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13934 SW MISTLETOE DR
I TY OF
T I G A R D ELECTRICAL PERMIT
DEVELOPMENT SERVICES DATEISSUED: EL/1Co 0,-000,4
13125 SW Hall Blvd.,Tigard. OR 97223 (503)639-4171 PARCEL: 2S104CD 05100
SITE ADDRESS: 13934 SW MISTLETOE DR
SUBDIVISION: HILLSHIRE ESTATES ZONING: R-7
BLOCK: LOT : 051 JURISDICTION: TIG
Protect Description: Installation of new 200 amp or less service and 8 branch circuits.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS _ MISCELLANEOUS _
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FUR: 601+amps -1000 volts: MNrOR LABEL (10):
SERVICEWEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: 8 PER INSPECTION:
201 - 400 amp: 1 st WIO SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD' BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC QCC:
Owner: Contractor:
JEFFREY & BROWN WILSONVILLE ELECTRIC INC
13934 SW MISTLETOE DR PO BOX 845
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503-521-0880 Phone: 503-638-5353
Reg#: SUP 38545
LIC 00075752
ELE 3-307C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 1/11/01 $133.50 2720010000( Elect'I Service
5PCT CTR 1/11/01 $10.68 2720010000( Elect'l Final
Total $144.18
This Permit is issued subject to the regulations contained in the'rgard Municipal Code,State of OR. Specialty Codes and all other applicable laths.
4. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is
Iz suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
F-- 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)
CO) 246-1987,
PERMITTEE'S SIGNATUREtj t ISAPED S_Y:
mC
-
OWNER INSTALLATION ONLY
J The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE- - -
CONTRACTOR INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: ��?5
Call 639-4175 by 7:00pm for an Inspection the next business day
CITY OF TIGARD Electrical Permit Application P�"� �` -
lei 25 SW HALL BLVD. Recd y
Date Reed "l0�
TIGARD OR 97223
Date to P.E.
Phone(503)639-4171, x304 D.Ae to DSI_=
Inspection (503)639-4175 Print of Type Permitar�'-'tet
Fax(503) 598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections E2r rmit allowed
Name(or name of business)_�"' Service included: Items Cost Sum
Address_�-,1 3 1/ i� M r s' 4a. Residential-per unit
City/State/Zip 'T f r w�r n _ 1000 sq.rt.or less _ _ $ 117.75 _ 4
-�_�--- Each additio ial 500 sq.fl.or
portion thereof _ $ 2675 _ 1
Commercial❑ Residential Limited Energy $ 6000
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit Issuance,applicants must provide contractor license 4b.Services or Feeders 50
Informali,m for COT data base). Installation,alteration,or relocation �O a0
ElectricalC ntractor L0r _ Vic,rte. 200 amps or less S yr* _ 2
201 amps to 400 amps $ 85.50 _ 2
Address - L�-109-1 -- 401 amps to 600 amps _ $ 128.50 2
City W t. _*,,�.,,� State L-Zip G ����_ 601 amps to 1000 amps _ $ 192.50 �� 2
Phone No. --L'7Over 1000 amps or volts $ 363.75 2
Jab No. _ _ Reconnect only $ 53.50 _ 2
Elec. Cont. Lice. No.. xp.Dfj2 Q.I-_�.>L 4c.Temporary Servicev or Feeders
OR State CCB Reg No. _ Ex ate L�1 Installation,alteration,or relocation
COT Business Tax or Me o ate L�o� 200 amps or less $ 53.50 2
201 amps to 400 amps $ 8025 L
Signature of Supr ec'rt,. 401 amps to 600 amps $ 100.00 _ 1
Over 600 amps to 1000 volts,
r3,�s see"b"above.
License fJ Exp.Date /b-- �/ .Branch Circuits
Phone Na. _.5123 le,�Q S .5 4dNew,alteration or extension per panel
a)The feP for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owners Name Each branch circuit $ 5,35 _ 2
Addressb)The fee for branch circuits
�_--- - without purchase of service
City State__Zip or feeder fee.
Phone No. First branch circuit $ 37.50
"""-- Each additional branch circuit $ fie'
The installation is being made on property I own which is not 4e.Miscellaneous 1&046 53 �
intended for sale, lease or rent (Service or feeder not induced)
Each pump or irrigation circle $ 42.75 _
Owner's Signature W� Each sign or outline lighting S 42.75
Signal cfrcult(s)or a limited energy
a 3. Plan Review section (if required):* panel,alteration or extension _ $ 80.00 _
� Minor labels(10) $ 100..00
rj Please check appropriate Item and enter fee in section 5B. 4f.Each additional Inspection over
4 or more residential units in one structure. the allowable in any of the above -
Pei inspection $ 50.00
Service and feeder 225 amps or more Per hour _ S 50.00
P
System over 600 volts nominal In ant S 59,00
Classified area or structure containing special occupancy as qii--
W described in N E C.Chapter 5 5. Fees:
5a.Enter total of above fees SSubmit 2 sets of plans with application where any of the above apply. 8%Surcharge(.08 X total fees) S /Q 4a
Not required for temporary constriction services. Subtotal $
5b.Enter 25%of line 5a for
NOTICE Plan Review H required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OP. !�
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account q
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $
i:\dsIs\fbrms\electric.doc:
CITY OF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : MST97--0/!49
13125 SW Hall Blvd.,nprrd,OR 97223 (503)&V4171 DATE ISSUED: 10/22/97
PARCEL: 2S104CD-05100
5 T TE ADDRESS. . . : 13934 SW MISTLETOE DR
SUBD I V T S I ON. . . . :HILL'-"HIRE ESTATES ZONING: R--7 PD
BL-OCV. . . . . . . . . . LOT. . . . . . . . . . . . . :051 JURISDICTION: TIG
Remarks: 2nd story deck with access door
----------------------------------_w —_------------ BUILDING ----- - ------------ ----------------____
REISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED------ -----
CLASS OF WORK.:OTR HEIGHT........: 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD....: 60 SECOND...: a sf FRONT.........: 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........; 22
OCCUPANCY GRP.:R3 BDRN,- 0 BATH: 0 TOTAL------: 0 sf VALUE..t: 3708 REAR..........: 55
------------------------------------------- ------------ PLUMBING ------------------------------ —-------------
SINKS.........
--------------- -
-----------------SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: a b%)NDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 8
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
T()p/SHOWERS...: 0 GARBAGE DIT) ..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PRFVNTR: 0 GRFgSE TRAPS..: 0
OTHER FIXTURES: 8
---------------------------------------------------------------- MEDMICAI. --------- --.---------------------------------------------------
FUEL TYPES----------- FURN ( 100Y ..: a BOIL/CMP ( 3HP: M VENT FANS.....: 0 MOM DRYERS: 0
FURN )-100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 9
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 8 WOODSTOVES....: 0 GAS OUTLETS...: 0
----------------------------------------------------------- ELECTRICAL - -------------------------------------
---RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- -TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 0 0 - 200 asp..: 0 8 - 200 alp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 508SF.: 0 201 - 400 amp..: 0 201 - 480 amp..: 0 1st W/O SVC/FDA: 0 SIGN/OUT LIN LT; 0 PER HOUR......; 0
LIMITED ENERGY.: 0 401 - 680 asp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL./PANEL...: 0 IN PLANT......: 0
MANE HM/SVC/FDR: 0 681 - 1088 amp.: 0 601+81ps-1880 v: 0 MINOR LABEL -18: 8
1888+ amp/volt.: 0 ---------------- __....-__.. PLAN REVIEW SECTION ----------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 9.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
----------------------------.--------------------- ELECTRICAL - RESTRICTED ENERGY ----------------------------------------------------
A. SF RESIDENTIAL----------------------------- B. COMMERCIR------------------- -------------�—_____�
AUDIO d STEREO.: VACUUM SYSTEM..: AUDIO X STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: DTH: BOILER.........: HVAC...........: LANDSCAPE/I RRIG: PROTECTIVE SIGW:
GgRAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: ::
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL II SYSTEMS: 0
Owner: ------------------------------------Contractor: ----------------------------- TOTAL FEES:$ 75.66
MCDONALD, KATHLEEN ABBREVIATED BUILDERS This permit is subject to the regulations contained in the
13934 SW MISTLETOE DR 949 DEER RUN LN Tigard Municipal Code, State of Orr. Specialty Codes and all
TIGARD OR 97223 WOODBURN OR 97071 other applicable laws. All work will be done in accordance
with approved plans. Ttis permit will expire if work is
a Phone 1: 590-3847 Rhone m! 503-982-2768 not started within 180 days of issuance, or if the work is
Reg i..: 125623 suspended for sore than 130 days. ATTENTION: Oregon law
N --------------------------------------------------- ------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 881-8010 through OAR 952101-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (583)246-1987.
---------------------------•----------------------- ----- REQUIRED INSPECTIONS - ----------------------------------------------------
Footing
-------- ----------------------------------------Footing Insp _
JFraming Insp _
Building Final
Tssued By: L-- Permittee Sign��t�.�re `ru
14++++++++4 +•+-++4 i 4--+-++•4+4+++++++4++4•+++++++.4..4..4.4..1..1..{ 1 4-++ + 1 f + 4 + +4.+ 1-•1.1 4 4 1 4+++.++
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
Plan Chec" W
CITY OF TIGARD Residential Building Permit Application Rec By &00-
1131.25 SW MALL BLVD. New Construction Additions or Alterations Date Roc'd 1b-- lv
TIGARD,OR 97223 Single Family Detached or Attached (Duplex) Data to P.E. IQ-(q q:Z_
V 503-639-4171 Date to DST /6- 7-4 j
F 503-684-7297 Permit 1111
om
Print or Type cam VOA'`-
Incomplete or illegible applications will not be accepted c�/,,, 6'
Name of Project I Na
Job - .�T�1�t� Ill Ilz ���' �'';
Address Site Address ''f�es� Architect Mailing Address
�` I—e- City/State Zip Phone
Name
Ka 0 1,e ,q _ a
Owner Moiling Addres
i
'� Engineer Wiling Address
3 �
City/State Zip Phone
0 2-7 � p" 11 City/State Zip Phons
General N me
Contractor Ai1 yr �� �(,(A P/� Describe work Addition O Alteration O Repair O
Mailingdress to be done: .f�QC h7
Prior to permit 9 y f fle er Rr,q Addhiogal Description of W rk:
Issuance,a copy Ity/ tate ZIP Phone / fa ` oL� Cel
of all licenses hize j'
are required if Oregon Const.Cont.Board Exp.Date PROJECT
expired in COT Lic.# I per VALUATIONJ$ f3 7190
database
Mechanical Na NEW CONSTRUCTION ONLY:
Sub- A� Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address 417_
Prior to permit Comer Lot YES NQ Flag Lot YES N
Issuance,a copy City/State Zip Phone check one l/ check one)
of all licenses Restricted Audio/Stereo Burglar
are required if Oregon Const.Cont.Board Exp.Date Energy System Alarm
expired in COT Lic.#
database Installation Garage Door HVAC
Plumbing N!m Opener _ S stems
Sub- (check all that Other:
Contractor Mailinig Address a "I Will the electrical subcontractor wire for all YES NO
rastricted energy installations? Ii
Pricy to permit City/State zip Phone
issuance,a copy Has the Subdivision Plat recorded? N/A YES NO
I/
of all licenses are Oregon Const.Cont.Bonrd Exp.Date
required if Lic.# Reissue of MST#: Solar Compliance
expired in COT Calculation Attached)
database Plumbing Lic.# Exp.Date I hearby acknowledge that I have read this application,that the
L infowmation given Ic correct,that I am the owner or authorized
C tram — agent of the owner and that plans submitted are in compliance
with Oregon State laws.
o Electrical � Signet
Contractor rson 0'2
f ri'.ent Date
~ Sub- M fling Address
Cont P Nam Ph ne
City/State Zip Phone r
9 Prior to permit FOR OFFICE USE ONLY:
issuance,a copy Plat 0: M
J _ ' IV
all licenses are Oregon Const.Cont.Board Exp.Date ' 1 v
required if Lic.# S Zo i Solar:, ,/i
expired in COT --
database Electrical Lic.# Exp.Oateng'n Awing Approval: Planni Approval: TIF:
I:SFREM.DOC (DST) 0?
kIIIQDBt)RN 13FFICE SUPPLY TEL : 1-503-981-8331 Oct 16 .97 10 :54 N0 .002 P .01
fin'., Fax Note 7672 9.7.
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WOODBURN OFFICE SUPPLY TEL : 1-503-981-8331 Oct 16 .97 10 :55 No .002 F .u2
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CITY OF TIGARD BUILDING INSPECTION DIVISION 2,3
c�
24-Moue Inspection Line: 6394176 Business Line: 639-4171
MST
OUP
Gate Requested AM PM BLD
Location Suite MEC
Contact Person 1 kw ye-- Ph 5t7 D –38517 PLM
Contractor le4i4 Ph _ SWR
ILDINC Tenan wne _ GU r Love- ELC
Wall ELR
Ft�tiQ�� „�(�
Foundation AcG NOT REQUESTED Z�'�`' FPS —
Ftg Drain' Inge FOUND DURING RESEARCH SGN
Crawl Drain --
Slab _ NO IN5PECTION(S) FOUND IN FILE SIT
Post&Beam CGLG/•(�J
Ext Sheath/Shear '' S A' '
Int- bWh Shear
ramin ) � _
nSutalierr�” -
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
A33 PIiRT FAI'. -------
PLUMBINO
Post&Beim
Under Slfib
Top Out
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post&Beam -- —
Rough In
Gas Line
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL — --
CL Service _
{� Rough In
UG/Slab
W Low Voltage r
Fire Alarm
J Final
W PASS PART FAIL
W SITE
J I Backfill/Grading �—
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Flease call for reinspection RE: [ ]Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date Inspector Ext
----
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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