Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00009
w�i� DEVELOPMENT SERVICES DATE ISSUED: 1/10/03
^� mmai 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S 112AA -00300
SITE ADDRESS: 14200 SW 72ND AVE
ZONING: I -H
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical industrial equipment placement of new CSG cell.
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 3
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:
GERBER LEGENDARY BLADES BECK ELECTRIC INC
14200 SW 72ND AVE 9318 SE CHURCH ST
PORTLAND, OR 97223 CLACKAMAS, OR 97015
Phone: Phone: 656 - 7396
Reg #: SUP 1326S
LIC 00002629
FEES ELE 3 -5C
Description Date Amount
Required Inspections
[HRELC] Hourly Electrical 1/10/03 $175.23
[HRTAX] Hourly Rate Tax 1/10/03 $12.27 Elect'I Final
Total $187.50
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 Notif•- tion C-nter. Those rules are set
forth i c • - • -:11-0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direc • Lion- to UN :t (503) 246 -6699 or
1 -80► 332 -2344.
Iss - d By: ■ ,� �;. ) •IIsu Permit Signature: A
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: 06..J2_111 L 47 DATE:
LICENSE NO: /5.9-6
Call 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit Application
• -.: Date received: / /O , e) 5 Permit no.: a �, � . i i `,j
. *t:I'f . City of Tigard _ _
ty g P ro ject/appl. no.: Expire date: —
City of Tigard Add - ress I3I23 SWl�ia11 Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: , , 1 : .
Phone: (503) 639 -4171=
Fax: (503) 598 -1960 Case file no.: - Payment type: `.;:: ";:;:c
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
,•, n :;.., +<w- .z -..:w F<.; ♦ .t \..{ .�.. e -zn�».H7ucaK a�?,..`-' :,- .- �+. »�ylt . .... _ Y
.. .. •. �: JUB' �iaG INt Q[(1�'ittT�l�l �'•' .: .:••.
Job address:
a 6 0 Q,V C. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: Description and location of work on premises: _ _ 1.
Estimated date of completion/inspection: . - /
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: be Li,(.4y- it.. Description Qty. (ea.) Total no. hop
New residential - single or multi-family per
Address:
J l Jf c-tt l i ,k.. dwelling unit. Includes attached garage.
City: C_ a c.l(rtwACtS 1 State:) 1 ZIP: `if)oi 5 Service included:
Phone: (. ' , 7 ?fit., Fax:/ `/,57 E - mail: 1000 sq. ft. or less 4
CCB no.: COc3�% Elec. bus. lie. no: 3 -5c, Fach additional 500 sq. ft or portion thereof
Limited energy, residential 2
City /metro lic. no.: ,5855 Limited energy. non- residential 2
./4 /4" 0.7 Each manufactured home or modular dwelling
Signature of supervising ele ( tred) Z Date Service and/or feeder 2
Sup. elect. name (print): /./.411 1 •J . '4? ltri License no: 13l/n, •-cam Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): ff054.p h f 6.e 601 amps to 1 1000 amps 2
City: rb e r 201 amps to 400 amps 2
Mailing address: T n BaX 3 601 amps to 00 amps 2
M
+1 ((4+5 't'5 � (� State Q. 1 ZIP: q13/91 Over 1000 amps or volts 2
Phone: &ic. S'ti Fax: 1E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary serdcesor feeders - •
which is not intended for sale, lease, rent, or exchange according to hsitalladon , alteration, orrelocation:
ORS 447, 455, 479, in 701. 200 amps or tens 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 s 2
• Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
Phone Fax E -mail: of service or feeder fee. first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not lncluded):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O 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,
O 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:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egtess/lightingplan O Other. Per inspection 1 1 I 1 ,
Submit _ sets of plans with any of the above. Investigation fee ,. R
The above are not applicable to temporary construction service. Other f f t L P .9 S�4l 411144 •� n
Not all jurisdictions accept credit cads, please call jurisdiction for more information. Notice: This permit application Permit fee
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. / / within 180 days after it has been State surcharge (8 %) .... $
Exp1es accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 400.4615 (600fCOM)
CITY OF TIpARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 •
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 3 '// -- ° AM PM BUP
Location ) 0 5 1N) r7 a, a flV Suite MEC
Contact Person b D vs G' Ph (S ) 55b-- 8 3) e PLM
• -ctor Ph ( ) SWR
Tenant/Owner ELC ..006109
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam NEW c S CE . f.
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 1 `
Insulation Pa 1) Lo \ -\ - 0 V P —
Drywall Nailing (� / 6 (�
Firewall J (3 1�J (9 (� 0- C C
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
AS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
C E
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
P.t • FAIL
ICA
Sery
Rough -In
UG/Slab
Low Voltage
F' e Alarm
El PART FAIL
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA 1/
Approach/Sidewalk Date Inspector f Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL