Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00484
i w +i ; DEVELOPMENT SERVICES DATE ISSUED: 8/6/03
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 101 AA -08200
SITE ADDRESS: 12455 SW 68TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT : 029 JURISDICTION: TIG
Project Description: Roof top gas pac and service plug
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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ROTH, JACOB TIMOTHY JR + THERESA EFFICIENCY ELECTRIC
12600 SW 72ND AVE #200 P.O. BOX 872791
TIGARD, OR 97223 VANCOUVER, WA 98687
Phone: Phone: 503 - 805 - 5821
Reg #: LIC 101543
ELE 26 -878C
FEES • SUP 3003S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 8/6/03 $53.50
[TAX] 8% State Tax 8/6/03 $4.29 Elect'l Final
Total $57.79
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: A „ �_
OWNER INSTALLATION ONLY
The installation is being made on property 1 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
FROM :EFFICIENCY ELECTRIC FAX NO. :360 896 -2032 Aug. 05 2003 10:12AM P1
1 •
►-
•
Electrical Permit Application r ! 1 l i 1 I ,1 n i, I ti
T,. Date wed. El 0 Permit nr -E(,�, .. no _00 4
,
City of Tigard ProjecUappl. nu.: Expire date:
City of Tigar Address: 13125 SW Hall Blvd, Tigard, OR 97223 issued:
Phone: (503) 639.4171 railli
Fax: (503) 598-1960 Case file no.:
Land use approval:
O 1 & 2 family dwelling or accessory ommerciaUindustrial O M ulti -tami ly U Tenant improvement
Q New consttvc tiom UAddition /alteration/replacement ❑ Other 0 Partial
Job address: / /, 5 1, a Bldg. no.: Suite no.; Tax map /tax lot/account no.:
LA: Mock: 'Subdivision: .. —.
Project name: I Description and location of work on premises: Fie f f p e,, 5 e_d_ L „
Estimated dato of completion/inspection: of G 1 v
Job so: Fes Mai
Business name: eff_G1 .` ...c./.0-4!h/C.. - -- otweliptiew Qty. (W.) Tem ao.tmat
Newandleatial-Ilaskuraulti-auslts per
Andreas: 4196 /A D A re•! T4) ttwalthavesexhactalwaassortwairmaw
Ci(Y: lJArvr. State :(,,a JZIP 17 8ercieetias.ma .
Pbono f 3 80.E 'r J LTax: 1-2d 3 e -mail: __ L or 1M 4
Ca3 no.: �A / fV 3 ! Elec. bus. lie. no: A(,. g7 Q G finch additional sea su n. w txat�,n nor Limit .
City /me. • ic. no.: r.i en er g y, • 2
/� 2 energy, rum- reddemtinl 2
it f' eS a 2 patch menwfacaarod hoax ot modular dwelling . .
S'._. ., saperv electrician (requited) Uwe Srr,jce and/or feeder w . 2
Sap. elect naps (pan): I -11 ,. oaires 1 i.•.... no: 009 S SelvkooOrfOO ere —cis aWtiea, I
dlerdfoaorreleeation:
V I( 014 1 4 I 1 1 111 \ 1 14 200 amps or km 2 ec Name (print): m 4 /'� .fNG/�f 101 a m 600 2 �...
M address: a,/ - - �p A ` _ 601 mars to 1000 amps 2
City: - ..,.'M State:M. 7 . Over IMO amps or vote . .�... i
Phone: Fax: E-mail: Re enneeet only 1
Owner installation: The installation is being made on properly I own Temponwyae►vICKOr feeders •
hastallatimtenti
which is not intended for sale. lease. rent, or exchange according to
ORS 447, 455. 479, 670, 701. 9mis Of less 2
201 amps to 400 amps 2
Owner's signature: Date: 101 to 600 2
J:\( , I \ F lit grants eluvial - mew, allegation.
or =tendon per panel!
Name; A. pee for hranch ci.auiu With purchase of
Addle ss: service or seater 4e, each branch circuit z •
City; Stale: I ZIP: B. Fee for blanch are-nits valetas perdu= - •
Phone:
� Fax: F3 mail: of sav:c or facia fu. fast Wench dealt � g 2
E ach additional branch circuit:
Mine. (Service erteedernotlnchsti lk
D Service aver 22.5 anzp4axomecnl O Heahh cave facility Each pump c ration tirde w - 2
U S e r e im 1wcr 320 Nair -m a lg of I &.2 O Hamadan gramon Each slim or outline 4okinc 2
fmmly Swellings U Banding one 10.000 square that four or Siena) thongs) Ora (imire4 t'neta panel.
U System ova 600 volts nominal role teddmoal antes in are muccac ahesatimi, or wombs. _ 2
U &IIId r'1 over du cc sitars U Feelers. 400 tare a Mum •Deevrwuon:
U thumpant lead over 90 parson t) MAroifeeneed wuaome ex av parr Iltse0 stiddgiosai taapeedonaverfeesalownblomashyo f .alone:
U h ae Jlightiap plea O Other: • Per urrpemon 1 1 1 1
Sitbbllt as s of plan with any of the shove. Ineestioni m fee
The above are not applicable to testporary construction service. Other _
Nd sal jai li iteu aria coda Ma tdeae au j v.u�tion for rase iaaxmsenn Notice: This amend application Perm fee w ~
s
l visa ❑ Maattemd expires if a pehnil w not obtained Plan review (al _ v /•) $
Cacdi, gated ersnt.m - ____/___, / __ within 18O days after it has hoes Slam surcharge ($%) --S .�
Espies accepted as complete. TOTAL $ .
5 t
�ardholda wamp m
ss noma , 44048I5 (Mini( tri n
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested AM PM BUP
Location / 6 (c7 Suite MEC
Contact Person Ph ( ) C9 7— ZZ PLM
Contractor Ph ( ) SWR �i�
BUILDING Tenant/Owner /1466 ��NCI /ft- EL C)'- oo (/ T U C7
Footing
Foundation ELC
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 ///"---M---
Susp'd Ceiling
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
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
M'': 'AN.. ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
.e= ` PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA /►
Approach/Sidewalk DatoA • 49 o3 Inspector _, 2 Ext
Other: �/
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL