Commercial Residential �� —
Each Manor Home of Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: AAA 4b. Services or Feeders
Installation,alteration,or relocation
.� /J ltion 2
ectrica ntra' r rn�� r7 200 amps or less $80,00 2
Add SQ• `7__Z_� 201 amps to 400 amps $80.00 - 2
401 amps to 600 amps $120 00
City �2'� State Zip _, F. 601 amps to 1000 amp. $tep 00 _ 2
Phone No. 7 _ Over 1000 amps or volts __ $340.00
Job NO. Reconnect only $50.00
contractor's license NO e, C _ _—_ 4c. Temporary Services or Feeders
' Contractor's Board Reg, 0. 1; Installation,alteration,or relocation 2
Signature of Supr Elec'n 200 amps or less_� T_ 2
201 amps to 400 amps $5000 License No-3 S' Phone No._ 401 amps to 600 amps —_ $75 00 2
Over 600 amps to 1000 volts $10000
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name-_ __ _ _—_ New,alteration or extension per pane
Address T a)The fee for branch circuits with 2
— — purchase of service or feeder roe.
City State____ Zip._—. Each branch circuit __ $5 00
Phone No. _ __._. b)Thr fee for branch circuits without 2
The installation is being made on property I own which is purchase of service orf)odor fee S�`�' 2
First branch rlrcui! $3500
not intended for sale, lease or rent. Each additional brFurh rircult T_ $5.00 Lai
Owner's Signature _ _.._ —_ 4e. Miscellaneous
(Service or feeder not included; 2
t5
Each pump or irrigation circle _!_ $4000
3. Plan Review section (if required): `
Each sign or outline lighting $40 00 2 n
Signal circult(s)or a limiled energy 1
Please check appropriate Item and enter fee in section 5B. panel,alteration or extension �_� $4000
_4 cr more residential units in one structure Minor Labels(10) $10000
_Service and feeder 225 rimps or more
4f. Each additional inspection over
System over 600 volts nominal
Classified area or structure containing special occupancy the allowable In any of the above
v as described in N E C Chapter 5 Per hour thn $35 00
_
P Per hour __ 355.00
In Plant _ $5500
Submit 2 sets of plans with application where any of the above
apply. tilt required for temporary construction services. 5. Fees:
NOTICE 5a. Enter Intal of above fees $
5%Surcharge (.05 X total fees) $
Subtotal $ __ t
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $
i A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED Trust Account #
Balance Due $
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