Permit ITV TI ELECTRICAL PERMIT
PE RMIT #: ELC2002 -00396
A _� I� DEVELOPMENT SERVICES DATE ISSUED: 8/16/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115BA -00500
SITE ADDRESS: 16035 SW PACIFIC HWY
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Reconnect only
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TOIVO SEPP
11855 SW KING JAMES PL
KING CITY, OR 97224
Phone: 503 - 620 -2185 Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect! Final
PRMT CTR 8/16/02 $66.85 2720020000(
5PCT CTR 8/16/02 $5.35 2720020000(
Total $72.20
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 -0080. You ob copies of these rules or direct questions to
Permit Signature: Issued # /1
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:OOpm for an inspection the next business day
Electrical Permit Application , FOR OFFICE USE ONLY
Receiv d t ' /1 �� Permit N o.: f A .939
Date/B Permi N �4�' ! SO
Planning roval� Sign
City of Tigard Test Form Date /B �, PermitNo.:
13125 SW Hall Blvd. Plan vie Other
Tigard, Oregon 97223 Date/ : Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 +i Post - Review Land Use
� a►d I
Internet: www.ci.tigard.or.us , A li Date /By: Case No.:
Contact Juris.: ❑ See Page 2 for
�
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information.
TYPE OF WORK PLAN RE VIEW (Please check all that apply)
n New construction M Demolition [1] Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
' Addition/alteration/replacement n Other:
CATEGORY OF CONSTRUCTION
❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
1 & 2 family dwellings four or more residential units in
El 1 & 2- Family dwelling _ 0 Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑Feeders, 400 amps or more Manufactured structures or RV park
n Accessoi y Building n Multi- Family 0 Occupant load over 99 persons ❑
n Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site addre ` � C FEE* SCHEDULE
Suite #: Bidg. /Apt. #: Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total
Cross street /Directions to job site: New residential - single or multi - family per
dwelling unit. Includes attached garage.
DolOrtA,W� / /'f A Service included:
I "t "l
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 I
'4 Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
,3 Tax map /parcel #: 5 115 BA. -6650t) Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
Services or feeders - installation,
alteration or relocation:
200 amps or less 80.30 2
• — 201 amps to 400 amps 106.85 2
4 .
401 amps to 600 amps 160.60 2
i i PROPERTY OWNER ❑ TENANT 601 amps to 1000 amps 240.60 2
n• v
t Over 1000 amps or volts 454.65 2
Name: To 1 VD se '{' Reconnect only / 66.85 2
Address: 11 $55 $(,t) i Qs P L Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: "Tiqeurok pee 97x)* 200 amps or less 66.85 1
Phone:503 (o. a its Fax: 5o3 ( 5336 201 amps to 400 amps 100.30 2
APPLICANT
0 CONTACT PERSON 401 to 600 amps 133.75 2
Branch circuits - new, alteration, or
ame: i Q QS a� extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City/State/Zip:
B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
2
Phone: I Fax: Each additional branch circuit 6.65
IC) E-mail: Misc.(Service or feeder not included):
CONTRACTOR , Each pump or irrigation circle 53.40 2
Each sign or outline lighting 53.40 2
Job No: w Signal circuit(s) or a limited energy panel,
alteration, or extension* 75.00 2
Address: l
Business Name: ,� • _,1 ., G
004 Description:
`
City /State /Zip: Por ‘1 op, Q 7a-t 9 Each additional inspection over the allowable in any of the above:
Per inspection (per hour - min. 1 hour) __ 62.50 _
,\ Phone: go; g.4. i .66 Fa • Investi fee:
CCB Lic. #: - Lic. • : Other:
Supervising electrician Electrical Permit Fees*
u
P g Subtotal $ & b, g 6
signature required: Plan Review (25% of Permit Fee) $
Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ 5 _ 36
TOTAL PERMIT FEE $ -e79, • 9..0
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: _/ • Date: . F - 16 'UL 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
PrFTY OF TIGA � 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 - .
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
Fill
BUP
Received Date Requested F1 l / AM PM BUP
Location 16 63 5 ! Suite MEC
Contact Person Ph (_____) 74 a - 7<3' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - ELC c -" 456 3
Footing u)/° J I ELC
Foundation ) 2 1
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: _ / ,•-111 SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation V (� + rf l V UOM' - ) n c j ,
Drywall Nailing ) l 1�
Firewall
Fire Sprinkler
Fire Alarm I EP V 1 (` y � 0 , �
Susp'd Ceiling \ 1 / // r te )) / (� ` 1 /
Roof -2• M V V k.\ k.\ pk g1 1G1 )-Al- oc s l�°aVI i lei
Other: 1
Final . P PNi
PASS PART FAIL l r �\ l ) 1� Fi
PLUMBING 3 �' V J V )\� ��!': Pi,AA -•� c,
Post & Beam
Under Slab , �
1' 4
Rough -In
Water Service
Sanitary Sewer J Q S M �'�
Rain Drains � r
Catch Basin / Manhole \ \ .. \ , . N `1 146 =PM
Storm Drain -
Shower Pan 1 V.A. ,
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab _r
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART )
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line �
ADA
Approach /Sidewalk ®ate / ? `� Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from t job site.
-- PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 3 AM PM BUP
Location %603 Sw 7 C( rt C /qui/ Suite MEC
Contact Person Ph ( ) 705 73 Z S PLM
Contractor Ph ( ) SWR
ILDIN Tenant/Owner ELC
F ooting
Foundation / ELC
Ftg Drain Acces Q C vcS `1 , " 1 he a � J S 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
Su
Roof Pr P
er:
Final
PASS PART FAIL
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
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL •
•
City of Tigard Building Department A 13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639 -4171
/ /an��lG p r s ' � II �
Re Roof Pre Inspection Report Form �..�y t•
Requested by Telephone f C63 ) lo..� 73Zs'
Job Address At) 3 5 , 71.0 e Permit #:
Roof Access Location 409 V)2(
Date Requested (5 /30/6 Time Requested 9'30
Type of Existing Roof ? 14 SP
1. Slope of roof deck
2. Roof /Penetrations /General Conditions air ❑ Poor
3. Are there blisters? 4 Yes [moo
4. Are there cracks? ❑ Yes No
5. Is there evidence of water ponding? ❑ Yes El<
6. Is moisture present under roofing (leak)? ❑ Yes ,0'N
7. Is roof insulation existing? ❑ Yes 1211
8. Is roof insulation wet? ❑ Yes 12-NO
9. Property line setbacks on all sides > 10 feet es S No
10. Building size [t sq. ft. ❑ < 6000 sq. ft ❑> 6000 sq. ft.
11. Building height 8-.t ❑ > 2 Stories
12. Class of roof required on-rated ❑ A. [; B.
❑ C.
13. Type roof deck E Combustible
❑ Non - Combustible
14. Roof drains Jj.erovided ❑ Required ❑ Adequate
15. Overflow drains ❑ Provided t;� q Adequate
16. Attic ventilation ❑ Provided y c!f: equired ❑ Adequate
17. Roof listing [l- Prirvided ❑ Required
18. Installation Instructions rovided ❑ Required
To re -roof this structure the following conditions must be met: -
't/ C A -f 7f Z4 /7 Z X // //Lkor) /ce'
The re -roof proposal is pproved for permit issuance if the conditions listed above are met. After obtaining your permit you must contact the
Building Division for an inspection when the roof deck is ready for the first inspection. The first inspection for a complete tear off is the deck
inspection. For a built up roofing system (overlay), the first inspection is at the start of the job. After the re - roof is complete, a final inspection is
required.
zei
Inspector 7_, _`.� Ext. Date O /
%
REitglingliteroof Form