Permit CITY OF TIGARD ELECTRICAL PERMIT
r °v - PERMIT #: ELC2004 -00085
44 . 6.� DEVELOPMENT SERVICES DATE ISSUED: 2/24/04
1 ` - " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 111 AB - 08600
SITE ADDRESS: 14425 SW 94TH CT
SUBDIVISION: PENROSE TERRACE ZONING: R
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: 2 branch circuits to AC outlet.
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 FOR: 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:
FERGUSON, DONALD W GRF ELECTRIC
JULIE A 15460 SE PARADISE LN
14425 SW 94TH CT MULINO, OR 97042
TIGARD, OR 97223
Phone: 503 - 620 -6748 Phone: 503 - 829 -4146
Reg #: L1C 76751
•
SUP 1655S
FEES ELE 3 -484C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/24/04 $53.50
[TAX] 8% State Surcharge 2/24/04 $4 Rough -in
Elect'l 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 - 332 -2344.
Issued By: c r �� � %� Permit Signature: Li C (i ��� � /c97c'->
U�� C�C?
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
Feb 23 04.12:05p GRF Electric 5038295747 p.1
; i t. ,
+'lectrical �U
Permit-1r i X11' �lg� • FOR OFFICE USE ONLY
ReceB :- ' / ived •
' r Q Electrical
Date ol /7 / 6 Permit No.: C JOY - UDV S
N City of Tigard FE 'S 7:°11 Planning ppro, al Sign
Date/B Permit No.:
13125 SW Hall Blvd. 1lGAR9 Plan Review Other
. Tigard, Oregon 97223 G�TY Or ON Date/B : Permit No.:
Phone: 503- 639 -4171 Fax: 5( 1t Di v Post- Review Land Use
Date /B Case No.:
rai Internet: www.ci.tigard.or.us _ � p I I Contact ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 'f """ 'a Name /Method: Su lemental information.
. /G -. ! —
. ... , :: •TYP.Et WORK' - .;` •. • PLAN:REVIEW. (Please.checklalthat ippik) `: ,
LI New construction n Demolition ❑ Service over 225 amps- El Health-care facility
commercial ❑ Hazardous
•Addition /alteration/replacement n Other: g location
Service over 320 amps- rating of Building over er 10 10,000 square feet,
:CATEGORY::,OF CONSTRUCTION' - 1 & 2 family dwellings four or more residential units in
_
R 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
Accessory Building n Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
. JOB. SITE;INFORMATION and LOCATION • Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: / rf 2-5 5 &t) . f e / C- .' " FEE* StCIIEDULE :;
Suite #: Bldg. /Apt. #: Th6,,fb„✓1'� ' Number of inspections per permit allowed
Project Name: po roe- gi•f„S UN i 72- vit '' r'eription 1 Qty Fee (ea.) Total
Cross street/Directions to job lte: New residential - single or multi - family per
dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: 1 Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
x;,; • . , . •: '..1•::::.:.:::•:'' service and/or feeder 90.90 2 • . DESCRIPTIOI��,IOFWORiC'.:`. , .:.''" �.� � :.;,:;;.
Services or feeders - installation,
64`,, /4 Cam, Li .4 1 .per alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
. 401 amps to 600 amps 160.60 . 2
P,RQPERT7C,'.OWNER :. .::i [' El TE' NANT' . ... . . 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: ,() U In >D r /4 , ) e: V) Reconnect only 66.85 2
Address: ( 9- L - sll✓ I v Temporary services or feeders - installation, 1
-�• alteration, or relocation:
City /State /Zip: 1 , Gj 7 2-2- - 200 amps or less 66.85 l
Phone: (j 2-0 — if :1 r_ Fax: 201 amps to 400 amps 100.30 2 I
401 to 600 amps 133.75 2
: 0 iaRIKAcNNT . ,, '' • •. • - :'❑- CONTACT PERSON "" , Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
ar
service or feeder fee, first branch circuit / 46.85 I I �, � 2
Phone: . Fax: Each additional branch circuit i 6.65 46 (v,5 '2
E -mail: Misc.(Service or feeder not included):
,. '' .. . ' •: ; J Each pump or irrigation circle 53.40 2
�; ' Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
• Business Name: � alteration, or extension Page 2 2
!`"'� P �-C_r' + � . Description:
Address: I 1, n S , PA y tl -*2 11 , •
City /State /Zip: M
t_4 Each additional inspection over the allowable in any of the above:
i r t ^ - 0 G r 'a 17 i t - Per inspection per hour (min. 1 hour) 62.50
Phone: 9) 3 - 0,G, - `r / LH p Fax: 61)3- 8 ^ s •7 <1-r? - Investigation fee:
Other:
CCB Lic. #: (q s Lic. #: 3 - ,c, (+ . •: .:::a ; .
`f '�: ? {�,...' �: , >: '•. .>s� •.': "�; '' � : Electrical�PermifFees * >�: >�: :;; :... .:. •
Supervising electrician -. Subtotal $ (
signature required: \---- -- P lan Review (25% of Permit Fee) $ �}
Print Name: w 1 7 ) i q,„, S L ic. #: ( C; i 5 C State Surcharge (8% of Permit Fee) $ t- Zd
f-. TOTAL PERMIT FEE $
Authorized Notice: This permit application expires if a permit is not obt ' ed within
Signature: Date: 180 days after it.has been accepted as complete.
- 'Fee methodology set.by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Perrnit Forms \ElcPermitApp.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION ' Business Line: (503) 639 -4171 MST 444 `/ �r� BUP
Received 3 / � D ` �� D �^ Date Requested r v AM PM BUP
Location /4 LI 2-5 ' `7' Cam" Suite MEC
Contact Person J9Tfl Ph� 6 2-0— (o 70 PLM
Contractor r ' L ' j '' fl p ( ) SWR 7 / • _
/
BUILDING Tena ' Owner p ""66 B g5
Footing (ALL °0 A �• It�1 f ELC
Foundation Access:
Ftg Drain r a ELR
Crawl Drain F-1 �`-3 1 3 41 1110/T11Q 1
Slab Inspection Notes: p T SIT
Post & Beam �/ � Lf (.� air.1
Shear Anchors C Q 'Y1•60Z., `r.A_A–C2A-t
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
c —PARE FAIL
''MECHANICA
Post & Beam
•
Rough -In
Gas Line
S -- •ke Dampers
-.-�_ •. - FAIL
LECTRICA"
Service
UG /Slab
Low Voltage
Fire Alarm
na El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line /
ADA
Approach/Sidewalk Date inspector — � ���' A Y ( Ext
_ `
Other:
Final DO NOT REMOVE this inspection record f om the job te.
PASS PART FAIL
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By 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
Underfloor insulation
Post/beam structural _
Shear walls /anchors ELR - Restricted Energy Permit •
Roof nailing - 4 Inspection Description Date Passed By
Firewall _ _ Low voltage
Tilt up panel Electrical final
Masonry/Reinforcement _ _
Framing
MFG-Structure set-up MEC - Mechanical Permit •
Insulation
Drywall nailing 4 Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Engineered soils _Gas line
Welding Lab Final — Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical 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
Ai 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 /IvManhole SWR - Sewer Permit
Engineered soils 4 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 ELECTRICAL PERMIT
PERMIT #: ELC2004 -00085
DEVELOPMENT SERVICES DATE ISSUED: 2/24/04
�. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 111 AB -08600
SITE ADDRESS: 14425 SW 94TH CT
SUBDIVISION: PENROSE TERRACE ZONING: R
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: 2 branch circuits to AC outlet.
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:
FERGUSON, DONALD W GRF ELECTRIC
JULIE A 15460 SE PARADISE LN
14425 SW 94TH CT MULINO, OR 97042
TIGARD, OR 97223
Phone: 503- 620 -6748 Phone: 503- 829 -4146
Reg #: LIC 76751
SUP 1655S
FEES ELE 3 -484C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/24/04 $53.50
[TAX] 8% State Surcharge 2/24/04 $4.28 Rough -in
Elect'l 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 - 332 -2344.
• .
Issued By: � °��L.! ;� -. ,. /, ;��.. /'U C. Permit Signature: 4: 1 C f. Z' G- C- i
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