Permit r
. = CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00584
,,ai DEVELOPMENT SERVICES DATE ISSUED: 9/18/03
" ' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 25101 AD -02800
SITE ADDRESS: 12665 SW 69TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING. MUE
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: Temporary service for new office building. Job No. 03081901
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: W /SERVICE OR FEEDER: 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:
CEDAR ENTERPRISES THREE PHASE ELECTRIC
MARTY GOLDSMITH & RON ENYEART 8960 S. BLACK BEAR
4004 KRUSE PLACE CANBY, OR 97013
LAKE OSWEGO, OR 97035
Phone: Phone: 503 - 263 - 2558
Reg #: ELE 24 -390C
LIC 128282
FEES SUP 4498S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/18/03 $66.85
[TAX] 8% State Tax 9/18/03 $5.35 Elect'I Service
Elect'I Final
Total $72.20
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 do 'n- 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 th 180 days. A • ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in R 952 - 001 -0010 th •ugh OA' • 2- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -800- 2 -2344.
Issu By: � i. $ / 1' Permit Signature . l I i / L! ��� ,
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 INST , LLATI • N ONLY
, i �' "�� Ow 6--(__, DATE:
SIGNATURE OF SUPR. ELEC'N: D �/
LICENSE NO: r �( u--
Call 639 -4175 by 7:OOpm for an inspection the next business day
FROM : Three Phase Electric FAX NO. : 5036513540 Sep. 18 2003 08:42AM P1
~ 4717J-‘ Lit . •
Electrical Permit Application
Datetteceived: 91765 Permitao•: tee,.,, -ct958
,*
i i ' City of ' and Project/appl.no.: A M22.111111111
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 . Date issued: • . • (IMPA Receiptno.:
Phone: (503) 639-4171 • , • .
Fax: (503) 598-1960 Case file no .: . Payment typo:
Land ust a pproval: . • •
11 pi: O1 Pi:itiNil1
O 1 & 2 family dwelling or accessory pikotrunercialfmdustrial 0 Multi- family 0 Tenant improvement
)&1-New construction . 0 Addition/alteration/replacement 0 Other: CI Partial
J011 Sift 'N10101:11 ION
Job address: -41 - .. , g Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: E. 1 Description and location of work on premises. , r e . 0 it Si , 4
Estimated date of co tiof/tnspection: ..• • - • _ 0 ' • ems:
CO \77t: ∎C AI'1't,1CA'1ION 1 1:I: St: 11ED( Ll:
Job no: f)'2,09,\g0\
Mao[
Business name: It Y o ;mot_ r! • . P 1 Total no. lost
Y - thee or multi-family per
Address: 41 . • dvra�mgtndt . laebodesatbdred®arege.
City: ■ State ISBN ZIP: 4 ' . • 3 Servieelnebrdetk
Phone: Q( T' - S E -mail: 1000 sq. 9. or less 4
w eac addrnonal 500 ' . ft. or '
- l ^ 6 ^ , *on thereof
CCB
no.: �'� : Elea bus. liC. no: -� V tinuted energy, residential 2
City j�� tro1 " . no.•/ L{ .'q \ Limited energy. non non-residential 2
. r .:. ,, An. - Jrc .-. 01– ' 1` ... (�� ` Faob tdaauf ed home or modular dwelling r
Sigiwiwe of A' _ - . ° , (required) . • Aste Sayioeand/orfeeder . — 2
Sup. elect. name (prin*: • • , -► a . _ , • License= i 1/2RS • Sarvtorsorfeed•es– itgtslt*doo, .
alteration orretooattasc
I'ROPI I OWN I;it 200 imps orleas 2
Name (print): 201 amps to 400 amps • 2
• 401 amps to 600 amps ' 2 -
Mailing address: _ 601 amps to 1000 amps 2 •
C it _ I State: I ZIP: Over 1000 amps or volts ' • 2
Phone: !Fax: I Frmail: i Reoonneccan�t r 't' . • 1
Owner installation: The installation is being made on property I own : Temapouarymttloesarfeeders• . -
which is not intended for sale, lease, rent, or exchange according to , • 0 A' a •
ORS 447, 455, 479, 670, 701. i Z oi amps to 4 00 • 2
ZOl amps m 400 amps ' 2
Owner's signature: ' • Date: - 401 to 600 ,,, ' 2
I_N(JNF :R Branch ciradts- new, tolteretion, •
OT extension perpasel
•
Name: A Fee forbraochciresits with purchase of
Address: • semi:nor feeder fee; eadhbrandiCiimit 2
City: I SM' H. Fee for branch charier without pun:base
' of se vizor feeder fee, firstbranch cuwit. 2
phone: Fax: E EaCLraddltlaia1 branch ciraoit „_
l'1, V\ Itl : \'I I:. (Please died: all that apple) Muse .(Seretecorfeederaotincluded):
ca Service over 225 amps•eommerdai . - 0 Bealth facility Bach pump or irrigation circle • 2
Each sign or cedilla lighting 2
O Service wer320arrrps•ratingof38 :2 0 1ia�Otrstocmien ; .
family dwellings . 0Bttil ¢ing otter 10,000 square lhet four or Signal circuit (s)ora limited energy panel,
0 System ova 600 volts nominal moretead�;al One s UM= alteration,orgasm:ion . 2
t? Sanding over area erodes • •• 0 tteedera.400 arms ormom • ' *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park fedi additional Ihspeallon over due allowable fa say of the above
0 Egress/Iigluingplan O Othe . Perlastpecaon • • _i . I' p. 1
Submit sets of plans with any of trim; above. . Investigation fee
Ilse above are not appltcabletotemporaey conntordon ice- Other
Not shits cos aoocvr c r el i t c a r d s , p l e a s e w i i fermoge.io[omtmloo. • N o t i c e : This permit a p p l i c a t i o n " _..: Pr rmlt f e e $ __- o v i s a • U M a s r a c a r d µ e x p i r e s ' • ' Plan rev (at -_ %) $ � •
/ / within 180 days afer.ithas bein ". , State sn charge (8%) $ �►
Oak wa =bee m complete. . TOTAL .. $ "4s, . Z
- • Name ei cardholder as dhawa on eaet4toard
$ • • . • .
Cordial& sI Amoons , •.. 4404613
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business- Line:' (503) 639 -4171 MST
BUP
Received Date Requested /0 — 3 AM PM BUP
Location / Leo t ' Co 9/1% Ave • Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing 3 — O O s$'I-It
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ��
Ext Shear Sheath/Shear Anchors
ir—e-ryspo-fe,:y �_ � /„ _ 1 _t _ � v (0E4, Ext eah/ .�l�fr �[
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
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
:T FAIL
i ce
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Fina�b Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI D Please call fo reinsp-ction RE: Unable to inspect — no access
Fire Supply Line
ADA Date d 0 Inspector Ext
Approach/Sidewalk
Other:
Final D • NOT REMOVE this inspection record from the Job site.
PASS PART FAIL