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Permit 'CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00230 DEVELOPMENT SERVICES DATE ISSUED: 4/23/03 I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135CD-02700 SITE ADDRESS: 11725 SW 95TH AVE SUBDIVISION: BOETCHERS ADDITION ZONING: R-4.5 BLOCK: LOT : 006 JURISDICTION: TIG Project Description: Installation of private street lighting for Greenburg Pines subdivision. 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: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: VISTA NORTHWEST TODDS LIGHTING & ELECTRICAL PO BOX 91459 938 HALEY CT. PORTLAND, OR 97291 OREGON CITY, OR 97045 Phone: Phone: 503 - 742 -1899 Reg #: ELE 3 - 510C LIC 146666 FEES SUP 4434S Description Date Amount Required Inspections [ELPRMT] ELC Permit 4/23/03 $86.95 [TAX] 8% State Tax 4/23/03 $6.96 Elect'I Service Rough -in Total $93.91 Elect'l Final 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 p _ Permit Signature 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: i ' � DATE: fr /C1- LICENSE NO: � Call 639 -4175 by 7:00pm for an inspection the next business day _t., • FOR OFFICE USE ONLY Electrical ICI " 1Ctl1t , )l�eat>_on Received Electrical DatelBy: y Permit No. �GC Planning Approval Sign 1 City of Tigard Date/By: _ _.- _ Permit No.' 1111 hest i (3 r m Plan Review Other t 3:25 SW Hail Blvd. Date/By: Permit No.: ,._ Tigard, Oregon 97223 . Post- Review , Land Use Phone: 503- 639 -4171 Fax: 503 - 598 -1960 , , fa D Case No. �.( ! Juris.: 0 See Page 2 for Internet: www.ci.tigard.or.us � ->a5i' e� ! Contact Supplemental Information. 24 -hour Inspection Request: 503 -639 -4175 " - Name /Method: l pp „_-.-_,,B oi _ ' TYPE OF_ WORif . �” } 'PLAN REVIEW lease che&alLtital; t+) : . �-- D emolition ©s crvrce over 225 amps- Health -care facility - - e« construction c ommercial ❑ Hazardous location Addition/alteration/replacement Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, ,.' � CATEGORY OF CONSTR " ` , . Y' : : 1 & 2 family dwellings four or more residential units n ` I 111 1 & 2-Famil ❑ System over 600 volts nominal one structure dwellin. _ Commercial/Industrial I 0 Building over three stories ❑ Feeders, 400 amps or more ( • Accessory Building - t ■ Multi- Family . j l ❑ Occupant load over 99 persons ❑ Manufactured structures or 1W pat k r Master Builder Other: C7 Egress/lighting plan I ❑ Other_ __. vi: JOB SITE.Ii�IFORi49A el., an d LOCATION I Submit sets of plans with any of the above. ` The above are trot _ applicable to temporary coestruction service Job site address: /j 7 a � EEE ; SCFIED1LE, is. LL Suite #: 1 Bldg./Apt.#: Number of inspections per permit allowed t Description Qty Pee (ea) Total Project Name. P rr r ua}e 5�t L rS k� �j New residential- single or multi-family per Cross street/Directions to job site: dwelling unit. Includes attached garage. 9S } i ,' o P t h Service Included: r-�e.n b,,,, c v 4 S 1 45.15 4 / / 1000 sq. ft. or less _ , Each additional 500 so, ft, or portion thereof 3140 -- "1 - 1 r D _._ Limited enerjy, residential 75.00 -- 2 .. Subdivision: 6. rez.4 r at-s I Lot #: 1 - 9 Limited ener>?,v, non residential 75.00 � 2 Tax ma 3/pa arcel #: DESCRIPTION OF WORK < , Each manufactured home or modular dwelling z` . '' t, ° service and/or f.,eder 90.90 2I . x <,, - t^ Services or feeders - Installation, e- L t's f - t.1 y Ses l c e_ alteration or relocation: t t 200 am or less I 80.30: g0, ? v 2 4 V 6 ♦ ' - ` °` t f a S -- ", , t ,_ 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 TENANT ", ' ••. : , ' i 601 drops to 1000 amps 240.60 2 12CDPERTYOWivER I ❑ 5, 454.65 2 / + Over 1000 amps or volts _ Name: v / 5 N , t.'i Reconnect only 66.85 _ { 2 Address: Pal . , - Temporary services or feeders - installation, /� alteration, or relocation: City/State/Zip: �TL� �2 9Zo^+ �1 _ 200 amps or Less 66.85 t — Fax: 201 amps to 400 amps 100.30 2 fa APPLICANT — ! Phone: ---- I ❑ CONTACT P EItStiN r ' ! Branch 1 t o circuit s - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee each branch circuit tt 6.65 `, '5 2 City /State/Zip: B. Fee for branch circuits without purchase of service or feeder fee, East branch circuit 46.85 2 P11oriC: __ j Fax: T Each additional branch circuit y 6.65 " 2 Email _ Misc.(Service or feeder not included): 'a. a ' CONTRACTOR " � ` 74 Each pump or irrigation circle 53.40 2 % Each signor outline lighting 53.40 _ 2 J 05) No: rSignal circuits) or a limited e nergy panel, t � / asi ter>uian, or extension' i 75.00 2 Business Name: l 9 c J �/t 1 ^�4 �e Cg'rt •Descripric n: Address: i1575 5. K a r(/ is Gj• --- Ciy /State /Zi : O r-e p6 s. Cal 0 I . • `' 70gs -_ i Each additional inspection over the allowable in any of the above: p Per inspection (per hour - min. 1 hour) I 62,50 Phone: CCB Lic. #: S/o3y - 766 ' /Bf�Q Lie. #: 3 -.SO Fax: 5o ? - ?% - /SOS �In feel - .^�. tr i-=, ,I , = Electrical Periult' i t v : •` , Supervising electrician Fax: • �� — signature required: ��GGt � Plan Review (25% of Permit Fee) $ _ Print Name: li3� Li. #: ' '5'Y S State Burch: ". e 8% of Permit Fee $ .16 TOTAL PERMIT FEE $ 73 . 4' I Authorized 1 y /_ / s Notice: This permit application expires if a permit is not obtained within Signature: P :1 Cps• Date: Zu e 180 days after it has been accepted as complete. o (d f. 4 y fc_ *Fee methodology set by Tri- County Building Industry Service Board, (Please print name) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested (9 AM PM BUP Location (1 9 t44 Suite MEC Contact Person ( Ph ( ) c l / 3 - - l 4Y PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 3 oo a3 c7 Footing Foundation ELC 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 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 rvice Roug -In UG/Slab Low Voltage Fire Alarm _ PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ��a ITE Please call for reinspection RE: nab a to inspe no access Fire Supply Line ADA Approach/Sidewalk Date 43 Inspector ` Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF,TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST �. INSPECTION DIVISION Business Line: (503) 639 - 4171 S q BUP Received Date Requested - ( AM PM BUP Location (1 � 1 a 5 / 5 fT Suite MEC Contact Person r 4'' `L Ph ( ) /13 —.21c/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner /-,1--td _ ELC 3 -00 -3 0 Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam 5- J J .0) Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing J �� Insulation / Drywall Nailing -.141 L , Ltd / � _dI • Firewall t / / Fire Sprinkler i • ' Fire Alarm /el/a-et ��� �� 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 ?fl$Iab Low Voltage Fire Alarm Final E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL SITE 111 Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date C d3 ins #10 ar Ext Other: Final DO NOT REMOVE this inspection recor rom the • b site. PASS PART FAIL