Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00498
* 11, DEVELOPMENT SERVICES DATE ISSUED: 9/18/03
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: 2 story office.
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: SIGNAUPANEL:
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 $507.35
[ELPLCK] ELC Pln Rev 9/18/03 $126.83 Ceiling Cover
[TAX] 8% State Tax 9/18/03 $40.59 Wall Cover
Underground Cover
Total $674.77 Elect'I Service
Rough -in
Elect'I Final
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: :4/ - _ 4 �/ Permit Signature:
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
rm.'s., • spree rnase e lectric FAX NO. : 5036513540 Aug. 11 2003 02:13PM P1
if; ectrical 0 # /
Datereceived: a , / Pe Wino.: _ _ y
• pro• `no.: Expire date:
o f Tigard p 1 20
City ef7igorel Address: 13125 SW Hall Blvd, gatd, OR 972 Datciisu an Receiptno.:
bone: (503) 639-4171 CITY OF TIGARD Case file no.: Payment type:
Fax: (503) 598.1960 BUILDING DIVISION •
Land use approval: •
1'11'1: 01 P1
01 & 2 family dwelling or accessory litgoinmercialfuidustrial D Multi 0 Tenant improvement
New construction . 0 Addition/alteration/replacement 0 Other: _ 0 Partial
JOB S1TL 1NFOlt!11AI ION . •
Job address: ( v �) co a
ZJ •tom Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: e - ek r Description and location of work on premises: tarJ Z O B c.4._
Estimated date of .•,,. ",'• . , t - -;on:
(:u.. I R:\C'1Olt APPl.it \ 110:Ns 1 1:1: SC111:1)1;1E
Job no: Ice
Devatiptieah Qty. REM 0o. We
Business name: "Lt. W �.al[:i�s.. we t- deldexandll-6milYPa
Address: - (p 0 41= &R e...- . di, ZIP: e0int;eab atmthedpat
2
p� r.A 1P:. a 3 Se nicafa hided
hoDe sta' , 2 R -' 7. aa LEA - ?mom: /4 _/ —a Fort .. it or lea 4
00 sq. R or Porten Manta t
• ■_■
CCB no.: _ . --.-5,:4 Elec. bus. lie. no: -24 - 3 • G United , .ev 2
City/ .• lie , •. • ' _ u energy, _M(_ 2
E 4rmitosAmmo, S —1. Each mmwraanred home ormudatardwelling ■.
of , �s►l . C"", t - .) Dare / / _a Service and/or feeder 2
- :.1 , : • :.� . • etterafioa or moan= OM
1.12OP1 at1 Y OV. '.\. ER 200 amps or less
Nam . ' .,, ): . le a..,-- . - • % ea . 201 amps eo 400 amps NM M 2
40 1 amps tn600amps =MM. 2
Mailing address: • q G O' �. 601 am . a to 1000 amps =MIME 2
City; State: . ZIP: Over 1000 amps or volts ME MN EMI 2
Phone: .Pax: E-mail: Rommel oIy 1 •
Owner installation: Ilse installation is being made on property 1 own Temporary tterviemorfeeders • .
which is not intended for sale, lease. tent, or exchange according to jA 'tl0O
ORS 447, 455, 479, 670. 701. �>�oslea 2
101 amps eo 400 amps 2
Owner's signadrre: • Date: • 401 to 600 amps 2
LNGINLLIt flranebdreaits new, awe+a11an, -
or eateaulon per panel:
Name: A. Few for branch circuits with purchase of
Adam service or feeder fee, each brand► circuit 2
City: . . State: ZIP: B. Fee for branch circuits without purchase
of =victor feeder fee, first branch circuit 2
Phone Fax: E awn mkatiooal branch chuck
II. v. RUN ' 1L• ' \ \' (I'Ic;ese ch•_ci. .ill that vp1111) Mae. (Se/lteeerfeeder nos MMe. ." -• 11111 III
,• Service ova 225ampshcommen9al •0HPahh•core Each am* or'' circle 2
0 Serviosovoe320 amps - rating of 1412 0 Haurdouslontron Each sign err cadent lighting _ MI _ 2
dumb dwellings 13 Building ova t0,0a0 mum GAR four or . Signal tit oit(s) or a limitodenergy panel,
0 Systemover600 volts nominal more naidenial midis one structure alteration, oremttenssionv 2
O BOiading over eararies 0 Feede s. 400 sops or arre • *D . :a
0 Occupant load over 99 ransom O Manurneorred sanctums or RV park Faeb addldopat inspection n*es 0!e allowable to any elite above
O Bgressdiab adlaa t • 0 Other. Per inspection •
.Submit,-sets of plans wtlb1 say of the above. Investigation fee
The above are not applicable to temporary ceuidradiouservice. Other
Not all jariseetmm tempt anal en*. please tall judediatiun for tae iaramaioa. Notime.This permit application Permit fee S . 0 ,rte
❑visa 0Maer -Cord at expires if a permit is m obtained Plan review (at�►5 %) $ L - (o D `�
cte4» cud aaa be / within 180 days after it has been . State surcharge (8%) .••• $ 5-c1
W accepted as complete. TOTAL $ (o
Name of a ardhalder as on oc Card '
_ $ •
Coadhatte aloe AmO4a1 4404615 (600/DOM1)
ebyx.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 1- )) o■3 /o -) AM PM BUP
Location a.bkcts svf 9' h Suite _ MEC
Contact Person r)�0.1eT �1. ��� I � • Ph (S ) �, �1 � -� � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC b 3 —Go Log
g
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation 4. � \ ° L� / to O n ati9dAf Drwall Nailing `" 1 Il ^l l sZ Firewall
Fire Sprinkler
Fire Alarm
• Susp'd Ceiling \ 1 / 1 , �(�
Roof cLisy6 -k -j J �3' \i) Gt kJ ) f1f c 1, cc. d
Other: �
Final 1�/� c �jkakip - c/\ ot Q,
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer 7(
Rain Drains
Catch Basin / Manhole V41
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL •
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
• _ SS PART FAIL
L
Servic=
Rough -In
UG/Slab
Low Voltage
Fire Alarm
4 t t Sp s PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspecti -n RE: r Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date G �.. Inc . or , . Ext
Other:
Final DO OT REMOVE this inspection record fro the Job s e.
PASS PART FAIL
•