Permit CITY..OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00254
"Pam i DEVELOPMENT SERVICES DATE ISSUED: 5/12/2004
AA „� I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 AB -01000
SITE ADDRESS: 12414 SW 72ND AVE 533
SUBDIVISION: HAMPTON PARK APTS ZONING. MUE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Reconnect Only
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
HAMPTON PARK LLC
BY WEST COAST MORTGAGE
4000 KRUSE WAY PL, BLD 1 STE 2
LAKE OSWEGO, OR 97035
Phone: Phone:
Reg #:
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 5/12/2004 $66.85
[TAX] 8% State Surcharge 5/12/2004 $5.35 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 done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, oriifwork is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adop - • 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 - e rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
..4/
Issued By: �2e� Permit Signature: \• k 1 1 � Mu i L_ /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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
06/11/2004 10:58 FAX 5035981960 CITY OF TIGARD Cl 001
;i lectr ical Permilit-AbDlication FOR OFFICE USE O:N L1
City of Tigard Received • Dat //r �
de - •••
13125 SW Hall Bhvd -, llgsud, OR 97223
4 ii111.111.1111111 111 Witt r '
Phone: 503.639.4171 Fax 503.498.1960 :`= i �';,
i. tote lteadyBy. , kite . El See raid 2 for
Inspection Liao 503.639.4175 J . -
ktemet: www,ci- tigatd.or.us Notified/Media S„ pptcmeneal Ieformneroe W
❑ •New construction ❑ Addition/alteration/replacement Pietist check an that apply
❑Service over 225 amps, cornet []Hazardous location
❑ Demolition ❑ Other 0 Service over 320 amps - tattng DBuilang over 10,000 sq, ft,
1 , - �i'w, '
' . , _ of 1- and 2- ferrety dwellings 4 or more new residential • .. ` pS OtRr � volts AO�IItinal urri m on stttrcnce
1 and 2- family dwelling 0 Commercialfindusizial ❑ Accessory building
MOAN/ over three stories Dry 409 arnps or more
❑ Multi --1=11 ❑ Master builder ❑ Off" poealpaat load Duet 99 persons Qtldanafactlaed atrueotreS or
RV park
- � -_ -- I � , 1 ^I i ...._ _ . D� �p� 2,04 ❑Oilier_
pith -care reality
Job no.: Job site address( i sti 1z ) � n 3 Submit 2 sets of plans with [My the above.
0 r The above are not applicable w temporary construction service- .
City /St1telZIP)( L .� .a
• _ -- ,..1 7 : 7 ,--- 5 ..,.... ve
Suits/bldgJapt ao•: Project nau1F - 1( ... 11 Qty. Fee Total inewripdou
Cross street/directions to job site New residential single- or mulld fatally dwelling volt.
. Includes attached garage- ,
1,000 att. ft, or lees 145.15 4
-
no.: Ba. add'l 500 sti- ft. expottion 33.40 1
Limited sum, residential 75.00 2
Tax meg/Qarcel no - Limited non-residential 75.00 2
manufactured
dvilin service andl or feeder 90.90 2
•
Services Or feeders installation, elevation, and/or relocation
200 amps or less 80.30 2
201 amps ta 400 amps 106.85 • 2
1 � ._ - rte + 401 amps to 600 , 160.60 2
Nat : t. : AA S1tt * l.' . &IA lob 601 to 1,000an5 240.60 2
Via:} a 41 LI sw - -22, ion A-�c -e # 1533. or voles / 434.65
66.83 .. � 2
pt ` • / . t` . el °, _' 1 i a- Temporary services or feeders installation, alteration, a nd/or
relocation
Phone '1 7 • 1., q is ( Fax ( • . - 7 2 — 200 amps or lees 66.85 , 1
Owner' .... 1 . ; .. •This ' , r .. on is being made oft property that I own which is not 201 amps to 400 amp, 100.30 2
I 401 I,- fo sale, l F mo t, ge • • 1 I : to O 7 449, 67 ,,•. 701.
„
amps to 600 eons 133.75 2
I ! a > _ Branch circuits- new, atteration, or exteasioo, per pane ,
— - } - A. Fee Elie branch circuits wire
- -- service or feeder fee, each
-_ — - breach circuit 6.65 2
Business tame: B. Fee for branch c77. mta
Contact win= withoM service or feeder fee. 46.85 2
each branch quit
Address: Each edd9 branch circuit 6. 2
City/State/ZIP: Miseellaneoua (service or J
feeder not Included) )
1?tmmp or irrigation dente 53.40 I 2
Phone: ( ) 1 Fax:: ( ) Sign or outline lighting 53.40 2
E-mitil: Signal circuits) or limited -
errergy panel, alteration, or
Business name~
Addle= . 1 FAO additional Inspection over allowable in any (lithe Above
Per inspection 6230
City/State/ZIP: investigation per hour (t br min) 62.50
IAduial planner hour 73.75
Phone: ( ) Fax ( ) , f
cca Lit: 1 Electrical Inc.: Subtotal I Suprv. Lin: Subtotal , , , S
Plan review (25% of permit fee) /_
SLtpTv.1?lectriciaC Signature, required: - State s 01% of permit fee) s 5, 33
Print name: . Date: 9 ti e?,
TOTAL pERNIIT FBE m � - aae L
1 Authorized sign , , ` i t . , a� e ' ? /� .l I •,. I The permit applitatioa s ea if a permit la not m within MO a = dare after It b bean aeespted tie complete
Nern Print °time` T . y �. Date ' L . . w ,n $ o, t°aasa''saricc eosin
t rtanitnwelee 12/Ca 440 Isr(1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION `-- Business Line: (503) 639 -4171 MST
BUP
Received Date Requested (5 / 3 M BUP
Location / /41 MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC .R/70 V - OOsi"
Footing
ELC
Foundation •
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: r/� ---- —� " SIT
Post & Beam IS
Shear Anchors -- _ r
Ext Sheath/Shear =rte
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm S , � c ■ TIC ` "� 1�' s� - �1
Susp'd Ceiling "' 1
Roof
Other: I
Final � - 1 N �� PLL ilk`* -e'
PASS PART FAIL
PLUMBING �' " C 0Q ��
Post
nd& Slab Under 1 \ \-e-
nder Slab 1`� `
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
Ro CS NIC@
n
UG/Sla
Low Voltage
Fire Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
SITE El Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 13 Inspector 67'm N B Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL