Permit - - CITY OF TIGARD ELECTRICAL PERMIT
,A PERMIT #: ELC2003 -00431
A TV DEVELOPMENT SERVICES DATE ISSUED: 7/16/03
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: Install (2) 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: 1 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 DU IT 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 7/16/03 $53.50
[TAX] 8% State Tax 7/16/03 $4 Rough -
Elect'I Final
Total $57.78
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- 2 -2344.
Issued By: j ��� ,r / - Permit Signature: (7,10 ;( 77-3
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: 4O / 5
Call 639 -4175 by 7:00pm for an inspection the next business day
vvv. 1x Ur lle..q,1(U LJ ". r.. " r7�
Jul•15. 2003 4:24PM CONDUIT ELECTRIC N0•6610 P. lJuz
�1 m . _ -1 63 Permit 1•Io.: 1--G 3 -40 5'3"
City of 'Tigard ��� Platrning Approve) Sign
Date/I Permit No.:
13125 see Hall Bled. 1 ,- 1001 Plan Itavie:w Other , •
Tigard, Oregon 97223 ,U� calm _
Phone; 503 - 639 -4171 Fax: 503 - a ., Post- review
59 p No.:
Internet www.ci.tigatdor.us 011 1 r p\V1 . 'i ; r t l � o
'� Cot B :
24 Inspection Rcquesr. 41 5= Contact
I I u . •1ee sec Page i for
I Su :tpiW Iatormatioo.
tz r- ,.:;
• i l' '��}? I a- T.C'r.. lK: =` : t uh? Wf'0 :•�r�_r..i ^;D ,iv. "kAVIENV,-.... v... -'.I '^ '"'yi. '• •.p c-
Ila New construction ❑ Demolition ' 6 Service over 22S asps- 0 Health -care facility
- • • 'tion/alt+.7rationlr • laeement ❑ 0
Other: "" ` ial • ❑ Hazardous location
Semite over 320 amps-rating of ❑ Building over 10,000 square foci,
bIufA , e - 'Ef sot • WV, t;C4 •,. =„,x; •`d: 1 & 2 family dwellings four or more residential units in
la •i:o : •• II' • • • ilia: 111A Commercial/Industrial ' 0 system over 600 volts nominal one structure
• Accesso Stuldia Multi -Fanv] 0 Building over three stories C Feeders, 400 amps or more
Q Occu load over 99 persons 0 Manufactured structures or KY part
❑ Master Builder II Other: 0 Egress/lighting phos 0 Cot= •
kTigragifftf C .. ' ' W WetriAM e • " . p u - , Vii{ K : 5 �. Submit sets ofplans with Any of the above.
Job Site address; LpO1 O , Thc above are not a Scablo to tem , ore construction service. Itagra suite #: Bid•J• •t #: rya 'ixiat;"� :Ye :t� : e 1 : 41 i „ } `.'�, '..
• 'Prultibcr of in • actions per permit aUOwed
Pro'ect Nazne: V '1 ..,&C-• , . dell(Ce Dn..' • tioii Qty Fee (eat.) I Tend mil • Cross street/Directions to jab site. New resldeatial -emgle or multi-family per
dwelrmg trait. Includes attached garage.
Service included:
1000 -. it. or logo 145.15
•
Each additional 500 S4- ft.ori onion lher of 33.40
Subdivision: i Lot # Limited eater residential 75.00
Tub iv ma • •areal n' Limited enegy, non tcsidential 75.00 •
_ Each maoufagttued hotnc or modular dwelling ��
X' �•, =a. , =�blrr
• ' ; ;4• PII ,. a ! „epti °_.a1 0 O i •:a "•r ' ,' . :,” u1v1`e A di” feeder 90.90
Services or feeders - ineta11ntioe,
alteration or relocation:
200 amps or lots II 80.30
201 amps to 400 amps 106.85 El
r ,y ' I 401 • pig m 600 amps 160,60.
L .1: ' i, �1 fl'." :veil % �1r3]' r 1 N ;� r <<► d o- :.`. 9 4iP�l c41 601 amps f0 1000 arapa 24p.6Q
Over 1000 • ., . or volts• I 454.65
Name: Reconnect o0 66.85 d
Address: Temporary soviets or feeders - iusta 1a ion,
alteratiea, or relocation:
' 200 amps or less 66,85
Phone: Fax 201 , .. to400sun. 100430 Q
(�ii'''it; ;: s :f u�H Ali G'I �iI :,3.r :� 401 to 600 ans. 133.75 � d
Branch circuits - new, alteration, or
rztension per panes;
Address; A. Fee for branch circuits with purchase of
service err feeder fee, each branch circuit 6.65.
Ci /,State/ • a , B. Fee for hooch circuits without purchase of I Vi
• Phone: FaFax: aerviee or feeder fee, era branch branch oircmt y
4 685 e.
Each additional brmtch ckexrit 6.65 r-'
E -mail: Misa(Sarvloe or fonder not included): •
�'l'1 Ire ? : ! 1 .01: veil ',og , „•: tumsporirtitloncirc>s 53.40
lob No: ', or oteilioe 1. ri 56.40
n ���rrsI���� Signal at;r,at(s) or a limited energy panel, Mg
Business Name: it A.MgaTlaWtt - alteration, or p t
V
rwicripdos
Address: (q J Cu) '9•. " e •
a /state /Z .: va [a 1 i A • r J ? oi(��- .. ,. '.a • hocr twin. 1 hour • MI 62.50 _NI
Phone: ..P3 °-t'72 -• Fax: '±0Z le - "R.-..-Ali mad - 'on P:cr III
C 'B Lie. �'l '. �c� ; '' r � � Other r MI
Supervising electrician ` r jl:] : e, • ' �• Subtotal
' "'W`,
r +ZEONE 1; A. �i. i� :•.�ii 4
i � µ a'�:� ".
/' Subtotal
si e.9 afore zc ■aired: �������` �i�L , nO
- a o 'ermrt eel
Print N atae: gi % I r i a/ximi
TOTAL PERMIT FEE EIDNER TBMIN
Authorized Notice: This
Permit application expires if a permit is not ohpurted.+5th1,n
Signature: gate: _ ISO days after It has been accepted as complete.
"Fee me:thodalogy sat, by Tr1 -County Buldlun Industry Service Board.
•
' (Please print name) .
i :\Dsts1Pestni; Farms1ElcPcmvtApp.doc 01/03
•
•
CITY OF TIGARD 24-Hour. -
Bl I�DING Inspection Line: (503) 63 5 • MST Y
INSPECTION DIVISION Business Line: (503) -4171
F- BUP
Received Date Requested • 0 - t--- AM PM BUP
Location / l0 O ( 2 c) g Suite . MEC
Contact Person (, —Q. Ph ( ) 6 9- f -f 2-g PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner C W S ELC 3 - Q v f i 31
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 •
Drywall Nailing • -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam •
Under Slab
6 rbf
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
Fir= Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•AS - PART FAIL
• I ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line -
ADA
Approach/Sidewalk Date P ✓�� D� Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
•