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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00616 DEVELOPMENT SERVICES DATE ISSUED: 10/7/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 DC -00701 SITE ADDRESS: 15985 SW 72ND AVE SUBDIVISION: FANNO CREEK TRACTS ZONING: I -P BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical tenant improvement, alteration of (8) branch circuits. 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: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 7 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: PACIFIC REALTY KUZBASS ELECTRIC 15350 SW SEQUOIA PKWY #300 16604 NE 80TH PORTLAND, OR 97224 VANCOUVER, WA 98682 Phone: 503 - 624 -3000 Phone: 360 - 882 -4768 Reg #: LIC 153252 ELE 37 -978C FEES SUP 4619S Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/7/03 $93.40 [TAX] 8% State Tax 10/7/03 $7 Rough - Elect'I Final Total $100.88 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- .'- . Is-ued By: � j ' ' 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 j SIGNATURE OF SUPR. ELEC'N: CTh P - ,iii, (' / � � DATE: LICENSE NO: y� "' S Call 639 - 4175 by 7:OOpm for an inspection the next business day OCT - 06 - 2003 05:17 PM 1MAHH LAM 50376071323 p.01 Electri al Pelt A , .. ication �a , � a04.9i City of . y rd Plaualug `o Sir 13125 SW I Blvd. P102 P vie • ► r _L��d 3 Tigard, dreg 97223 Wei*: P -• one; 50 x 9-4171 Fax 503- 598 -t960 POB �' 0 � ° • Cafsc too -: Internet ci.tigacdor.as J E '' e 4 nuts -: the lPagesfor 34 -hour , ',. , .,• Request 503-039 -41 , Method: J . • lntorseation. .7•7 ' fate arEwa rosidaadal upitsid : ,.: War 600 Y011s R9nsn81 MO etrOdUro clartllin r d ,, , 1 over 11aeo stories §Menulhotarrarl FeeQe�.400 sears or mate ■ - Fes. :: Buil ',,, :. 11111 Multi-F , ; teed ova 99 PONOPO strueturee or RV rat Other M a i 3 t a r � � Ba6mit eras aipuas "da a.y of the abase. . r t.a ,., a.w. • Pro'ectN . e; $A- L07v Qf4 sFiC 1 . 011122=11-N1 Nab reame or asuld4 udy Per C5rot;s . _ . • •, • tuns to job site: daedg arcs t■eodaa Writhed pm*. s. SU) uP•ER 600 N &g Fl y R s OD (2.-E . • Xi Bu "NESS P.A -i'K I11) , A ar..... ... •..., N_ .f0 u Q Su'�divisio Lot #c : T ..' '.– 3.00 . Tax .. • • ... ormodtdrr dae� 2 k aee►ieo faedae � 1'4 •. aw E�., 0 Jj ggi .•, 2 Z en m 400 1•1•60 Q 1111111 • ; ?. .AO 111111111111111© = WM MINIM Name: :' ♦, , c . - - + SS ° ; I — 66 -n —ES Address: , Temporary antes yr Ware' f000dletiee, ingoin o p-o• Fax:. V 6a 775s- en ........ to 4430 .....- ��r� ., J Pho e: �� )1: sal to -, , ....... ]area oh - steer, sileesri0ss, eur ... k ttiAIST c ?" `r- "5R�►t41.3& Lt ( eu au ands ,.. f6'8 i X63 3 N = _ _ - - >..,.rt. '`"" " 2 ... "' Phone: ti }pia Fax; 7 -'a - 7.23 , ... _• _.. t'7 �G'lJ 1111 tGSr*F1s F19 : r V ,: . or grader o . .. ailed}: 11111111 II � �� Rah addideaat iss _ : a.- iae aflswebte ie w DMus abase , Ci /3 . I - Zi .: V. to U •-1/ r r& .r _ - - 62.50 _ in Phone: V ._ -V.17.-__/7(7% Fax: , � 6, ' :: - to t. 11 - CCD Lic #: t S 3 2' •2 Lit. #: 7 - 9 c, S si !s., . � J .. electrician I-..- A p Review % • ' Permit Subtotal ees UIIIIMIIIIIIIMIIIIIIII Print N; I n . r,., - 'B' . . ti.... 'Mri S stet - , , • ., 13% . _ • :.,; Fee �" '� %� . TOTAL S /ee) ANN . N a i g C I ma p e r m i t a g p * e s r l a a aspires 8a portatt to amt eba dared Wilda as ettaspleta. VIE sure hadotc rg>aulidtng �da'y5a71ae1Beart "Bee+rat - by' Maws . r furraWicPasdtApp 4QC 0%30 • CITY OF TIGARD 24-Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received / C Date Requested G 1 AM PM BUP Location ` 5 ` Fs 7.2 r Suite MEC Contact Person Ph ( ) !d O '00 d 7 PLM Contractor Ph ( ) SWR // BUILDING Tenant/Owner ELC 3 -Do 6/ p Footing ELC Foundation Access: Ftg Drain v ISO' v . ---� -z f- ELR Crawl Drain !� J T�-' Slab Inspection Notes: SIT Post & Beam F Shear Anchors 1 Ext Sheath/Shear Int Sheath/Shear Framing 7 Insulation (/ Drywall Nailing Firewall `.' Fire Sprinkler - Fire Alarm Susp'd Ceiling Roof • Other: Final PASS PART FAIL PLUMBING , Post & Beam Under Slab 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 Low Voltage A/& E) 4 rm final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SPART FAIL Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date N., I ) 03 Inspector fr 6, Ext Other: `� c Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL