Permit r CITY OF TIGARD ELECTRICAL PERMIT
t in: PERMIT #: ELC2007 - 00292
. = COMMUNITY DEVELOPMENT DATE ISSUED: 4/30/2007
I 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
' x i5t'AT 111%, PARCEL: 1S134DA-01600
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -7
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: GU
Project Description: Service and circuits to bring electrical to code.
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: 1 W /SERVICE OR FEEDER: 6 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
YUAN GU SYLVANIA ELECTRIC CO
2605 NW BIRKENDENE ST 5328 SE 109
PORTLAND, OR 97229 PORTLAND, OR 97266
Phone: 503 - 740 - 5549 Contact #: PRI 503 - 762 -2714
FAX 503 - 771 -5305
FEES
Description Date Amount Reg #: ELE 26 -1086C
[ELPRMT] ELC Permit 4/30/2007 $120.20 LIC 167146
[TAX] 8% State Surcharge 4/30/2007 $9.60 SUP 4830S
Total $129.80 REQUIRED ITEMS AND REPORTS
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
w• will be done - cordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
ore than 180 days. A ENTIO : i -gon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 throug' 0' - 952 - 031 - a0. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
ssued By: —. . JL_\/ 0 / Permittee Signature: e„, UteN.e.eda__
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:
ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. EL - 4 , %a �. St r ' 1 — i DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Elee- Permit Application • FOR OFFICE USE ONLY
City of Tigard Received permit No.: s •
71
13125 SW Hall Blvd., Tigard, O R 97223 Plan Review
' e Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: / (0- Supplemental information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all otherinstallations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 1/1 6 3 5 W to 6 Ave 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 'rl (mkt bc._ 9 ''7 WI ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. 110.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
Slydi C. -� residential (with above sq. ft.) Limited energy, multifamily
75.00 2
�,Lh �� � �
0- n Services or feeders installation, alteration, and/or relocation
!��C� 200 amps or less I 80.30 To, 50 2
❑ PROPERTWN - I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT - . W I ❑ CONTACT PERSON above service or feeder fee, 6.65 pl?. 94 2
Fee branch ah circuit
Business name:
t+f•t �t� L. L. G B . Fee for branch circuits
Contact name: S f 1....V/ 4) 8 U /r✓(8 without service or feeder fee, 46.85 2
first branch circuit
Address: 53 ZB • 5 - g /( ST— Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: ?1, v 0 t q 12 (oA. Each manufactured or modular
_ dwelling, service and/or feeder 90.90 2
Phone: (Sb3) '354 11%4 Fax:: (7 O3) --/ '1 / 5'$09 OS Reconnect only gi 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
t_ � 6-11- o , Signal panel, or limited -
Business name: a U energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: (61 14 6 Electrical Lic.:z6,10g6c Suprv. Lic.: tft3o S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES �
Suprv. Electrician signature, required: Subtotal: 7� , •
Plan review (25% of permit fee):
Print name: S //,.V/ t.) 6E/ 8. Date: State surcharge (8% of permit fee): 9, CpQ
Authorized signature: TOTAL PERMIT FEE: r ` ,g0
Print name: Date: This permit application expires if a permit is not obtatne wi thin 180
days after it has been accepted as complete.
•
' Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PenoitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
111 11kt .
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
Garage Door Opener* `
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY
Fee for each commercial $75.00 .t.. :.
system :..:, .,to; :. r: _,r.:, P. •ip '?' a i'v -v •a :,
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
0 HVAC
*, s1
❑ Instrumentation _
❑ Intercom and Paging Systems ,.. " ; R ' 'tr `•-` !:' 47.1
ID Landscape r+rigation. Control* '`• { `•
0 Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
Other 3 ';
J` •
Total number of commercial systems: , ,
*No licenses are required. Licenses are required `
for all other installations - .., •
I:\ Building \Pertnits\ELC- PennitApp.doc 03/23/06
,Ef /A/72S / / 77 J/9( �O/,� 6 /zz /o 7 4L
5 , I Y CITY OF TOGARD ELECTRICAL PERMIT
71 COMMUNITY DEVELOPMENT PERMIT #: ELC2007 -00292
k „j DATE ISSUED: 4/30/2007
TIGARDj 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
,, ' iz iVOil g PARCEL: 1S134DA -01600
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: GU
Project Description: Service and (6) circuits to bring electrical to code. 5/2/07, ADDING TEMP SERVICE. 6/22/07 ADD (14) BRANCH
CIRCUITS & REMOVE TEMP SERVICE.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 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: 1 W /SERVICE OR FEEDER: 20 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
YUAN GU SYLVANIA ELECTRIC CO
2605 NW BIRKENDENE ST 5328 SE 109
PORTLAND, OR 97229 PORTLAND, OR 97266
Phone: 503 - 740 -5549 Contact #: PRI 503 - 762 -2714
FAX 503 - 771 -5305
FEES
Description Date Amount Reg #: ELE 26 -1086C
[ELPRMT] ELC Permit 4/30/2007 $120.20 LIC 167146
[TAX] 8% State Surcharge 4/30/2007 $9.60 SUP 4830S
[TAX] 8% State Surcharge 5/2/2007 $5.35
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $302.55
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: - _ Permittee Signature: Awn _ —
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or re .
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 4 /\/ /- /Jl°c -/ e "9-T /0 n/ DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
� ° ELECTRICAL PERMIT
CI l TIGAR® PERMIT #: ELC2007-00292
` � '' I 4 � COMMUNIT DEVELO
� 4 �� J E ISSUED: 4/30/2007
D AT
l Tt t 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134DA-01600
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: GU
Project Description: Service and circuits to bring electrical to code. 5/2/07, ADDING TEMP SERVICE.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 1 W /SERVICE OR FEEDER: 6 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
YUAN GU SYLVANIA ELECTRIC CO
2605 NW BIRKENDENE ST 5328 SE 109
PORTLAND, OR 97229 PORTLAND, OR 97266
Phone: 503 - 740 - 5549 Contact #: PRI 503 - 762 - 2714
FAX 503 - 771 -5305
FEES
Description Date Amount Reg #: ELE 26 -1086C
[ELPRMT] ELC Permit 4/30/2007 $120.20 LIC 167146
[TAX] 8% State Surcharge 4/30/2007 $9.60 SUP 4830S
[TAX] 8% State Surcharge 5/2/2007 $5.35
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $202.00
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 -00
, t , h 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 �. v , Permittee Signature:
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/30/2007
Phone: (503) 639 -4171 N, .�'�,�,����
Inspection Requests (24 Hrs.): (503) 639 -4175 ....�W" !
INSPECTION. WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 70
SITE ADDRESS: 11163 SW 106TH AVE_ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: G(J
DESCRIPTION: Service and (6) circuits to bring electrical to code. 5/2107, ADDING TEMP SERVICE. 6/22/07 ADD
(14) BRANCH CIRCUITS & REMOVE TEMP SERVICE.
OWNER: GU, YUAN PHONE #: 503 - 740.5549
CONTRACTOR: SYLVANIA ELECTRIC CO No 1 , 04'/O PHONE #: 50176 12714
Inspection Request Scheduled For: Date: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 093-01 501997 -5955 N
Corrections /Comments /Instructions: E h�Y
r 9 o
— r vi 5 i s cm n► P1 ' I 6p of
e-r3 Al Itl■ v� • ry % Er N RGI. k CA 0 5
No T GZ . rv\, i 1 Cr M,L -
(?6 ki■ wo k 4 to) D 6A •
1
_ iN b CY f'N 0�
-7 \n‘-. PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED .
Inspector: G ' M tie Ii Date: b'24.01 Phone #: (503) 718- JJ^[
CITY OFTIGARD ,*
BUILDING DIVISION PERMIT #: ELC2007 -00292
,13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/30/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 „ r — 1.L
INSPECTION WORKSHEET FOR DATE: 6/25/2007 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GU
DESCRIPTION: Service and (6) circuits to bring electrical to code. 5/2/07, ADDING TEMP SERVICE. 6/22/07 ADD
(14) BRANCH CIRCUITS & REMOVE TEMP SERVICE.
OWNER: GU, YUAN PHONE #: 503 - 740.5549
CONTRACTOR: SYLVANIA ELECTRIC CO PHONE #: 503 -762 -2714
Inspection Request Scheduled For: Date: 6/25/2007 Pour Time:
Code # Inspection Description ( Confirm # Contact # Message
1 ?0 Electrical rough -in 050854 -0: 503 - 997 -5955 N
Corrections /Comments/ Instructions:
� oak LocA4g -
NO S WL p7 botk.
91i15
MY
❑ PASS ❑ PARTIAL APPROVAL CANCEL yNO ACCESS
X FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 6R) Date: t( �t) Phone #: (503) 718 - lA 'V
i
CITY OF TIGARD r / \.. r
BUILDING DIVISION `• ^' • PERMIT #: ELC2007 -00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/30/2007
Phone: (503) 639 -4171 r �1
Inspection Requests (24 Hrs.): (503) 639 -4175 1.1.
INSPECTION WORKSHEET FOR DATE: 5/11 /2007 - TIME: 7:01AM PAGE: 7
SITE ADDRESS: 11163 SW 106TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GU
DESCRIPTION: Service and circuits to brine electrical to code. 5/2/07, ADDING TEMP SERVICE.
OWNER: GU, YUAN PHONE #: 503- 740 -5549
CONTRACTOR: SYLVANIA ELECTRIC CO = t A,b PHONE #: 503-762-2714
r
Inspection Request Scheduled For: Date: 5/11/2007 ` Pour Time:
Code # Inspection Description i no firm #' Contact # Message
115 Electrical service - \ 048145.01 ) 503 - 997 -5955 N
Corrections /Comments /Instructions:
•
, PASS ❑ PARTIAL APPROVAL ❑ CANCEL fI NO ACCESS
I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
inspector: ( 1• Date: Phone #: (503) 718 -
A 2/ V/ EL �/Z, / T /Or+i 6_ GJO7 4,/zz / 7 ' b�
4 "�� �; ; � ' �� �/ �$ _ _ ELECTRICAL PERMIT
�` CITY OF TIGARD
It PERMIT #: ELC2007 -00292
COMMUNITY DEVELOPMENT DATE ISSUED: 4/30/2007
— ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
try _'u 1, 1 g PARCEL: 1S134DA-01600
SITE ADDRESS: 11163 SW 106TH AVE ZONING: R -
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: GU
Project Description: Service and (6) circuits to bring electrical to code. 5/2/07, ADDING TEMP SERVICE. 6/22/07 ADD (14) BRANCH
CIRCUITS & REMOVE TEMP SERVICE.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 20 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
YUAN GU SYLVANIA ELECTRIC CO
2605 NW BIRKENDENE ST 5328 SE 109
PORTLAND, OR 97229 PORTLAND, OR 97266
Phone: 503 - 740 - 5549 Contact #: PRI 503 - 762 -2714
FAX 503 - 771 -5305
FEES'
Description Date Amount Reg #: ELE 26 - 1086C
[ELPRMT] ELC Permit 4/30/2007 $120.20 LIC 167146
[TAX] 8% State Surcharge 4/30/2007 $9.60 SUP 4830S
[TAX] 8% State Surcharge 5/2/2007 $5.35
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $302.55
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: --) , —_ Permittee Signature:
–
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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: (A/ ,4/i C' f} T/p // DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD - ,-
Bt LbING DIVISION PERMIT #: ELC2007-00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/30/2007 •
Phone: (503) 639 -4171 A , pil 4,
Inspection Requests (24 Hrs.): (503) 639 -4175 '`' i(
INSPECTION WORKSHEET FOR DATE: 5/212007 TIME: 7:01AM PAGE: 74
U
SITE ADDRESS: 11163 SW 106TH AVE t N a 6\ D a u CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE: .
PROJECT NAME: GU
DESCRIPTION: Service and circuits to bring electrical to code.
OWNER: GU, YUAN PHONE #: 503-740-5549
CONTRACTOR: SYLVANIA ELECTRIC CO PHONE #: 503 - 762 - 2714
Inspection Request Scheduled For: Date: 5/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 047488 -01 503 -387 -5355 N
Corrections /Comments /Instructions: -
bo I,
(i ,,,,--- I ads `C Ni v We krectlaQ S I
( inn tv.G b 7w3 P61AIRk_ et LI.
•
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
7 X 1 FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , .. N661-6 Date: 5 Z' 01 Phone #: (503) 718- 214