Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00592
l W DEVELOPMENT SERVICES DATE ISSUED: 11/7/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 2S112AC - 01700
SITE ADDRESS: 15065 SW 74TH AVE
ZONING: I -P
SUBDIVISION:
BLOCK: LOT : 016 JURISDICTION: TIG
Project Description: 2 branch circuits to correct wiring to existing exterior fixtures.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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: •
INTERSTATE DEVELOPMENT LLC OREGON ELECTRIC CONST /GROUP
15065 SW 74TH AVE 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: ELE 26 -95C
FEES
Description Date Amount
Required Inspections
[TAX] 8% State Tax 11/7/02 $4.28
[ELPRMT] ELC Permit 11/7/02 $53.50 Rough -in
Elect'I Final
Total $57.78
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 .2 -2344.
Issued By � 1 �/ /� / , � j /'_ Permit Signature: (7)-1. > '
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. EL 0 �
EC'N: �d =—e- (U- DATE:
LICENSE NO: '
Call 639 -4175 by 7:OOpm for an inspection the next business day
- Electrical Permit Application
OFFICE USE ONLY
4 0 k D ate received; Pcrmit no. ,,.,g.„, ,e) J
$ .,Ill City of Tigard Projcct/appl. no,: L•xpirc date:
City, of Tigard Address: I3125 SW Ball Blvd, Tigard, OR 97223 -
Mimic: (503) 639 -4171 Date issued: By: V Receipt no,:
Fax: (503) 598 -1960 NOV 0 5 2002 Case file no Payment type:
Land use approval: C; 6 i• t,;-- 1 • ,
TYPE OF PERMl'1'
❑ 1 & 2 fancily dwelling or accessory OCommercial /industrial ❑ Multi - family 0 Tenant improvement
0 New construction C3otlddition/alterati /replacement ❑ Other: _ Partial
JOB S1"1'E 1NFOR('1A'I'i()N
Job address: 1 f • W 7 ' 1 Bldg. no.: Suite no Tax map /tax lot/account no.
Lot: Block: Subdivision;
Projcctname; inter Rootfiefigiption andlocationof workonpremises: c _ orrect wiring to existing
Estimated date of completion /inspection: • "" CONTR AC'['OR APPLICATION - - • SCHEDULE -
FEE
Jobno: 77988 r Max
Business name; • - • s _ • Description Qty. (ea.) Total no. insp
• • New residential -single ormulti- familyper
Address: 1 01 0 S E 1 1 t h F ive
d. vetlinguniLIncluttcsattachedgaragc.
City: Port land I State: OR 1 ZIP; 9] 214 Serviceincluded:
Phone: 2 3 4 — 9 9 0 0 I Fax; 114-1 0 OI -mai 1: 1000 s.. (t, or less 4
CCB no.: 203 Elec. bus. lie no: 26.95C Each additional 500 sq. it or portion thereof
Litnit energy, residential 2
I v, inc O tic no.- Limited energy. non - residential 2
• — `-‘4"-/I'' 14-5-4,2_--- Each manufactured home or nodular dwelling
S ofbtpervi• ngng ectn qu red) oats Service and/or feeder 2
Sup, elect. n � c (p ,- t): Mar' erne License no; 4 4 6 08 Services or feeders- installatio
alteration or relocation:.
,PR',) OWN.EIt
'• ' ' ` r' 200 amps or less 2
Name (print); 20I amps to 400 amps 2
401 amps to 600 amps 2
Mailing address:
swamp to moo amps 2
City; 7 State: I ZIP: _ over 1000 amt's or volts 2
Phone: Fax: E Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders•
which is not intended for salc, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 ramps or less 2
201 amps to 400 amps 2
Owners si_ attire: Date . 401 to 600 amps 2
- ' ENGINEER , Brunch circuits. new, alteration,
Name;
or extension p er panel:
A. Fee for branch circults with purchase of
Address: _ service or feeder fee, cash branch circuit 2
City: State: ZIP: B. Fuc for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 1 4 6. 35 2
Each additional branch circuit:
PLAN REVIEW ease ceck all that a 1 6. i�
(Please h -
� ll apply) Nfisc .(Servicenrfeedcrnotinctuded)c
0 Service over 225 amps-commercial 0 l- Ioatth -care facility Each pump or irrigation circle 2
O Service over 320 am=ps -rating of I&2 0 Hazardous location Each sign or outline lighting _ 2
family dwellings 0 ]sodding over 10.000 square feet four or Signal circuit(s) or a limited energy panel.
❑ System over 600 volts nominal mere residential units in one structure alteration, or extension' 2
0 Building over three stories ❑ Poerlers, 400 amps Or more
"Description:
0 Occupant Toad over 99 persons 0 Manufhoturrd structures or RV park Each additional inspection over the allowable in any o f the above:
0 Egress /lighting plan ❑ Other; Per inspection 1 I I l
Submit sets of plans with any of the above. Investigation fcc _
The above are not applicable to temporary construction service. Other
'
Not all juris lotions accept credit orals, please Call juriddiction for more nlfotmationl Notice: This permit application Permit fee $ a 3 , 50 �
0 Visa ❑ MasterCard expires if a permit is not obtained Plan review (at „_ o) S _
Credit card number: / 1 within 180 days after it has been State surcharge (8 %) $ — 4 - 28 —
Expiras accepted as corn fete, TOTAL 57.78
M me of cardholder n5 Shown on credit card $ - —
$
Cardholder sl( tto[urc Amount 440.4615 (6/0OICOM)
1795 -d 100/100'd 1N -1 -MOH 5160 ZO- 90 -AON
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 41 . 71 MST
BUP
Received Date Requested 02 —01 AM PM BUP
Location / d 69 -5 7 V Suite MEC _
Contact Person Ph ( ) gq 9 — Z c 23 PLM
Contractor Ph ( ) SWR -
BUILDING Tenant/Owner ELC — DD s1°-
Footing
•
Foundation ELC -
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
-
Roof
Other: J
Final
PASS PART FAIL
PLUMBING
Post & Beam
(1/
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
Fire Alarm •
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS - PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date _C71-40 _ 9.3 Inspe �� Ext
Other:
Final DO NOT REMOVE this inspection record rom the job site.
PASS PART FAIL