Permit CITY OF TIGARD RESTRICTED ENERGY
��� DEVELOPMENT SERVICES ELECTRICAL PERMIT -
PERMIT #: ELR2002 -00231
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 10/25/02
SITE ADDRESS: 15205 SW 74TH AVE PARCEL: 2S112DB 00600
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 014 JURISDICTION: TIG
Project Description: Low Voltage for voice and data cabling.
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:
DENNY MEYER ESP TECHNOLOGIES
7340 SW LANDMARK LANE 7929 SW BURNS WAY STE. F
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503- 620 -2086 Phone: 503- 628 -4195
503- 628 -4195 Reg #: LIC 73872
ELE 34- 269CEP
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 10/25/02 $75.00 Elect'I Final
[TAX] 8% State Tax 10/25/02 $6.00
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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699. ,� J �
Issued by 102 /� r ec- r� Permittee Signature F)' t! � C:t�t
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 dY ( C 7 L' DATE:
LICENSE NO: o ] �
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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a9)1L1\u' I: , ' , ; . Date received: i ab - 0 . 2 — tno_: Permi tor ', ,:l � 1 �`'�� ` �'� -�: Expire date:
11 w R ojccdappl. nv.: " ` ' v ' sty j !�`j . city of Tigar g Receipt
no.:
J� ga iF:
Ciry ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 972��� Date issued:
Phone: (503) 639 -4171 OCI �'° Case files no•: Payment type:
503 598 -1960 - Is�liV -1)
Fax: ( ) X1.1 g ur „,,....i
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� ° � ' r � F� r � cA. ❑ Multi- family 0 Tenant improvement
Commercial/industrial ❑partial
O. 1 8t 2 ons tly dwelling or accessory ddttion/altetationlreplacement ❑ Other.
0 Ncw construction .� '-�`� rt �i ��L St ,�t* � `� i.��";il'�A � t� �'�r,r`�19
4Y 5.� 1 S' I�t� ' :i� i W .+agnfxb.. p. •.J. � t � °' map/tax lot
/account Y � M ,� �,jt �.e � �`. -, •,�a'.:. Tax ma count no.:
Job "w 1.5a /fir a
Job address' �SaOS' � Bldg. no.: Suite no.: Ta
Pot:
Block: Subdivision: I to
Project name: Description and location of work on premises: .�
atcd date of complction/tnspe.ction ;,”} ..:.- ,, . , ys f nt 1 C �Dl ',�` ', ` S, F
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Job no: Descrtidlon ill Fe2 Max
(ca..) no. insp
New ros#dertial -single or multi- family p°'
•
A
II ddress: 1 , G • ( ), i,r-,iQ4 S i (3....f l Sit-E' dwelling miiincludesiatrachedg:
�: • 1u Servieeinelutled: d
•
sq. et. or less __ _— •
(. " , L { [ � ' loon s Each sq. ft. n sl 500 ft, or por i thereof
Phone: 11� <„ 2
�> ',)-- Elec bus. lic. no: '3 1 r' = 2
CCB n '. - (off C_ — = ' •
City/metro lie. no.: — 111111111 o�8 —a`rs Each man home or modular 2
i// 4 D ate Service and/or feeder
of sue Ist electrician (required) Servl�orfeeders -Ins illation, ■ Sim• r 1111 ant) ��- � �^Cc i � � , alteration or rrlo®lion= Sup. elect name (p J 2 g t W a, ggitg**** t . R” + A AY, ? t �i 20o amps or t _ 2
y ' lt y� . � M. ay aP- t�tu , a� C ,, ,a t, 201 amps to 400 amps
Name (print): 401 amps to 600 arms
amps to ]000 amps
Mailing address: over 1000 amps or volts
State: ZIP: __
Phone: Temporary service or [ce -
installation: The installation is being made on property I own llation, alteration, or relocation:
Owner ins to 11111 III
wwn acco
Insta
200 amps or less 2
which is not intended for sale, lease, rent, or exchange
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps = == 2
Date 401 to 600 am • s
Owners signature � ; Branch cimits- new , operation,
S
a
e'Y •t - 'K#k 'S ^ °t4 ,`� 'a , ,V , :,t� q t r-., or rzt ens ion per panel:
z
av�FSt ' � I g l C .
�a...aE<s- ,,,�i f4,� � _s �''�. °
A. Fee for branch c with purchase of
_ _ -- — - sc:vie or fecierfee; branch cit lit 1111 -
A idreSS v B. Fee for branch circuits without purchaae
of scrVicc or Mader fce, first branch circuit __ _ 2
Phone is „ �} Each additional branch cirL , n lade )
circuit: 111111111111 a u„v „z,� -,t � r� S'a+C��� �? tsc. (Scn' ice or feeder not i c d
1! P . zY __�
1•rIE1Y�(I�1�1$C C�1CC�CEBUs� }��10�f� � � ��i,.' .° i� E pump or irrigation circle
s �omrgr f a1 OHcaado Each sign or outline lighting 111113 ❑ Servis avrt'L25 amp U Elazardouslocation panel, U Service welUfl 0 amps-rating of L &2 limited energy p
family dwelling., 0 Building over 10 OC10 squirt tact four or Signal eircuit(s) or a alteration, or extension i ov structure 600 volts nominal more residential uni in one structure D System 0 Feeders, 400 amps or more • Dtveri • lion: of the above
D B cc di a over th v estories ion over the allowable in any
❑ Manufactured structures or RV park. Each additional inspection ___
D Egiess ntload plan person:, D Othrr. perinspection
D Egr :�lightittgplan
Submit _ sets of plans «hh any of l nvcstigation fee
he above. -�
The above are not applicable to temporary cooslruetion service. Other Permit fee $ —
a i dlcl on foe r int�'tip°a Notice: This petTnit applicatjon Plan review (at _ %) $ -- r
Not all jurisdictions accept ar�it card:, Pleaac call j • expires if a permit is not obtained State surcharge (330) •••• S
Uvisa p M ,, // within 180 days after it has been $ l
C�ei1 cant nom <r E accep nee complete. TOTAI
Name of rard,otder as .hoa 00 - t cart]
$ qsO oG15 (FyOU COh
Amount
C�trdholdcr r.ltnutuc
CITY OF TIGARD 24 -Hour .
- BOILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ifoa" -� AM ` PM BUP
Location / s - ® 5 — 7 1 MEC
Contact Person gat---rvivv Ph ( ) 6 a-o -R -0-00 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner S I_C
Footin --0 d a 3
Foundation Access:
Ftg Drain . BL °��
Crawl Drain NT ""
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 r
Other:
4, iir - , _ Ai , - Al
Final
PASS PART FAIL
....7 PLUMBING
Post & Beam
Under Slab I
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
-- &LICTR ICdl _
Service
Rough -In
UG /Slab
Low Voltage
F Alarm
Fina 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Si E AS
PART FAIL Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date Nov. / Inspector 1/p Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL