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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service F iNAL: y, I "Al
Foundation Water Line Ceiling -Plumb, zAg
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Post/Beam Mech. Shear/Sheath Framing -Mach. '
PIbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. i
San. Sewer Gas Line Appr/Sdwlk Reins.
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Other:
Date: �1 A.M. P.M. Entry:
Address: 3 9 gS C_ --
Tenant:'— _ ` Ste:--- MST:
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BLIP: --
/Own: �� —__ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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tor: DISAPPROVED/CALL FOR REINSP. CF CO
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CITY ELEC'FRtCAL PERMIT
�F TIGARD PERMIT #: ELC96__0536
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/14/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8160 (503)830-4171
SITE ADDRESS. . „ : 08985 SW MC.. DONALD ST
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SUBDIVISION. . . . : E:DGEWOOD ZONING- R-4. 5
BLOCK. . . . . . . . . . .. L-01' . . 1 1
R Pr•o.ject Desitription : Installing one cir01_iit.
----RE:SIDENTIAL UNIT------ ---TEMP' SRVC/FEEDE:RS_--•- -----MISCELLANEOUS-----• �
1000 SF OR LESS. . . . : 0 0 - 1,00 amp. . . . . . . : 0 PUMP,/IRRIGATION. . . . : 0
r.-"ACH ADD' L 500SF. . . : Qr :'01 - 400 amp. . . . . . . : 0 SIGN/OUT LINE: LTG. . : 0
L I M I TED ENERGY. . . . . : 0 401 - 600 camp. . . . . . . : 0 S I GNAL.../1=,AlgEL. . . . . . . 0
IrIAI\IF`. HM/ SVC/FDR. . : 0 601+amps-•1000 volts. : 0 MINOR LABEL (10) . . . 0 �
--SERV I CE/FEEDER-.___..._ --.-...-..-BRANCH C'I RCU I TS- ---- - ADD' L INSPECTIONS—-
200
NSPEC:TIONc.3_-_-200 am
p. . . . , . : 0 W/Sc
ERVICE OR FEEDER: 0 PIER lNSF=ECTION. . , . . : 0
201 - 400 ramp. . . . . . . 0 1st W/O SRlOC OR FDR. .. 1 PIER HOUR. . . . . . 0
' 401 - (,00 amp. . . . . . : 0 EA ADD' L BRNCH CIRC': Qr IN PLANT. . , . . , . . . . 0
601 1000 amp. . ,. . , 0 -._____._.______.__._. ._.----_FI_AIV REVIEW
10004 amp/volt. . . . . . 0 ) =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0GVC/FDR > = 225 AMPS. . : CI_ASc. ARl fa/SPEC OCC.
Owner,; __.__.._..__.___._____.._..__.___.._.._.._._____.__ ________.___________ FE:E�
RATALSKY type amol.tnt by date recpt
8985 SW MCDONALD ST VIRMT $ 35. 00 CJS 08/14/96 96--E:82889
T IGAF7D OR 9%r_'2,;s iF'CT $ 1. 7'S CJS 08/14/96 96--382881)
Phone #:
I
Contractor: -------- ----•--.... --______-___.____.__._____._._._._._____._________-____.___._._____--
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I 7f''C ELECTRICAL SERVICES INC 36. 75 TOTAL �
4040 SE I NTERNAT'I C?NAL WAY I
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REUUIRE:1) INSPEC"PIONS
1ylILWAUKIE OR 97222 Wall Cover- Elect' 1 Final
Phone #: 503-654-33::5 Elect' 1 Set-vice
Pell it. . 9;:5774
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This permit is issued sub)ect to the regulations contained in the
Tigard Municipal Code, Stats of Ore. Specialty Codes and all other p'et-mittee Signatr.lre �
applicable laws. P11 work will be done in accordance with
approved plans. This permit will expire if work is not started
within 168 days of issuance, or if work is suspended for more
than 188 days. Issued By
INSTALLATION
The installation is being made on pr-operty I own which is not intended for
sale, lease, or- r-ent.
OWNER95 STGNArUREs
r.._.______-.._________.__._..._...._.___.___._._____..._.._....._...--•.---......_...._..-..____- DATE::
INSTALLATION
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S I G N A"(U Ft E:: OF S U F'R. E L E:CIV: _�<���..._-�.�--•--__._.___..__._....__._...._.____._ U A TE:
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LICENSE NO:
Call for inspection - 639--•41'75
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Community Development ELECTRICAL PERMIT APPLICATION '. l
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 4C-, - 2P
Permit # ELC-9 -f)53F _
Phone (503) 639-4171 Date Issued 4- 1 K
y CITY OP TIOARQ FAX (503) C8A-7297 Issued by r-Aoe les
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Develcpment Number of Inspections per permit allowed
Address SqS!� S;"J MC 160N aL� ST Service included: Items Cost(ea) Sum
City/State/Zi /& > G 9.7 4s. Residential- per unit 4 a
W 1000 aq It or tees $11000
Name (or name of business) P A`r n L-S K"`�
Each a n thersl 500 sq It m 1
-- portion thereol $2600
Commercial 17 Residential® Elm4od Energy $2500 _
Each Manul'd Hume or Modula, 2
Dwelling Service or Feeder SM 00
2a. Contractor Installation only: 4b.Services or Feeders
Installation,alteration,or relocation 2
Electrical ConttactorZM E 0.41 Se-0 0 icej 200 amps or lase $6100 2
Addressglmoo Se —0/c1 201 amps to 400 amps $8U 00 _
Cih�/�it,WF1uK/E State Zi 9 -;207 th Sot nmpel01a
00 ms $12000
rl
State_(V— 801 amens l0 1000 amps $18000 _ 2
Phone No. (p S Y- 33-?2 _ Over 1000 amps or volla $34000 2
Contractor's License No. 94 37a C Neconned only $5000
( Contractor's Board Reg, N0._ _ 4c. Temporary Services or Feeders
,-- !- nalnllation,alteration,or relocation 2
Signature Of Supt. EIeC'n 200 amps 0r lose $5000 2
License No. 41 / Ar--e— - hone No. 6;V i�»�S 201 amps to 400 amps $05 00 2
401 amore to 800 amps f100110
Over 800 amps 10 1000 volts
2b. For owner installations: sea-b-ANNA
Print Owner's Name 4d. Branch Circuits
Now,Alteration or extension per panel
Address _• _ a)The lee for branch circuits with f
City State Zip pu/cheN of"mice cw Aseder AM. 2 I
Each brunch cvcurt $500 I
Phone No. b)The lee for branch circuits without i
The installation is being made on property I own which is purchase of eervke or Areder Are. 2 �!
First branch circuit � 635 00 3s.iJ0 2
not intended for sale, lease Or rent. Each additional branch circwl $500
Owner's Signature 4a Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (J required): Each pump or irrigation circle $4000
Each sign or outline fighting $40 00
( Signal cimuitts)or a limited energy 2
Please check appropriate Item and anter fee in section 5B. panel alteration or extension !_ $4000 _
_4 or more residential units in one structure Minor I abnln(10) $10000
Service and feedlot 225 amps or more
System 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 Par inapeclwn $3500
Per hour 115500
Submit 2 sets of plans with application where any of the above In Pant $5500
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above leas $ 3 5 U(J
5%Surcharge(05 X total fees) $ 7 S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ;15
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Sb. Enter 25%of line A for
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 M
Balance Due $ 3t�,
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AMOUNT 1-101f)