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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00576 A DEVELOPMENT SERVICES DATE ISSUED: 9/17/03 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112DC-01500 SITE ADDRESS: 15765 SW 74TH AVE 100 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT : 006 JURISDICTION: TIG Project Description: Installation of service and (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: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 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: 74TH AVENUE INDUSTRIAL PARK LLC GENIE ELECTRIC CONSTRUCTION 8100 SW DURHAM RD 8701 SE 156TH AVENUE TIGARD, OR 97224 PORTLAND, OR 97236 Phone: Phone: 503 - 762 -9296 Reg #: LIC 56639 SUP 4536S FEES ELE 34 -488C Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/15/03 $173.70 [TAX] 8% State Tax 9/15/03 $13.89 Elect'I Service Rough -in Total $187.59 Elect'I Final 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 - 332 -2344. Issued By: _�1�� / ,z lirjcy0 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 SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:OOpm for an inspection the next business day _Se.p'i:15 03 04:36p GENIE ELECTRIC 503 -762 9188 p. 2 09/15/2003 14:18 FAX 5035981960 CITY OF TIGARD LP. . FOR U1•:r'1C'L USE ONLY �' Electrical �e On , Received Electrical • DatelBy: � /s� , 0. ,ctttdt Ne.A-teplOo3 BO.s ty o " S EP 1 5 200 Plannin ppr oval sign L' f T - aY- Date/ay: PermitNo.: 13125 SW Hall Blvd. Plan Review Ocher Tigard, Oregon 97223 CITY OF TIGARD DatrJB': Permit No.: Phone: 503- 639 -4171 1 . 1 - X4/11 N Post-Review Land the 4 : ,,: 7 .,, '' • !'' Dateity: Case No.: i Internet: www.ci.tigard.or.us _14.- 4_ l contact See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 '" " , Name/tv(cthad: r)1:83 Supplemental Information. x _ .. •._.77.. .,0::---.:. - — _ .. 74- 1=1 y ew construction 1 ra Demolition 0 Service over 225 arts- II Health -care facility ' commensal 0 Hazardous location I Addidon/alteratton/r • • lacement ill Other: ❑ Service over 320'araps- rating of 0 Building over 10,000 square feet, ti L. ._:. ' ' 1l i1.: _,. ;.a. . .7.:: ?. .:, _ L.. - :: !.Y,. 1 8: 2 family dwellings four or mare reaidcatiul ,mils in 3 = 2- . r • • ' • 1 la • I■ Commercial/Industrial 0 System over 600 volts nominal one structure 0 Building 99 over three Manufactured 0 Feeders, 40e stare or more ❑ A a 'BS 1. i 1 I. Multi -Famil 0 Occupant load over 99 persona ❑ structures or RV park • Master Bualde.-r II■ Other 0 termstightingplan D other: --r -, ' ; Submit sets of plans with 'any of the above I K '� - 1. "� - - -� '' i1 te �. j "' `f-F ' - c The above are not a • licable to tea , or construction service Job site address: J 70 ' _;�. <.... r_ _._.. r ,,, .. ' ?_ _ .,'_. m ' Suite #: Bld_. /A • #: Number al inspections per pertnit allowed rte US7 - "4' Description • ttrr Fee (ea.) Total 1 Project Name: -74/1% -� New reaidcn a tlatehas ar maLfi- fatally per j Cross street/Directions to job site: dwelling malt. Includes steadied garage. i2 i - 40 , e/ £5d,,/CT service Included: 1000 aq. ft. or less 145.15 4 � rL additional 500 eq. It. orporlion thereof 33.40 1 Subdivision: I Lot #: Limited eaet/y 75.00 2 Limiird merry, non residential 75.00 2 Tax ma / a arcel #: Each manufactured home or modular dwelling T , •r q _ _r� �!r..a_.- 7,57 7.. t -t _. �.r.:_y_�d- j'_'•_ setvicearidiorfeeder 90.90 2 4.4 -- a- - Servkes orfeeders - Installation, ' alttrattoa or relocation: 200 amps or Ices l 80.30 ?O. 20 2 201 amps to 400 amts 106 -85 2 401 amps to 600 amps 160.60 2 ^i" _�- ^. -�' _ � •, ._.. i. i `t�. �ait••i '4:t i ii _ 601 amps to 1000 naps 2.40.60 2 :- - _ � - ^ cis l Over 1000 amps or who 454.65 2 Name: i 14 /X //7 e- Reconnect only 66.85 • 2 Address: qj i ) /UlLia,01 e ' Temporary services or feeders - installation, - alteration, er relocation: . City /State /Zip: 7 i d,' 200 amps or Ina 66.85 1 Phone: 0.34/39_5' ' Fax: Az $2c-d 201 lame to 400 amps 100.30 2 7-i..".:.1... .. — r 401 /D15°11 amps 133,75 IL `•ice t , h:_.. '� . •, : :: -.S '. r. _, �• • Branch dreulu - new, alteration, or Name: extension per panel: a Fee for branch purchase circuits with purc se or Address: service or feeder fee, each branch airmail 6.65 2 City /State /Zip: B. Foe for bench circuits without purchase of service or feeder fee, Fast branch circuit / 46.85 VG ..rES 2 Phone: I Fax: Each a: national branch circuit . -. 7 6.65 +' , 54 2 E-mail Misc.(Serviee or feeder nor included): -. - r- Each pueam 9t eriRazioa cacle 53.40 2 r.. -r - :,t... t .._.�._.,1 - ,�._'___._: -..._ , •. �...._'- _..,:._ ,�_! •, :.o.. Eschew: or outline iiXhtinR 53.40 2 , Job No: G• 0/E &A e - 3 3,3 signal cirewga) or a limited energy papa, ( � G. t-r alteration. or extension Page 2 2 C Business Name: N� t Destaiption: Address: ? a / 5g / C t /)-= ' ©�� 7 2.-3 Each additional luapectioe over the allowable In anZ.of the above: CI /.State /Zl� Per inspection per hour (min. 1 hoer) • 62.50 Phone: $)> >6 2- 9 2_4•,C F ax: 4'?:) 3 7 6 2_ i ot t ' investi gation fee: CCB LIC. #: 5"6 6 L ie q #' J'j -41 R 8) L i 5 7 T t r J n a i • Supervising electrician ��� c _ Subtotal S Q 3 . 7th signature uired: � (. Plan Review (25% of Permit Pee) $ Print Nam - - 'Z e y d• , 1 Lic. #: G (, f 3 6 S State Surcharge ( of Permit Fee) $ / 54" �p / 8% TOTAL PERMIT FEE $ /1"2, S9 Authoriz Notice: This permit application expires if a permit Is not obtained within Signature: '' Date: �/ i679 150 days after it has been accepted as complete- // L / / 'Fee methodology eet.by Tri- County Building Industry Syr ire Board. ,J.• M �l25,`/� (Please print acme) i:\DctslPermit FarmslElePermitApp.doe 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST Received `4/ 7 Da quested l 2 -1 ( g /0-3 AM PM \ BUP Location / 576 6 S - Suite 0 MEC Contact Person •vi ` 64 Ph (Y.124 J 7/ - 7 2 [ Z. PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner LC) .? S Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam s oL1 Shear Anchors / (,(GL Ext Sheath/Shear Int Sheath/Shear Framing 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 PAS T FAIL ECTRICA Se Rough -In UG /Slab Low Voltage Fire Alarm c.- FinaT) Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ;4' j PART FAIL SI Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA DateNC W C g C 3 Ext Approach/Sidewalk Inspector - - -� (1 Oft Other: Final DO NOT REMOVE this inspection record from -the job site. PASS PART FAIL