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Permit
CITY OF TIGARD ..� .I � ELECTRICAL PERMIT - RESTRICTED ENERGY . i - i DEVELOPMENT SERVICES PERMIT #: ELR2001 -00315 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 12/20/01 SITE ADDRESS: 14200 SW 72ND AVE PARCEL: 2S112AA -00300 SUBDIVISION: ZONING: I -H BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of Data Signal Wiring. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: ASGARD L L C HENKELS & MCCOY INC c/o GERBER LEGENDARY BLADES PO BOX 20009 14200 SW 72ND AVE PORTLAND, OR 97220 PORTLAND, OR 97223 Phone: Phone: 255 -5125 Reg #: ELE 26- 895CLE LIC 63699 FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 12/20/01 $75.00 2720010000 Elect'I Final 5PCT CTR 12/20/01 $6.00 2720010000 Total $81.00 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. i Issued by 1410 � 1 Al . �// Permittee 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: c9 (2( Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day _ 12/14/2001 11:51 FAI 5035981960 CITY OF TIGARD al 002 ElectricalPermitApp • . Datereceived: 17- %/j) t na L 7 , _ 0 3/5 ,Ak ;, , :',i i' City of Tigard • Pi o txtlapPl. no.: Expire dace: Address: 13125 SW Hall Blvd, Tigard, OR ' M_ p Bye R no -- Cuyo � Phone: (503) 639 -4171 - issued: Fat: (503) 598 -1960 1 / Case file no.: Payment type: ,— Land use approval: . T1FE OF PERMIT 0.1 8a 2 family dwelling or accessory - • miner ialTtndustrial ❑ Multi- family O Tenant improvement Cl- New construction r • . dition/altezationheplaccment 0 Other. 0 Partial JOB SITE INFORMATION Job address/ 240 2 — ffigiliMI Bldg. no.: Suite no.: Tax . tax lot/account no.: Lot Block: Subdivision: _ Project name: — _ • . , Description and location of work on premises: 1 J,, , _ i r Estimated date of completion/ins • ton: CONTR.AC1 OR APPI.1CA17ON FEE SCIIEDELE o p i Max Job no: • i „" .• i_ PI (e Det ) oak iosP xsi Business name: r„moJ . g A ! = New er- s(ttgk vt ypet Address: G i % it dwellfogomit lttebrdetatladtedgaeagm City: j'.Aril- i IMMO 12 -/! ' ZIP: i _ ...s • Serwoemdnded. Phone: " ' ;. '/A��.`a E - mail: s q' 4 or less • •� Each additional 500 sq - ft. or portion Melva CCB no-: , Elec. bus. lice. no: - --Air C'LE 1===mmimi 2 Cityhnetro Tic. V 4.: , - 1 - - 2- li . © mitedeaergy, non residential W 2 - _, _ o - ° Each manufactured home or modular dwelling Service and/or feeder 2 �}±rT^_ r7 electrician ( - •aired) 1 - Ilalioo, p. data. tone (Oa is ,f - :• • ri.�7i a .ic® I o kedi a ction : • PROPER l CAN NER 200 amps or less 2 ..� 201 a .,.: to 4„ amps 2 Name (print): ./ 5 401 amps to 600 amps ' 2 Mailing address: e:W 54) z,,sid 601 amps to 1000 amps 2 rate, ZIP: ,-)90M Ova 1000 amps or volt_ 2 ��' ? � � Recoruarxonl �� 1 Phone: , Fax: E -mail: Owner instal fr' on: The installation is being made on property I own Thepecaey smiles or ore : which is not intended for sale. lease, rent, or exchange according to 0a ' 200 or lima 2 ORS 447, 455, ■79, 670, 701_ 201 amps to 400 amps 2 Owner's : Date:. 401 to 600 amps _ 2 EN G I N I: ER Branch ehrcaits- new, altesaaon, or extension per panel: Name: . k Foe for branch circuits with purchase of Address: • service or feeder fee, each branch circuit _ 2 St ZIP: B. Fee for branch circuits without purchase City: State: service or feeder fee, firat branch circuit: 2 Phone: Fax: E . Each additional brands circuit PLAN REVIt \V (Please check all that ai pl }) 14 .(Serviue urleedernotincluded): -. 2 amps-commercial 0 Healdr.Carefacitty Each pump or irrigationcircle O Servi over 3 �sign oroullineliighting 2 O Service over ngs ampsdatirrg of 1&2 0 Bilding Hazardous lecation Signal ciic it(s) *fa Haled energy Pastel CmrWYdaenings 0 Building over 10.000 square fed foot or 0 System over 600 volts nominal more residential units in one stnrcnrte alteration, orextension* 2 O Bulldog overthteestories 0 Feeders. 400 amps or mom *resod .kat 0 Occupant land over 99 paws 0 Manufactunx1 structure or RV park Foch add"ttimd inspection over the allowable In troy of the above , O F$vwwdyttM'ngPlm O Other. Per inspection Sabedt _ sets of plans with any coffin above- ova ' fee - The above ore not applicable to temporary coven service. Other Permit fee • $ 15i ao Not an a era* cars, plaice call ja cdcn for rase N otice- Th permit ap p l ication Pl i f e . (at _ %) $ - O Visa 0 Mastc,C,erd expires if a permit is not obtained State ere (8`X7) .... $ t card a - / 1 within 180 days after it has been &P" accepted as complete. TOTAL $ one d ese®alda a mown on credit $ ` , «x4615(6 0 - DEC -14 -2001 11:48AM TEL)5035981960 ID) PAGE:002 R =98% CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST ,c— BUP Received Date Requested — Z Z AM is % PM BUP Location �Z O() ! ?` d / — Suite MEC Contact Persor61/ ' ' ' IPh ( ) 4 3 / 2- PLM Contractor Ph ( ) 7 g ga SWR BUILDING Tenant/Owner ELC Footing Foundation • Access: ELC Ftg Drain p�y ELR c�7 603/C Crawl Drain ; D U '° • • ) Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ?-fIcS-S Framing Insulation p L i & Drywall Nailing it - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING rt Post & Beam A11111 Under Slab or . 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 Rough -In UG /Slab w olt ()It ire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. • SS PART FAIL ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line I��1 ADA - o� ` �i actor Ext Ins L�� aJ'+�n Approach/Sidewalk D p Other: Final DO NOT REMOVE this Inspection record om a job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 IN$P.ECT.ION DIVISION Business Line: (503) 639 - 4171 MST BUP Received , Date Requested ° rs AM PM BUP Location 0 v - AI - Suite MEC Contact Perso 6Y1 /2;t2..) % 11), Ph ( ) PLM Contractor e Ph ( ) 7 6 1 - ear/t SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR 60 / Do . W,c Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear , Int Sheath/Shear Framing Insulation Drywall Nailing ` 1 Fire Sprinkler NI � 1v ' ` A ' •-.) -,■. (A) 1 ■ I Fire Alarm 1 Susp'd Ceiling ,I Roof C 1 5- CA �V`y — Other: Final PASS PART FAIL PLUMBING Post & Beam is 1 15 S / nrl I �_.) p o� Under Slab t�V t YJ� 4 Rough -In 4=4****---AMft Water Service Sanitary Sewer t ilk ► \ Rain Drains • ! �� Catch Basin / Manhole _ AiD 741 0 L MAW= Storm Drain ■ Shower Pan s Other: '7 Final PASS PART FAIL MECHANICAL 0 Post & Beam Rough -In ey Gas Line i Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab e�e Fir= Alarm Agir 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ill Please call for reinspection RE: • El Unable to inspect — no access Fire Supply Line / ADA q Approach/Sidewalk Date � -- /� ° Z Inspector ■ Ext Other: Final DO NOT REMOVE this inspection record from the j i site. PASS PART FAIL