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Permit
AT CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00558 AIM DEVELOPMENT SERVICE'S DATE ISSUED: 8/31/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AD - 00100 SITE ADDRESS: 12725 SW 66TH AV: 202 SUBDIVISION: WEST PORTLAND H HTS ZONING: MUE BLOCK: LOT : 034 JURISDICTION: TIG Project Description: (1) circuit, add (2) can lights make single switch into 3 -way. 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: 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: PARROTT, VIAL LLC HIGHLEND ELECTRIC COMPANY INC 12725 SW 66TH AVE #202 PO BOX 655 PORTLAND, OR 97223 TROUTDALE, OR 97060 Phone: Phone: 220 - 1935 Reg #: LIC 109850 SUP 2431S FEES ELE 26 -962C Description Date Amount Required Inspections [ELPRMT] ELC Permit 8/31/2004 $46.85 [TAX] 8% State Surcharge 8/31/2004 $3.75 Rough -in Elect'I Final Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By: ) 1 Jl�� Permit Signature: y�i n OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Cali 639 -4175 by 7:OOpm for an inspection the next business day FROM : HighLend. ELect. Co // ��,(/ PHONE N/O. :: 665 +7436 Aug. 30 2004 09:2OPM P2 'FOR ;01, ICE USE ONLY " `, Electrical Permit Application Received /n Electrical — D ate /3 3/ �l7 PermitNo. �[v C�I j j City off Tigai ii ECEI �® Planning Approval Sign N . - _ Date/ y; Permit Na,. 13125 SW Hall Blvd, Plan Review Other _ Tigard, Oregon 97: 23 AUG 3 1 2i : " Date/By: y: —• ,•+ Permit No. : • /� eview Land Use Phone: 543- 639 -41.71 Fax: 503 -59$ -1960 , . Date Post - Re Case Nn.• Internet: www.ci.ti CITY , "i M ,,; y ! - -� ruris.; a se. P ay,e2 f or 24 -hour Ins Request: 503- fRiktll DIVISION Namc/Method: r 1 Supplemental Xnformation: y r .{','!:��4p�'s �'�i ,�p:A r �� �' C1it1,+....+BL/�t: ' i9���ifl� . '` l5 ..kg 2k• .M1i.', i .__ `�i r_ ` Tt a a i Ui ii _, u,f ` ?, n...::: •`. t ; z :s .. e.. . New construction Demolition ^ © Service over 225 at bps- ■ Health -care facili ty commercial 0 Hazardous location A clditiozl/alteratiot> lacerl.cnt ❑ Other: 0 Service over 320 amps - rating of 0 Building over 10,000 square feet, c . T s •. r14 1E � 3 � T Th MI's' v '; 0ti - & :!. 1 & 2 Iamily dwellin s four or lucre residential units in I & 2- Fa 0 System over 600 volts nominal one structure dwelling i! Commerciai/lndustrial Building over tin ee stories ❑ Feeders, 400 amps or more Accessory Building w Multi - Fatally El Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ E gress/1ighting plan !] Other: ME Master Builder r Other: Submit sets of plans with any of the sbuve e I9l' : oR ;T iMad ' ..`fi ! �»? * ;' r Fly ` rl ble to tern , orar construction service. „ �, The above are not a r ca Job site a ddress: _ a _ ' � 2 S' • /,� r , ./- i '' "' 4...� i t�.� � l fT" � : ' Suite #: �,�C��Z ._., BI /Apt. #: Number of ins . ectfions • ' . ertnit allowed Project Name: _ Descri . ties Q Tota II -- New resfdentlal- single or multi - faintly per Cross street/Directions to job site: dwelling unit Includes attached garage. Service included: 1000 .:.. R or less 145.15 ' m - r ) . - ' . 7 Each additiona1500 :.. ft. or • • pion ther of . (Jf� Limited en= ;, residential 75.40 • Subdivision: _ _ - - Lot #: Limited en= 3 . non residential ?s. arcel #: Each manufactured home or modular dwelling Tax ma .« .. service and/or feeder 90.90 1A : ��"Wit rr! ,;p r: t $ r .017 ®� .. _: u's �s : � services or feectcrs - iuetanation, �J `' . it � %iii . LL /4 . alteration or relocation: I� - ' � 200 amps or teas 80.30 c /.y.z 201 amps w 400 ammys 160 A 3 .1.tf'lt.>' _ _�_,.._... 401 to 60 60 antpe y? amps w 1000 a mps 240.60 re'rEi I�k �4 ,S N", gib •, "�' :. E. ''� ... . 'n 3ui, i�;ih .J Over 1000 amps or volts R 454,65 / Name: �i. 1. 66 85 econnect only ` . I.I J t _ ' Temporary services or feeders - installation, � S' Address: alteration, or relocation: e. ,� 200 am 3 or lase 66 City! StS#6 /Zlp ;. j/ � . / •�Y�'t'�• _ . •'� 100..30 � 20 amps to 400 anus Phone: y �/O Fes: 401 to 600 amps 133.75 , � r ?r ;t. //� : • e I[ r ct?,je ;( ,:..;.. , :a1 Branch circuits - pew, alteration, or 'h4Sb �w. yG.e�i'1 �, � { � .� 1 '...: ,'� �LCV extension per panel: N' s I ..� _ /'�41Ria r A. Fee for branch circuits with purchase of Addre ss j3 service or feeder fee, each branch circuit 6.65 /StatE /l — — ~��' B. Fee for branch circuits without purchase of _ _ fir service or feeder foe, st branch circuit 1 46.85 Phone: _ .l Fax: F,ach additional branch circuit 6.65, lvfisc.(Service or feeder not im luded): Li nt on circle 53.40 E-mail: y � • � Each pump or Q�[l > i :' �4 , t�'�s ®} i , ?i' ;: tf . ?s or outline lighting 53 Job No: Signal circuits) or a limited energy panel. r i alteration, Or extension _. Page 2 Business Name t/! 0 " # • , rDescription: Address: 4 0 4 0 J ,✓� -, — t• • Each additional inspection over the allowable in spy of the above: C,1 /,S.tlteiZl.: vA-e_ ! / � tm C r per . - lion . hil). 1 hour 62.50 �i� our m Phone ,_, _ q ? � ' 1 ?ax 7 M 7 7 f2_ o �� on fee: , CCB Lic. #: / 5� Lic. #: _ -.— , 'i i, : �L' Y L a , 9°" ",,. ' as h. '•, Supervising e,lectrici Subtotal �1� 3 si_ attire re weed: - Plan Review (25% of Permit Fee $ �, v .- me: NT State Sur c har � e 8% of Permit Fee Print Name: p �� r t�[S1L� TOTAL. PERMIT FEE $ . Authorised ', ., ` ✓ � /�� Notice: This Permit appticat1On expires if a permit is not obis within Date; 180 days after it has been accepted as complete. Signature: 7. ._ - $ *Fee methodology set.by Tri- County Building Industry Service Board. ___.C--e-L&4Y.0 _1:62—.(------...— (Please print name) • .,..win.......... n.....-.<tti4• 0i /03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 7- /3 AM PM BUP t0 Location / a 1 oZ lQ '- Suite g MEC Contact Person 9ty A — Ph ( ) / ,� 3 / ( 7 Z O PLM Contractor Ph ( ) SWR BUILDING - i o wner ELC - 6 6 ' 5 Footing 6 - 0 is 6 Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam NL Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation A &'S - j /k,,ct - Drywall Nailing �/ ` Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling CV l Roof Other: 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 q_Pe/Levl (7 91 CI&r-i2 -w/57 1 z7 ,Jer6. Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage larm F ; ❑ PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line j� 14fri Approach/Sidewalk Date ✓ 3 ✓ �/ Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL