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Permit
• C ELECTRICAL PERMIT CITY OF TIGARD �►► -. PERMIT #: ELC2001 -00280 iw�iii DEVELOPMENT Tigard. (503) 639 -4171 SERVICES DATE ISSUED: 05/31 /2001 4 SW Hall PARCEL: 2S111 AA -02300 SITE ADDRESS: 14415 SW 86TH AVE SUBDIVISION: GREENSWARD PARK ZONING: R -4.5 BLOCK: LOT : 015 JURISDICTION: TIG Project Description: Installation of (1) branch circuit to NC. 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: DEHN, STEPHEN L GRF ELECTRIC 14415 SW 86TH AVE 15460 SE PARADISE LN TIGARD, OR 97224 MULINO, OR 97042 Phone: Phone: 503 - 829 -4146 Reg #: LIC 76751 SUP 1655S ELE 3 -484C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 05/31/2001 $46.85 2720010000( Elect'I Final 5PCT CTR 05/31/2001 $3.75 2720010000( 1 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 imp 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 OUNC at (503) 246 -6699 or 1.800- 332 -2344. Permit Signature: it ",e - t- 447- Issued By: L � ! <Lizt ;r(, `'1 0 G' ) 1 �.� `f �C Y� -f 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 C SIGNATURE OF SUPR. EL EC'N: ( ) DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By J Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain _ Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final ,i/— / i' Underfloor insulation Post/beam structural Shear walls /anchors _ _ ELR - Restricted Energy Permit Roof nailing / Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation 4 Inspection Description Date Passed By Drywall nailing Post /beam mechanical Suspended ceiling Gas line Engineered soils I Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank _ Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab _ Catch basin /Manhole SWR - Sewer Permit Engineered soils / Inspection Description Date Passed By Engineering acceptance _ Sanitary sewer Final inspection _ Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 CITY OF TIGARD BUILDING INSPECTION DIVISION -4 r 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST �J BUP Date Requested / / ( AM PM BLD Location / c( q 1 5 3 c✓ gG 6f AL, Suite MEC Contact Person Ph 2 u7 ' 3 ( PLM Contractor A l= i e c_ i n C Ph SWR 1 BUILDING Tenant/Owner D€ h vi _, Si'-e jok e yl ELC Z( /�" ) 24—° Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam /� / Ext Sheath /Shear 1 -C- Uh , 1` Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall 4j 6 h k Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING F 11 /--. O GC Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL 0 Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough In UG /Slab Low Voltage Fi Alarm PASS ) ART FAIL SITE lracictill /G rading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: / [ ] Unable to inspect - no access ADA 1/ `1O / ? Approach/Sidewalk / Other Date Inspector • e L r)-y1 Q Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00280 r 13125 IA DEVELOPMENT Tigard, SO R 2 (503) 639 -4171 CES DATE ISSUED: 05/31/2001 SW Hall PARCEL: 2S1 11 AA -02300 SITE ADDRESS: 14415 SW 86TH AVE SUBDIVISION: GREENSWARD PARK ZONING: R -4.5 BLOCK: LOT : 015 JURISDICTION: TIG Project Description: Installation of (1) branch circuit to NC. 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: DEHN, STEPHEN L GRF ELECTRIC 14415 SW 86TH AVE 15460 SE PARADISE LN TIGARD, OR 97224 MULINO, OR 97042 Phone: Phone: 503 - 829 -4146 Reg #: LIC 76751 SUP 1655S ELE 3 -484C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 05/31/2001 $46.85 2720010000( Elect'I Final 5PCT CTR 05/31/2001 $3.75 2720010000( 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800 -332 -2344. Permit Signature: Issued By: > I C< 4i, (Lzr 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. E... C'N: (fi) i �'" �f .ir-r ,7 a . -7 DATE: LICENSE NO: �5 Call 639 -4175 by 7:00pm for an inspection the next business day May 30 01 02: 10p GRF Electric 5038295747 p -1 OF A Electrical Permit Application Date received: 5- j &) Permit no .:C. -/..C»D -C () ze1i'1i‘ Cit o f Tigard ] Expire date: g Pro 1 ect/a PP no.: of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 City f 8 Phone: (503) 639-4171 Date issued: By: l Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: • Land use approval: TYPE OF PERMIT • & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: ' L- / LA.) , 'fie) Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: ,'T . Project name: I e . Description and location of work on premises: Estimated date of completion/inspection: . CONTRACTOR APPLICATION FEE SCHEDULE I ;al: •:V: Fee Max Business name: Description Qty I (ea.) l louj I no. insp G� .r c IC.G• +rf G New residential - single or multi- Grmily per Address I S 5, Par v i ice Z-Lek, dwellingunit . Includes attached garage. City: /11 ( r b 9)3 Slate: Pg., I ZIP: 4 7 ©c{ Z Service included: Phone: 5b3 -e yal - ct i.f [ . Fax: ("21:I -5 f7I E -mail: 1000 sq. ft. or less 4 CCB no.: •'? L q I I Elec, bus. lie. no: 3 - ti- 8 4- Each additional 500 sq, ft, or portion thereof Limited energy, residential 2 City /metro tic, no.: '3 r- 7 0_ Li / energy, aron- residential 2 / . l <1 3 a / e2 / Each manufactured home or modular dwelling Signs arum oofupper is nng� eccttrriic rt (required) ` Date { Service and/or feeder 2 Services or feeders — installation, Sup. elect. name (print): A a l; k _ �.... - t,. License no: 6 S 1, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 9 e v e- f , I e y 1,.-- ' 201 amps to 400 amps 2 Mailing address: ) &+ Li—( ( .S k / _ /t-11C - 1000 401 amps to 600 amps 2 tp / 1 601 amps to 1 amps 2 City: 0 ip , X 2' , State: ZIP: a- Over 1000 amps or volts 2 Phone: E-mail: I/z7fIA/il Reconnect only 1 Owner installation: e installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrebocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per pastel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: • ZIP: B. Fee ferbrneh circuits without purchase l of service or feeder fee, first branch circuit: G i•f'� (�� 2 Phone: Fax: E - mail; Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): 0 Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle 2 0 Service over 320 amps - rating of 1&2 0 Hazardous location Each signor outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, C] System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories 0 Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above: 0 Egress/lightingplan 0 Other. Per inspection I I . Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all juriadictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ D Visa ❑ MasterCard expires if a permit is not obtained Plan review (at — %) $ Credit card cumber: / / within 180 days after it has been State surcharge (8%) .. - -� __76-- Expires accepted as complete. TOTAL $ S Name of cardholder as shown on credit card D Cardholder miniature s \ J miniature Amount 'C 440-4615 (6mWCOM) 1 K r, Y w