Permit CITY OF T ELECTRICAL PERMIT -
RESTRICTED ENERGY
,���
- 13125
DEVELOPMENT H B S R 2 C'ES ) 639 -4171 DATE SSU 06/20/2001 00170
SITE ADDRESS: 14915 SW 72ND AVE PARCEL: 2S112AC -02100
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: 047 JURISDICTION: TIG
Proiect Description: Installaation of Low Voltage for Voice /Data.
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:
CHAMBERLAIN -HUSSA PROPERTIES NEW TECH ELECTRIC
18755 SW TETON 1400 NE 48TH AVE
TUALATIN, OR 97062 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 -1900
. , Reg #: LIC 41868
SUP 2113s
ELE 26 -418c
FEES Required Inspections
Type By Date Amount Receipt Elect'l Final
5PCT CTR 06/20/2001 $6.00 2720010000
PRMT CTR 06/20/2001 $75.00 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 tQ OUNC at (503)
246 -1987. / 1
Issued by _` AO, ,44 Permittee Signature c th 04 /Y'
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: t l 3
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/19/01 TUE 13:43 FAX 503 648 3131 NEW TECH ELEC -»-) TIGARD 001
--- "A ' Electrica1Permitik • lion
Datereeeived. 1 / Permit no.: e2 DO . je
4 t f t / i,t.
City of Tigard T I Projectlappino.: Eupdate:
Ciry ofTiard Addrs: )3125 SW Hall Blvd 0 2 23 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case tile no.: Payment type:
Land use approval:
TYPE OF FERMI
O 1 & 2 family dwelling or accessory ,'Com m
morcial/industrial 0 Multi- family 0 Tenant improveent
L o New coaslrucdon Additicnlalteration/replaeemene 0 Other ❑ Partial
JOB SITE IN'FOR(►IATION
Job address: /Y /.r 6 72 doe Bldg. no.: Suite no.: Tax map/tax lot/account no.;
Lot. I Block: 'Subdivision:
Project name: 1Descrir don and location of work on premis }°, /norzjd -
Estimated date of completion/inspection: J
CONTRACTOR APPLICATIO: FEE SCHEDULE - '
Job no: d Fee Mac
Business name: New Tech Electric Description Qty. (ea.) total oo. rasp
Address: 1400 NE 48th Avenue Newttz tfatl- dagleretaalti••fattlh'per
dht lI1ngtwitIachtdesivadrcd
Ciry: Hillsboro 1State.OR I21P: 97124 sawioalttdatlesk
. Pho&03 -648 -1900 Fau648- 3131 E -mail: I000 sq. ft. orlon 4
CCB no.: 41868 Elec. bus, lie - no: 26-418C Each Witham! SOO `°a- ft. or p0flaon thereof
City /metto lie. gm: meted energy. residential 2
c Limiradenergy. non- naidcods1 2
4 �/ Eac manufactured home or modular dwelling
Signature of supervising electrician (required) Date . Service and/or feeder 2
s dect name (p - ,i2, I ., J 6m A. .. , u „.,,, ; ,„ .s 8ernirtporf edeis— knstatbtlon, n.
PROPERTI' \ ER airendionorreloeat,a
200 ttnrps or leas 2
Name (print): , - aX 201 amps to 400 arias 2
Mailing address: 401 amps to MO amps 2
• City: I Slate: Ie2P: ov z l
io00aamp wolts 1- 2
Phone: I Fax: - 1E-mail: nomntmctenly 1
Owner installation: The installadon is being made on property I own -- Tempotuyae wIcesorfeedern- . -
which is not intended for sale, lease. rent, or exchange according to Iomllatlao , alteration, orretocadoo:
ORS 447. 455. 479. 670. 701. 200 amps of 1 2
201 amps to 400 amps 2
Owns signature: Di te: dot to 600 amps 2
Brat,dideadta -thew, ■Itcratioa,
- or extension per pool:
. a Fee for branch circalts with purchase of
Post - it° Fax Note 7671 Date /�/9 Ar D, / • service or reader fee, each branch eimsit 2
�/ pe l� 7 B . Fee for branch drabs without purchase T�1 �!*� From of service or feeder fee, first branch circuit: 2
Go./Dept. Co. Each additional braat orcule
®�'� "�� I Mae. (Service rfeodanotIncluded):
Phone # PhonsjL 6. /ft,0 Each pomp erinigarloneiselc 2
Fax is Fa: 44-a Each sign outline belting 2
rI' � ` -3/_ /
Signal ciredit(a)oralimited energy pand, 7.3..;/ /�
alteration, or extension° / N/ r _ V 2
0 Building over three stones i Fenlar:,dOOampiorraota °
O Orapun[ load or r 99 paeans 0 Maw(aduted su, tcyates or Rv pat If,� nal additio (ospedia�or� the allowable m any of the show=
Per O EBi*ti6 +5Flaa O Other - _ Each dditio
Submit ae[s o[plaas with ally (tithe abore Investigation fee ,
The above are not applicable to temporary coafi versos service. othv
(0 Nan all jues6bimc °ccept emit cads. plait call )miaticram for more ie °mtiad Notice: This permit application
Permit fee $ Q
Visa o MasrcrCard expires if a permit is not obtained Ulan review (at _ 96) $
Cncdir eare number; 1 1 within ISO days error it has been State surcharge (890; .... $
E "p''er accepted as complete. TOTAL $
Name of can:Nardv a/ Vrown on credit card
S 1 Txutst Acaourit 4# 41868 E—
Cynrdholdv eieatutc Saslow 4404615 (603ICOM)
(•T 7%
-�� CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 ') AM PM BLD .
Location kV, 5'' 7 2 I'l' Suite MEC
Contact Person Ph / c e l f/9 , ° PLM
Contractor Ale % �ci, f= /ca c L yf c Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 1 ' /-GU / 7a
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam ,1
Ext Sheath /Shear Vv / ( L,CC 4 s
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall r
Fire Sprinkler ,! h/1 r � In ri S< ,
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final / - G — ss
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ServiC e
Rough In
UG /SIa •
• ' olta • -
ire Alarm
um4ri) PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 7 — 0 / Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.