Permit = Ty OF TIGARD ELECTRICAL PERMIT
PERMIT #: -/^ =DEVELOPMENT SERVICES DATES ISSUED: 9/13/02 -00469
°' ��-�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112BD -00100
SITE ADDRESS: 14640 SW 76TH AVE 064
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT : 065 JURISDICTION: TIG
Proiect Description: Fire restoration: Install 5 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: 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: 4 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:
BOROS, STEFAN A + FIVIA KELSO ELECTRIC INC
PO BOX 1890 545 SE 3RD
GRESHAM, OR 97030 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 -6360
Reg #: LIC 116254
SUP 4270s
ELE 34 -433c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 9/13/02 $73.45 2720020000( Elect'I Final
5PCT CTR 9/13/02 $5.88 2720020000(
Total $79.33
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 to
Permit Signature: Issued By: 6 J' ui
U
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: T C A � f DATE:
LICENSE NO: q - )0
Call 639 -4175 by 7:OOpm for an inspection the next business day
__....ii , . . ......... .' • .. . ' 1 r''
FROM : KELSO ELECTRIC INC FAX NO : 000000
Sep. 09 2002 02:01PM P9
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Ir'i• - .'Zi , l \I.: '',-- , . _.,
D q 7 .. . • - F011 OFEt I.:SE.- oL'i'
, . Fie..ived
Sign
City of Tigard T es t v - DI'''''' D-7'7'1...Drigmrs Approv4]
, o
13125 SW Kali Blvd. Flan Row, Other
Tigard, OlTiCrla 97223 tatelity: 1 No.: I
Pe: 103.639.4171 Fax.: 503.598.1960 ., „I Posi-Royi.v. Land Uss ..---i
IttoMet: www,ci.tigard.or l&
.us '..i.PS:;i. ph Datertlhe. caw No.:
.iO''' ''.!-E. COrtract kirit,i ' Cl see p 2 for -- I
2 inspection R.oquest: 503-634-4175 ' Nirrnett.4ethodi _Supp4cmgetei Intern:moon. _
-
-
-:.: , : !!!!!. ',.....!..,::! •i OF •WEIRK i'lEll:I iliIII:Il7I iilcIlI • ' leIsh'ilili:islIlItlisa. av .:I:::ill'- .?:!:,.. '• •
0 New construction U Demolition • service over z26 Amos- M Healdrcare faciiity
coral Is liturdous lor.aaor.
jA.dditon/alteration/replacement W Other: 0 scrsrioe over 32 a amps-rating of 0 Building over I0,000 !q;lare foci,
• . ;'..‘.::' ..- Oil'rT,E0ORV,AWC6N51712.1JItt9tr,4!rgf,T(-!:;:W.:::■ I & 2 fano dwellinp four or utore residential ur, i:s in
(:) 1 & 2-Fain:Ix dwelling 0 Commgcial/aciustrial 0 system over 000 vdts nominal OrLe structure
__ Building aver three stor Feeders. 400 amp morr_
- Auoessory Buildin. r Multi-Parnil Occupant load over 99 persons Manufactured sit uctures or RV park.
ID lviaster Builder le Other: 0 Egin.sailighting plan 0 Other:
.-- ..• . : J;JOEI.511lE•LINEOOTATION.S.ari'L,tac Submit sct2t of Firms with any of tho ve.
abo
The alsovo are not sinble to eemporary co nitruction 4qrviee.
Yob site address.: L g 0 j , _ : ':':::,=: - ::;77 . ;:l.III!I'l - III: : il.''I'I'll?I'l'ITF.EIE,:".'SCII.E.DITLZ II., : l l.`. I ': - ::'I.I .:4:I.V:II.." '. : -
1 Suite : i 731cle./Apt.4: ( • Nurolser of inspections per permit' allOvred
Pro i ec t Name: Deseri on • . Ns (as.) Tsai
New rcsidennal-stritte or tmtlti int v
CroaS sreetiDh to job iite: di.olitoe u nit. Itrehsdes arcsehcri goruge- 1
• Scr4ce(aclodsdi I
moo -. ft arks!. 145.15 4
. J • V: : • tr 540 .. or 1.4 . . i. 1111111111111111M11 1111
LITalted e . 4 rockier:Mal • 75.09 IIMMEMUES
Subdivision! _ i Lot g: . Lurked N. no •:dential /5.0o 1 2.
Tax rnap/Darcel #: Bach rrtirtufscturei borne or moduisr ?Notting
2
:. .': . - ''. '': - .:' 7 .' 't•: :,'DRSCtri7.7:(0&!OFAVOR.R'': - '-j-' lerdice andre'r feeder :C.90
Fire je-cs or -
,k)yrii-i Servioe feectcrs inTullation,
sitsrodoo or rolooadoal I
1 1
I
, 200 on - or less Ill 50.30 ; 2
-- 201 aro . to 490 • or • IllEiMilaffilM11= 2
• 401 arrrps to 00 Brow 5 MIMI /
OPERTYOWNER:::.; .. 'LI,: .277+-7: • i 1 ... : , ILM saw ;40 7 -
— . ' Crvcr 1000 am- Qr votes 45,4,65 2
. Name; . Itocohnect_onfy MO 66.$5 _ Ill
-
Acid.res — : Temporary services or feeders • Installatio a,
- ateoraTion. or relocation: I
a iState/Zi.: 200 arn.s or lmg
Phone: Fax: 201 am.: $0 - $ 2= )00-10 IIIIIIMIO
- , .' 4010 630 arnoe IIMMOMMIIIIIIIIII 2
i. '!",MA Brett& eircgitg - new, alteratiOa, or i
Name: extension par paneit i
Addrcss: .-- 1 ..k. Fcc for Orarich circuits w1d ourchsze of
scrvicc or foods frt., each ;:rerta C/TFIllt 6.65 I / ii
City! StattiZiti: B. Fest for branch stmv.isi withcat putchtsc of ' •
- ,.; 9 '2
Phone: LF2X: laeri a ddicional branch circuit IMII 6.51 .._,... .xsall
.
E-rn: Misc.(Serviec or feadsr not included); !
! ... --. ::--.....:..... :,!.:!tij!,:!;;;:..; :III:is:IiI: :• - '",Ill:.. ....: Ew' Puf_ "In cl'cle •53Ao MI 2
Ech t si or etzdios I; St , I S3 2
Job No.. si argot* or a iitaitildautrilY Pitar
BUSilIC55 NaMe: 650 0 Pa L AC. thereziec._101.4ion
*Decal-pion: T
1 i
A.ddresz: .. i
-- _
ci t . 4 Mirrillp ILIMAIIIMIll , Each addl inagcctioo over the atiow4i1e a any of the pleove; _
! : 62.50 r ---
.--
: Per khspection (peY hour - min- 1 hour) I----
Phone: s in,,Vd111.11 Fax: „, , -
-
CC) I 3 I.., ic. 5. A ,,, Maar ' , Other. ' I
- ; I.I. -....: i:: ;:' • I: :?::'7';:' 174.0i..'.;. l5...I. I . -. 4lIlIF• I I :.,:''. ' : :.:. '
Sups in g e ectrician Su total I $ _
signatur e re • uired: 4/, e___________: .
Plan R as% of Pertrtir Fes1 $
. ____
=P.t Name: 0,‘ L eitnoiN11 ' Li c. # : Lid "70 S. I
i Ti State- Sui:thorze OM of Perroit Fee) 5
TOTAL PERMIT FEE S 1 , 3
Author:24d •
Noticm Thla permit applIcailoa expirts If a pon is not 0 Ingo cd !vill?'
Signature: .C.:1)iet.SEI-11-‘P .., Date: 111.0 days sitar it has been toe/spied sli complete.
— me th
• Fee methodology sat by 1'r-C-Quaty Building Industry See Soerci.
-......- -..-
(Nast print cunt)
or,rr 7 es 1 1. Tr% T y 'T'l nowtoilCU1C YV,1 vilrt ZflOZ/9g;a0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / AM PM BUP
Location (7,5-2-0) / 4 q 0 5C- % P Suite a' C ( MEC
Contact Person / / Ph ( ) 193 _ 3 z7 4 PLM
Contractor Kelso L(��° 'r' Ph ( ) SWR
BUILDING Tenant/Owner ELC 5-06Z - 00 110 f'
Footing
Foundation ELC
Access:
Ftg Drain 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 f ,��
Roof p Cocis — P/9,_ssA,-
Other:
Final •
PASS PART FAIL
PLUMBING
•
Post & Beam j
Under Slab
Rough -In 7
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 PART FAIL
ervice
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Fi Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
- SIT El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date . /�� 2 � 0 2.. Inspector /�� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL