Permit fi CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00325
; DEVELOPMENT SERVICES DATE ISSUED: 7/16 /02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 DA -00104
SITE ADDRESS: 13333 SW 68TH PKWY
SUBDIVISION: FARMERS INSURANCE ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Elevator Disconnect
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: 4 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:
F I G HOLDING COMPANY ELECTRICAL CONSTRUCTION CO
REAL ESTATE ACCTG PO BOX 10286
4680 WILSHIRE BLVD PORTLAND, OR 97296
LOS ANGELES, CA 90010
Phone: Phone: 224 -3511
Reg #: LIC 049737
SUP 2986S
•
ELE 26-45C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 7/16/02 $73.45 2720020000( Elect'I Final
5PCT CTR 7/16/02 $5.87 2720020000(
Total $79.32
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 may obtain copies of these rules or direct questions to
Permit Signature: A/f 1 . / it/
6
Issued B Y�
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
07/12/2002 15:37 5032205347 LYNN ERICKSON PAGE 02
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1 k
A Electrical Permit Application
• Date received: Permit no.: ELLj„002• -005L
,,j.'.`.���! Clty of'Titgard Project/appl -no.: Expire date:
• City of Tigard Address: 13125 SW H�ll 13.l�d,�T O Y 2 23 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 JUL 12. 2002 Case file no.: Payment type:
Land use approval: , l ! V n02' �
'fl'1'E OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction ddition/alteration/replacement 0 Other. 0 Partial •
JOB SITE INFORMATION
Job address: , X3' Sk,.) p 0 .., Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot:. Block: 1 :T ,,,.,,A
Project name:rh a ^t- t - 1 Descnptlon and location of work on1remiises: v.\ a vti44-n r 'A% s c 0 r ..c c ki
Estimated date of completion/inspection: 0\ ,
=i. . '.......(:O TRACT'O1( I' I..1,C1110`.: , _ .: 1_,,,. _ _ . " .. E S 211,EinJI,1:...
;.. ,. _ ,
•
Job not "7 D S . Fee
B
Mil usiness name: ,. 'uOq 004 UIJ
New residential-single or multi-family per III
Address: j�(J /3 1 0 . 0
' dwelling unit. Includes attached garage. •
City: * i. a , State: p - ZIP: • . . Servicetnetudeth
Phone: • 7 Fax: _ O y-3011 E-mail: C WOO 4
no.: .. ,�, IK ,;"‘V _ V Elc. bus. lie. no: G „ I t/- dditio �� reaidential � �um 2
!E etro lie. Amur 0 , 0 MN. MEIN
,*, . ..firril sualsark -7 - Each manufactured home or modular dwelling IIIIII
z Date Service andfor feeder 2
Uceose no: • i S
alteration or relocation:
PROPERTY OSVNElt r ., : .� 2
Name (print): A tr e rs r ,3 .. 201 amps to 400 amps _U 2
Mailing address:
401 amps to 600 amp .�� 2
601 crops to 1000 amps
s
City: State: ZIP: Over 1000 amps or volts
Phone: Fax: E -mail: Reconnectonly
Owner installation: The installation is being made an property I own Temporary services or feeders • •
which is not intended for sale, lease, rent, or exchange according to mstaUptlon,slteration , orretotstion: II
201 amps-or less 2
ORS 447, 455, 479, 670, 701. • to 400
' 201 aropsto400am•s _MEI _ 2
Owner's signature: ... Date: . 401 to 600 am ��� 2
_ ENGINEER Branch circuits -new, alteration,
or extension per panel:
Narne: A. Fee for branch circuits with purchase of
. Address: = vice or feeder fee, each branch circuit 2
City: State: ZIP
of service or feeder fee, firstbranch circuit: X 1 .' c,p7" 2
• Phone: • Fax: E -mail: Each additional branch circuit: _ a
PLAN REVIEW (Plt•.tsc t•hccic all that apply) Misc. (ServIce or feeder not included):
O Service over 225 amps - commercial o Health-care facility Each1ump or irrigation circle 2
0 Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension _ 2 •
O Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable to any of the above
0 Egress/lightingplan 0 Other: Perinspeetioo I 1 1 l
Submit sets of plans with any of the above. Investigation fee - _
• The above are not applicable to temporary construction service. Other
•
Not all jurisdictions accept credit cards, please call Jurisdiction for more information. Notice: This permit application Permit fee $ 73•
0 visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
credit card number: / / within 160 days after it has been State surcharge (8%) .... $ S
Expires TOTAL as complete. TOTAL $ 'l �► `3 7
Name of cardholder as shown on credit card
S
Cardholder signature Amoum 440-0615 (6AOICOM)
CITY OF TIGARD 24 -Hour
BUILDING- Line: (503) 639 -4175
INSPECTION DIMISION Business Line: (503) 639 -4171 MST
�� - BUP
c�
Received Date Requested / �)i AM PM,��`� BUP
Location / 333 e Suite MEC
Contact Person Ph )'S v — 0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner � /YI?QA ELC 117) 3 °ZS
Footing
Foundation ELC
Access:
Ftg Drain ELR • A
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall 6 ` ?Pt �Sv
Dwall Nailing 1t �� 1..� '
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling �' , - • ur r
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
1%= D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
') PART FAIL
SI Please call for reins ction RE: 111 Unable to inspect — no access
Fire Supply Line r� �,
ADA Approach/Sidewalk Date v Inspector �" '—jC Ext
Other:
Final DO NOT REMOVE this Inspection record from the] site.
PASS PART FAIL