Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00035
14 DEVELOPMENT o
SERVICES (503) 639-4171
DATE ISSUED: 2/5/02
7 ' a 13125 SW Hall Blvd.,
PARCEL: 1 S136AA -01500
SITE ADDRESS: 10313 SW 69TH AVE.
SUBDIVISION: FUR VALLEY ZONING: R -4.5
BLOCK: LOT : 006 JURISDICTION: TIG
Project Description: Installation of 2 branch circuits.
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:
LUKE -DORF BENTLEY ELECTRIC
10313 SW 69TH 41547 SW WITHYCOMBE RD
TIGARD, OR 97223 GASTON, OR 97119
Phone: Phone: 503 - 985 -9500
Reg #: LIC 44467
SUP 1382S
ELE 2 -20C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 2/5/02 $53.50 2720020000( Wall Cover
Elect'i Final
5PCT CTR 2/5/02 $4.28 2720020000(
Total $57.78
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. ATTENT N: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 - ugfi OAR 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1-800-332
Permit Signature: Issued By:
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: ,7)1 Ct DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
JAN -30 -2002 07:56 PM BENTLEY ELECTRIC. INC. 503 985 9595 P.01
. `95 -0N • • • • 1 1 il•: Yli�l .l
Electrical Permit Application tlt•i•It
-4 WASHINGTON G'OUNT �' Halt received: �'� Permit no, �LC �Da -000 • S
Address 1 SS N. 1st AV, Suite 3S0 12, Hillsboro. OR 9712.1 Project/appl _no . _ - _- 1- :*pint date.
Ok tilf' Phone: Sf)1_84& -3470 Fax: 503 - 846.3993 Date issuatl. ter Receipt no.:
interne+ Address: www.co.waahingtou.or.ua 77& Case file no Payment type!
Laud use approval: • ._- -- __ _ _ -- -_ _
'1 ,• 1•r 1 rri x.-.1; 1- - -
l; 1 & 2 family dwelling or accessory U Commercial/Industrial 0 Multi - family () Tenant improvement
0 Ncw construction !.I Addition/alteration/replacement 0 Other - -.• • -_ _- _ -.___ L Partial
_ ,1,r,•, -. ,1I1. 1•..1:;1:_.1,\!!,
Job address_ )03 — bG�_ 6 7 City 17611 Idg. no.: .Suite no_: -- Tax reap /tax lot/account no._ -- - -
Lot. -_ P - I tock: 'N /A Subdivistou:
-- - - W _ _ _
- _ - _-- _ -___ _ • __ _ -
Proiect name: Lu. e.4. Description and location of work on premises: N t w Liv K? iii Cy
1%stimated date oleo lotion/Ma ction: 2_ Er o L -� • ... _ _ .. .1 ....... --
- - - - - - - -. - - - - I I:I- -. ; , . I I! I - ` ? - - - -
Job no: _ Poe Mu
- - - --
_ - - - - - -- Dascrfpdnn jQry. (co.) Total .rinse
_ - 1
Business Hanle: � BEY �( , ,rnL4 New reattlettlal- dapkerreok4familv
Addresa_ .. .. y7 S _ .... _ - .1 n
City: p, tr —
--------
"tale: ORTZ(P - - - - - - unto Included:
Phont:: 71sq - ( 4 , „ 1 0 F : t x : .4 - B o r a t e woo . ft. ur lets - . . . 125 00 _ -- 4
Each addition 500 sq. fl oe portion thereof SS UU i
CC: i nt.: yy (, i� Y F.Irc. bus. lit:. no: a -aOG 60, Linnet ntetgy_ 1 rZiy .. .,.---- 7:47 n0 i - ±7
1 Cityhne U c no et rith.t14 — . limited energy. Multi- Family 55.00 _ 2
Bach ntanufactural htmsc or rt�xlulur 4v/riling Service and/or r 2 f -- - - �� !ceder 85.001 1 Sitninii al iiprrtisinc E ' •ion aired) Uate Sup. elect name (print). ��t rdnl MC
no: i 5) $ Services or feeders - installation, .i
alteration err relocation:
200 toper ter less 75 00 , - _� - 9
Name (print): Led ti- - Z?P F LNc . 201 amps to 400 amps _ 100.00
Mailrny, address: IO • — �W (�!T(F --A ✓- -- •-------- _._- __. ---- ul songs to oW amps Y _� 1 . S0 oU 1 --- 7 --- •
- _ .-- ----- •--•-- - 601 antes to 1000 says 2 25.00 Iira
City. - Aw _ 1' Sate: 62_1 2-L - --
... - -.• . -- -- .._ C� ' .° river t1N10 an or rr>!t. 4 20.00
Phone: S98 !IB' c, Ti ax 51e, t :c 32.(& ath Reconnect only -.__ ..._..-- ...__._ •___.l_ 65.00
1 Owner ;mutilation: 'liar. installation is being made on property I own Temporay 'services or feeders -
which is not intended for sale, !orate, tent, or exchange according to tnstaaatfea alteration, or relocation:
ORS 447, 45'i, 474, 670, '101. _ 'l amps w tear - - -- _ _ rts.
20o 1 amps. to 400 amps 90.Otr
Owner's sigtaturc: Date: 401 to 600 125.011
1:',.... ;1: I 1.1.'. Branca eirculta - oew, alteration,
er astsmdoa per pond:
Name -_ -- -_- -- _- - -___- - -_ A. Foe for bunch circuits with purchase of
Address: service or focder fee. each branch circuit ? 00
City: 5 (atc: ZIP: N. Fee for branch circuits without purchase L�(��
P _____ •— _-- -•-- - - - - -- , __ --- . - - - F: -tuna, — of service or 'teller fec first brooch circuit i.•. Q�O0 2
tech eddirionol branch arcu,i - -- - •'• _ -
_l'_i._1'' .It L.1 1I•.`.'''i!1”: :c :::.,u :a■ :I,.0 .:;.P1.' _ - - - Mist. (Service or feeder net included): •
1 .1 Rotvtre over 225 amps•cnnmxrr1:0 11 I kvlth tare facMty Farb pump or inspalion eirek 50.00 2
0 Sawn* ova i20 utnpt- toting of 1 t2 0 Hazardous lecsnm EbM sir or outline lighting , —,— -_^ .. 50.00 2
faintly dwselhnc. 0 ltuiktins over t0.001 were get (bur or %trio circuits; ter a limited energy panel.
11 S ystem n'o 000 volts nominal mute rtuidential tittles in one structure new alteration. or extension* 50.00 J
-
0 Building over three dories 11 fenders, Oat amps or meson •Deter(pdon: - -- -- -� -
1) Occupant toad two 00 persona r Manufactured structures or RV park Eath additional Itutpection over oho aduwable is aoy u( the above.
(1 F..gresslliahhngpan 0 t)ther: - ,__-_—. - . - • ._ —
_ _P er . m spo,�stun �� afwr —
Submit 2 toots of plans with any of the above, inventigation fee
The above are not applicable to temporary conpruetlen'service. other - - - --
- _ ' ' _ -_^ - • - -- -_ - --� Notice: This penes application - Permit fe _S �_55 ,_ 5C� _._._
• CI visa 0 MastoCard evokes (fa permit is not obtained Plan review (at 25'x6) $
/ _ / -. Y Jl a (8 %) State surcharge S ,. _
l'.rAit coal 4111111t1.1: : . . .. within I aO do a O er o f �9 bee,. '- � .. -... .! - .
1?�ms err epted aycomplda TOTAL S....6. . ?• ? .
ir oar ul caniln•Aicr a• s awn r n t n: n real
S
- -- • .. - e; iii, iu '-- - -- - -- -- _- __iio-Z-,'.. 440-4o is (7rct cam)
CITY OFTIGARD 24 -Hour �1
BUILDING ; Inspection Line: (503) 639 -4175 -
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested D (3 AM PM BUP
Location 1 6 313 ( Suite MEC
Contact Person - 1 77 Yn Ph ( ) -S 7 `f / p.) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner -4(__-/--L_ 0 (9-JA__tfr ELC D L:= _
Footing os ' 67 - 5 -( 1 9 ELC •
Foundation Access: ii
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation I
Drywall Nailing
Firewall
l■ \--' ? I S C
Fire Sprinkler ci Fire Alarm v
Susp'd Ceiling ��
Roof 4)o W 1 Lti Q1) TD S f G- L� e'f-
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
UG/Slab
Low Voltage
Fire Alarm
OM
�,�� 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
0 Please call for reinspection RE: 111 Unable to inspect - no access
Fire Supply Line
ADA Date �� - ° Z � Inspector Approach/Sidewalk D p t" Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL