Permit (11) CITY OF TIGARD ELECTRICAL PERMIT
kr PERMIT #: ELC2005 -00043
� DEVELOPMENT SERVICES DATE ISSUED: 1127/2005
" Ail. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S136CD -01600
SITE ADDRESS: 11674 SW PACIFIC HWY
SUBDIVISION: ZONING. C -G
I BLOCK: LOT : JURISDICTION: TIG
Project Description: (2) branch circuits. Job # 1023.
•
1 RESIDENTIAL UNIT TEMP SRVC /FEEDERS 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 HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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 OCC:
Owner: Contractor:
DOUGHTY, J PAUL LILLI GEORGE + SONS ELECTRIC CORP
10150 SW CANYON RD PO BOX 339
BEAVERTON, OR 97005 CLACKAMAS, OR 97015
Phone: Phone: 503 - 654 - 8634
Reg #: L1C 35600
ELE 3 -117C
FEES SUP 3185S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/27/2005 $53.50
[TAX] 8% State Surcharge 1/27/2005 $4.28 Rough -in
[ELPRMT] Investigation 1/27/2005 $62.50 Elect'I Final
Total $120.28
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes 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 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Issued By: Permit Signature: -c, ("
OWNER INSTALLATION ONLY \
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
01/27/2005 10:15 503- 653 -6886 GEORGE & SONS ELECTR PAGE 01
t . .,.E� Permit VED . E
City of Tigard t N 7 2005 gA P. No. : ��i�i_ ed d1(�5/
ans9
13125 SW Ball Blvd., Mend, OA
Pb: one 503.63'9.4171 Pas 503.5011.1960 . A ., . P Review ramlt:
Other P
In.peaticin "De: 503.639.4175 CITY OF TIG • e C ' u CI" lteady/By: ,a .. I SI 5e. Pew 1 Ibr
ldasse www.citigartior.us NatiBea/Meebod:
• a . I. . . an ,i )
. 1••.: "n''.:`ld'y " q,a+( lf tffy.` N 1, M;1 ".Y�J -:-..--. ' . ,.
;.:� 1'�'� • 4 :.
�fF t r ' }' ro le' y i - 4 A . �� ''c 'r �, ' t 7 j .
■ .- � � ' 4Je `r s „A� ht.' �7'te.t r. a. Hr:�, r
NW/ ccastr'Ction • JUdditienfalterlstiasl Pieces check all that apply:
• Demolition ■ Other ['service over 225 atttpu oomnt) ❑llaardous looniest
w - v
El Service over 320 0 over 10,000 sq. d,
i _ + : ,; , A W: . ,,1 �N,4` ,,P7 ",: ,
� •
❑ ' _ .. ti';r.:j:p�; :Fs4vi ?k�`��� }4' , of 1 -and 2- family dwellings 4 or more new residential ]- and 2-family dwelling ►: CceimereiaVindustrial ❑ Armory building ❑ System over 600 volts nomhat units in one structure
• Multi ■ — El e ❑� ng over throe dories ❑Pocders, 400 amp or morn
. ❑ lead over 99 person ❑ aed muss or
-, Fr ,';,E 5 to�` :',$--.
t: :a, • a,'f�t?M1?f;tX:` . ❑ESighting RV pelt
L , ^ Health-owe ❑�sr
Job m.: Jo s address: ❑ terry
_• /•: ...'...d / Submit 2 seta of pies with wry ,3f the above_
City/State/ZIP: The above are not applicable to temporary oomtrootioa pandas.
Suite/bldg./apt. no.: Project name: _ �
�' D.w+Mw r.. raw
CMS street/directions to job site: New el mss- er meal►aub tw'u aaIt.
Lrelois Meld garage.
1,000 q. B. cm lase 145. 15 - 4
Subdivision Lot no.: La add•l 500 a4 A ay patios 33.40 1
Tax mop/plied m.: limited energy. residential 75 2
75.00 2
asp m' yrw C3mited mesgy, noo-raaidatNal
Al ' $' r: C' f,-t�l S i�Fl ' ia,' ' Each manufactured or modular
dweiling sndor fords- 90.90 1 2
LJ / I or fee. / otseS Service* or feeders lretaltaliea, eltaufdoa. eadlor re1sealioa
200 a or lew 80.30 '. 2
µrtF`1s;Srf, is r: ; '; 201 amps to 400 amps 106.83 2
401 amps to 600 160.60 _ 2 _
N / • 60 1 amps to 1,000 mop 240.60 2
Ate: O 7 5 YR l� G w G✓ � Over 1,000 amps v volts 434.65 2
Rearmed only 66.85 2
Cityi'3tde/dP: , . . e R 9 7 z z 3 T emporary serv or tti tr wat�MM& alasr Mier '
tobedloa
Phalle: (rOl) 62o— . tZ Pam ( ) 200 +anps or less 6625 1
Owner inlitrWtba: This installation is being made an property that I awn which is not 201 amps to 400 amps 100.30 2
intended far sale. lease, rent, tar exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 ampere 133.75 _ 2
Ownef signature: Date: Brandt draft - new, alosstlsa, or esteatloa. per peed
,: _ , .. • QQ .. " < ;s > ,i„ ... A, Pea for btancb circuits with
? F a•. ••rcr:•. yuL: service or feeder fee, each
Buaise® sane' branch circuit 6.65 2
•
Contact nee:
B. Fee for branch circuits
e i feeder !se / 46.85 42s 2
each Each • id'1 branch circuit l 6.65 ' PT 2
City/State/22P: llasce.weass (ses•dae or lee+ye toot Ldn+ed
MINK ( ) Fax : ( ) Pump or irrigation thole 53.40 2
S ignor cartine ligt 53.40 2
E -ami1• Signal clangs) or iimited-
rrc
extmaion. Describe: fags 2 2
Add . re - rata .
weeleasl NeepM V afire loo o eralkesob e in es aim
-' _ - Per inspection 62.30
City/State/ZIP: e Llc O P ' 76/ investigation per hour (t hr mm) / 62.50 K QZ. )
( ) _ .. _ Fax: ( S6 6 5,499,4' lethistriel pleat • hour 73.75
... Electrical Lin_. ,//7- =WOE" Subtotal 5 3, yo
v. Electricity) signature, required: �� - Plan review (25% "Opera* 10e)
sage =charge (a% Vixen& fee) 54 28
Print name ty ,, A MISIMIN Date: 1 -Z -p
TOTAL r FEE r 1, 7 F'
Attthoaiaed nigoaha+e: 4. 1911111W 4"t Thai t'.rt 11 110kmaia wens If *vomit It set oaetlsed wMaas lee
Print name; efiJ/ v fdot,! DWI: / - . 7" - or • Fee methodology Tr� de* �
-caaty Building Industry Service alma
•• Number of iaboed,oae ear elpjilt rowed.
k
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 09 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Request d ' ZZ� AM PM BUP
Location / 0 -7 -�- Suite MEC
Contact Person -7-7..45v4 ll � Ph ( ) (05 -( — o. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Y r�� ! ELC �r'�O. 5
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
PASS PART FAIL 13/1 PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
•
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
SS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA 40' _ 1 �
Approach/Sidewalk Dated �� Inspect Ext
Other:
Final DO NOT REMOVE this Inspection record from the jo site.
PASS PART FAIL