Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00314
DEVELOPMENT SERVICES DATE ISSUED: 5/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113B0-00600
SITE ADDRESS: 16060 SW 85TH AVE
SUBDIVISION: SEWER TREATMENT PLANT ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (1) branch circuit for pole lights.
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: 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:
UNIFIED SEWERAGE AGENCY CONDUIT ELECTRIC
150 N 1ST AVE DBA DUIT LEVEL TOOL CO
HILLSBORO, OR 97123 2074 NW ALOCLEK STE 405
HILLSBORO, OR 97124
Phone: Phone: 466 -9754
Reg #: SUP 4501S
LIC 109669
FEES ELE 26 -905C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/30/03 $46.85
[TAX] 8% State Tax 5/30/03 $3.75 Rough -
Elect'l Final •
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
1- 800 - 332 -2344.
Issued By: Permit Signature: ef 4 / i e
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
May.30. 2003 7:27AM CONDUIT ELECTRIC I , No.5421 R. 1 .
._ l
Electrical Fern-tit Applicati®n :,` -
Qti ,� 40 _ Date received: S 3d Permit no.: �(��003 ij,
.11 City of and
g P.r'ecdappL no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, 0 ,
Phone: (503) 639- 4171Ew ttt�u issued: t ;'r Receipt no.;
• Fax; (503) 598 -1960 - C ase the no.: _
- �7. �l Payment type: . •
Land use approval: Mpy 3 0 U
' ? TYP'E er,PFlk11y''1' - {
O 1 & 2 family dwelling or accessory 0 Commercia rta 0 Multi- fammil 0 Tenant improvement
0 New construction gl Addition/alteration /replacement Q Other, 0 Partial
r , . X70$ SJTEJNFORNiATA.C. c ,,
Job address: � • � La k . �.� :., :' I , , ; .,
t'_ • Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot Block: Subdivision:
Project name: Description and location of work on premises: ' Pe � A is
Estimated date of corn detion/inspection: - .
' CONIRACTORA ��'""r,,
.Yob no. • Fee N . - � � ' CIIEbL -LE , , . � ..
M ax
Business name: r rAngf_aggrarAraiMil Description Qty. (ea) Total no. lesp
Address: "� : New residential- single or multi-family per
dwelling unit. includes attached garage.
City: ua. ! / ma ZIP: 1 7 r, , Scrrice included:
Phone: Ot t : 1000 sq. ft of less 4
CCB no.: �� Elec. I. IiC. no: fj5 . Each additional 500 sq, k or portion thereof
Limited enelgy, residential M = 2
City /;c e . o ic. o.: , /0 / 03 Limited ���
p. /50, energynoa- residential 2
i;
d�= Each manufactured home or modular dwelling ■��
Signature of su.ervising electrician r Date a MAT Service and/orfeeder 2
Sup elect name(pnnc) jar 63.. r 1 1 Servicesor feeders — installation,
PROPERTY 033NIR alteration or less �e 2
� ` ,, •. ` ' Tt .•7,.� ".�; 200 amps or less
Name (print) 201 amps to 400 amps
Mailing address: 401 amps to 600 amps ��
amps to amps MEd 2
•
Over State: ZIP: Over 1000 amps ps s or or volts
Phone: Fax: E- mail': Reconnect only MINI__ 1
Owner installation: The installation is being made on property , I own Cempocaryserricesorfeeders-
which is not intended for sale, lease, rent, or exchange according to l nstpliation ,alteratiop,orrelocat,on: 1111 ORS 447, 455, 479, 670, 701. 200 amps or less 2
401 s amp 40 0 s amps � � 2
Owner's signature: Date: 401 a a 2
ENGJ,NEER ', Branch circuits • new alteration,
Name: or exteosioit per panel:
A. Fee for branch Circuits with purchase of
Address: service or feeder fee, each branch circuit
City: State: . ZIP: B. Fee for branrtt cit'cui.ts without purchase
Phone Fax: E - mail_ of service or feeder fee, first branch circuit MFR. 2
Each additional branch circuit: 1111111111111
,„ PL LN ' RFV1L Plea cLeck 211 that anp)) • M isc- (Serviceor feeder not included): 11111111.
❑. Service over 225amps-commercial QHealth- catefacility Each pump or irrigation' circle 2
❑ Service over 320amps- raingof 1&2 Q Hazardohslocation Baths sign or outline li :bting _S 2
family dwellings ❑ Building over 10,000 square feet fqur or Signal circuit(s) or a limited energy panel, System over 600 volts nominal more residential units m one structure alteration or extension* 2
Q Building over three stories ❑ Feeders, 400 amps or more *Description:
O Occupant toad over 99 persons Q Manufactured structures or RV park Each additional Inspection over the allowable in any of the shrove:
O Egress/lighting
0 Other Ferinspection
Submit _ sets of plans with any of the above. ����
p Y Investigation
The above are not applicable to temporary construction service. Other •
Not all juriadi accept credit cards, please call jurisdiction for more info: na:ion, Notice: Th i s perm app Permit fee $ 7 �O' i d 7
0 Vtsa ` ,I surC 4 expires i f a permit is not obtained Plan review (at — %) $
credit , 4 number: e g c0 O 4(' J.5— within 180 days after it has been State surcharge (8 %) ,, $
. , .. . J = Al . Expires accepted as complete. TOTAL $ -=
' h n oe credit rd $ ' ' ' 4 k 6 0
• holder signature Amount
440.461 (MO/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION ; ) Business Line: (503) 639 -4171 MST
BUP
Received l � I 7 )2 Date Requested / 2-- (g 3 AM PM BUP
.Location /67 0 &2 0 Suite MEC
Contact Person Ph ( ) /O i2 — 7 4 PLM
Contractor Ph ( ). SWR
c� t /--'L 72' 7444.(
BUILDING Tenant/Owner - ELC
Footing 3/S
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: / �/ SIT
Post & Beam 41 (A_41. / — l t / i (- poles
Shear Anchors
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
PASS PART FAIL
AL
Rough -In
UG /Slab
Low Voltage
Fire Alarm
.111E1) ' ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 111 Please call for reinspection RE: D Unable to inspect — no access
Fire Supply Line S
ADA Date <fi C I d3 Inspector /� d Gv, Ext
Approach/Sidewalk
Other:
Final . DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL