Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00115
DEVELOPMENT PMENT r S ERV A ) 639-4171
DATE ISSUED: 2/27/01
13125 SW
PARCEL: 2 S 112 B D -00700
SITE ADDRESS: 14655 SW 76TH AVE 008
SUBDIVISION: MARCIENE II ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: This permit is for 1 1/2 hours of inspection time to inspect electrical wiring for new vent fans that were
installed in units 8, 9,10, 12, 13 &14.
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: PER HOUR: 1
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
BOOTH - HEYDON LLC ELECTRO WIRE INC
PO BOX 1185 18857 SE SUNNYSIDE RD
LAKE OSWEGO, OR 97035 BORING, OR 97009 -9271
Phone: Phone: 658 -8136
Reg #: ELE 26 -667C
LIC 67879
SUP 2717S
FEES Required Inspections
Type By Date Amount Receipt
Wall Cover
PRMT CTR 2/27/01 $93.75 2720010000( Elect'I Final
5PCT CTR 2/27/01 $7.50 2720010000(
Total $101.25
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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.ofthese.rules or direct questions to OUNC at (503)
246 - 1987. (.\ PERMITTEE'S SIGNATURE X /777 ? IS BY: r1 O � / 4.44 ./
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: r e. %�Cl DATE:
LICENSE NO: c /7■,
Cali 639 -4175 by 7:OOpm for an inspection the next business day
j• 1
Electrical Permit Application -
b h Datereceived: / /,)7 (,� Permit no.: "'t' - ' _ • 1; j 1 7
b',^.�!yi City of Tigard Project/appl. no Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT ` .. • '
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial Isi Multi - family ❑ Tenant improvement .
l] New construction ❑ Addition/alteration/replacement ❑ Other: l] Partial
JOB SITE INFORMATION '
Job address: )t Sc " 5 tom.•• (t - P - II lc %,„ /,j Y/ Bldg. no Suite no Tax map /tax lot/account no.:
Lot: Block: ISubdivisfon: ' 1
Project name: I Description and location of work on premises:
Estimated date of completion/inspection: •
CONTRACTOR APPLICAT ``. _" :-`•--f-,,, - , FEE SCHEDULE
Job no: Fee Max
Business name: , /),--) f� Description. Qty. (ea.) Total no. insp
N ew res - single gle or multi - family per
Address: /Vi; 7 7 j f -S H y /)(' 4 dwelling unit includes attached garage. '
City: l , . , • I Stat 0 ZIP: //J 5 Serviceincluded:
Phone: (,..CF(.-1/3" r ax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: t, 7 I Elec. bus. lic. no: 2 4. - e jt 7 Limited energy, residential 2
Cit /metro lic. no.: / ,, r Limited energy, non- residential 2
• G�/ ZZ 0,/ Each manufactured home or modular dwelling
Signature of superv electrician (required) / Date / Service and/or feeder 2
Sup. elect. name (print): 1 - -7 • 5o ,r/ License no:27 7r Services or feeders — installation,
• aka alteration or relocation:
- PROPERTY OWNER ' 200 amps or less 2
201 amps to 400 amps 2
Name (print): /,,e ,/f,��
Mailing address: j ,...9 5
��7 -"� 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: / 6'/ /, • I State:42,e_71P:9J,- _Over 1000 amps or volts 2
Phoned Z" r . A • x: - , -, / 4‘E-mail: Reconnect only 1
Owner installation: The installation is bein: made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, r 70, 70 200 amps or less 2
201 amps to 400 am s 2
Owner's signatur.. , ' - 4 !.ifs( "Ji 401 to 600 amps p 2
• - ENGINEER . Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) - Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle • 2
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* -- 2
0 Building over three stories ❑ Feeders, 400 amps or more *Description:
0 Occupant Toad over 99 persons 0 Manufactured structures or RV park Each additional inpection over the all wable in any of the above:
0 Egress/lightingplan 0 Other. Per inspection `, hr ( „y 0-,...-I 1 1 1
Submit sets of plans with any of the above. Investigation fee ��TT
The above are not applicable to temporary construction service. Other {�_
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $�`
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $ _
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ 7•
Expires accepted as complete. TOTAL. $ _75.1,_g_5_____
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00/COM)
•
FCITY OF TIGARD BUILDING INSPECTION. DIVISION : - : 7.4Y
MST
24- Hour'Inspection Line: . 6394175 • Business Line: 639 -4171 - , .- . q .. .
BUP
•
Date Requested 3 - /S O/ - AM ` PM Ls ., BLD
Location "(6-57:5 5(.O 7, ` Suite. M EC rrs w!%
Contact Person ' 7:,�„�e -z
Contractor * 7'o 1A•, P;F . ' l/✓2 , Ph- ecacg - 2/36, SWR _
BU,ILDING4",,3 Tenant/Owner ,.,
Retaining Wall - � - _ - : I � _ :C' ..
Footing f .7
Access: '� W -- /� t
Foundation F y - g
N'
Ftg in . S .. .
Crawl Drain Inspection Notes: - • • _ ._ Slab ,. tit/ i +S 7 - . SIT • • _ .
Post &.Beam - �-
Ext'Sheath/Shear _- - 1: _ %'C/: S. '.y :LS • /n/: .• f.
• Int Sheath/S_hr
ea
Framing ":. .... :.
Insulation --- cr A• '
Drywall Nailing. •
Firewall S 3 �,.- o Y3 S � -
Eire Sprinkler :.. _ , /
Fire Alarm •
Susp'd Ceiling- -
Roof •
Misc: - .
Final
PASS PART. FAIL -
PLk JMBING ' -4 . ` .', : .
Post &'Beam ` . .
Under Slab �` A , �7 ,� 2 �, /. �QU� / g Out /�C
Water Service Ranitary Sewer ?--'
,` . tl)G - / Rain Drains - / .(/ �T
Final
PASS PART FAIL' • "—
MECHANIGAL -• ` ` -
Post °& Beam - •
Rough In 19 5 //tt 4 1 - -
Gas Line �___. ,/
Smoke Dampers
Final -
T FAIL
ELECTIC' , . , - . -: ,
ervice - _
Rough In
UG /Slab .. '
Low Voltage
Fire Alarm
PART . FAIL -
BackfilVGrading
Sanitary Sewer •
Storm Drain . [ ] Reinspection fee of $ required.before next. inspection. Pay at.City Hall, 13125 SW Hall Blvd_ •
Catch Basin Unable to inspect - no
Fire Supply Line [ ] Please call for reinspection RE: - [ ] access
p
ADA . 1416cr . fip 61.ecnat (-CI 1.—
A roach/Sidewalk 5 / /-7 (� c-?----- ------------- '
, ;/ EXt • '
Other Date . I Inspect Other
Final
PASS.. PART FAIL - DO NOT REMOVE this inspection reco from the job site.