Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00315
; �� DEVELOPMENT SERVICES DATE ISSUED: 5/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112CB-00403
SITE ADDRESS: 15200 SW 81ST AVE
ZONING: R -4.5
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (3) 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: 2 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:
JANES, KEN & LYNETTE GARNER ELECTRIC
15200 SW 81ST AVE 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 624 - 7133 Phone: 503 - 648 - 4552
Reg #: LIC 121159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/30/03 $60.15
[TAX] 8% State Tax 5/30/03 $4 Rough -
Elect'I Final
Total $64.96
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: Permit Signature: "/' /7
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 7:00pm for an inspection the next business day
0711212001 04:55 6427925 PAGE 01
Electrical. P ermit Application Permit no
A : ____-, - _ Date recei � Q iitex03 /S
RECEIVED
1‘ � City of Tigard Project /appl. no.: Expire date:
Address: 13125 SW Hall Blvd. Tigard, OR 97223 Date issued: By:4.1 J Receiptno.:
City 4 Tigard Phone; (503) 639 -4171 MAY 2 9 2003
Case file no.: Payment type:
Fax: (503) 598 -1960 CITY OF TIGARD
Land use approval: ,
'l'YPI'. OF'TIME!'
'r ercia /industrial ❑ Multi - family O Tenant improvement
' ^ 1 & 2 family dwelling or accessory 5. CJ Partial
❑ New construction • Addition /alteration/replacement CI Other:
JOB SITE INFORMATION
Job address: 00 E :Lt..
Bldg. no.: Suite no.: Tax map /tax lot/account no.:
-
Lot: Block: Subdivision: .._ tau { t s �
Project name: Desert .tion and location of work on premises: C3) CA tau
1.-- crr t,.�
(.r - k}; to - car, et 1-w�S .) '"" 3
Estimated date of cotn•letion/inspection' Fl SCHEDULE ('UN1'RA(;'t
CONTRACTOR APPLICATION Fee Max
Job no: ea. Total no. ins
p
may, (ea.) L
� - ' !: / a! o multi - fondly r
Business name: New single r t#
Address: ,,,2 6/ : mot _ e • ,.9.,_ 7 0'_' yea , dwelling unit Includes attached garage.
IMMINIIMIIIIIIIIIMMOMINZEMII Service included:
4
Pf � 7 rrlail: _
1000 sq. ft. or less
�� Each additional 500 sq. R or portion thereof 2
CCB no.: : % 'if Elec, bus. lie. no :�3 A Limited energy, residential
CityLm o tic, no.: Limitedelle% ,non - residential 2
5 , _ Each manufactured home or modular dwelling 2
� %" Service and/or feeder
� } ► rt' /i!• 0460 —required Date
_
y , � s i -� '-s " r- i Services or feeders - installation,
_ License no:3 /(r' /-3
alteration or relocation:
P KO1'EK•1'Y UwYNEIL 200 amps or less 2
201 amps to 400 amps — _ 2
Name (print): t) i 5C1rS It Ai• —
401 amps to 600 amps 2
Mailing address: �J / Q/Yt -e-4- ' 601 am.s to 1000 amps _ 2
City: L /VC a ZIP: Over 1000 amps or volts 2
ty Reconnectonl l
Phone: —"7 Fax: E-mail: Temporary services or feeders -
Owner installation: The installation is being made on property I own losta nation, alteration, orre.ocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps
Owner's signature: Date: 401 to 600 am.s 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,brancb circuit 2
State: 1ZIP: B. Fee for branch circuits without purchase I g � , I � �j
City: of service or feeder fee, first branch circuit: �(
Phone: fax: E-mail: Each additional branch circuit: a_ . 1p,‘J% ( )
Pl.AN ltEVIICW (Please cheat sill that :grply) Misc . (Service or feeder not lhcluded):
Each pump or irrigation circle .
2
O Service over 225 amps - commercial ❑ Health -care facility Each sign or outline i i circle 2
ID Service over 320 amps- ratirts of 1 &2 ❑ Hazardous location
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
D Building over three stories 0 Feeders, 400 amps or snore -
Description:
O Occupant load over 99 persons ❑ ,��-
Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection 1 1 I I
Submit _ sets of plans with any of the above. Investigation fee _
The above are not applicable to temporary consttucttion service. Other
/ 03 Permit fee $ (off , i
Not aillurisdiedons accept credit cards, please call Jurisdiction for more information.' Notice: This permit application Ply review (at _ %) $
visa ED MastcrCttd � expires if a permit is not obtained
Credit not tuber: N3 oQ0 1 01 U 7 O_ ' within ISO days after it has been State surcharge (8%) .... $ L ( J • 3 r 1
K. LEG"T G G 3 ' 5xpires accepted as complete. TOTAL $ . 9 yo
n 1 oP cazold q+ own on creAlt card ( c i 4 , q I
l g. CCga trite f1ro/4� A
$ �` l t to 440 -4615 (6/ooiCOt.-1)
Cardhotdar sipssWre mount
CITY OF TIGARD - 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested / (o - .5" AM PM BUP
Q
Location i s o� D d O ! -4-?5 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 6 $ --gSc SWR
BUILDING Tenant/Owner ELC 3 — e ) d)3 /c5 —
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation /11 A- -
Drywall Nailing • i its
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
PASS PART FAIL
ELECTRICAL
Service
•
Rough -In
UG /Slab
Low Voltage
Fire Alarm
410 v ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
TE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA t 6/5 I p ctor � ae ns a 6 � Approach/Sidewalk D` j � `
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL