Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00673
Irk DEVELOPMENT SERVICES DATE ISSUED: 12/6/00
• '�' •' l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135CD-02000
SITE ADDRESS: 11760 SW 98TH AVE
SUBDIVISION: GREENBURG HEIGHTS ZONING: R -4.5
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Fire repair, replace panel and (2) branch circuits. Job No. 1019 -01
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: 2 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:
DAWESM, UNA JESSIE PIONEER ELECTRICAL SERVICES IN
11760 SW 98TH AVE 615 14TH ST
TIGARD, OR 97223 OREGON CITY, OR 97045 -1610
Phone: Phone: 657 -9666
Reg #: LIC 105484
SUP 4083S
ELE 3 -376C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 12/6/00 $93.60 2720000000( Elect'I Service
5PCT CTR 12/6/00 $7.49 2720000000( Elect'I Final
Total $101.09
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 a• _• -•• • e Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain .. •ies of these ru - - or direct questions to OUNC at (503)
246 -1987.
PERMITTEE S SIGNATURE ISS D BY: , / / ,
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: ✓ -42---/ DATE:
LICENSE NO: 1 7003S
S
Call 639 -4175 by 7:00pm for an inspection the next business day
•
All _________________
Electrical Permit Application
Date received: .A.4.-0. Permit no.: Eze `kYx, -00(
2 City of Tigard Project/ ippl. no.: Expire date:
City- of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date iss led: By: Receipt no.:
Fax: (503) 598 -1960 Case ill no.: Payment type:
Land use approval:
_ a
•
, TYPE O(F
D 1 & 2 family dwelling or accessory D Commercial/industrial D Multi- family D Tenant improvement .
D New construction D Addition/alteration /replacement J Other: D Partial
v JOB $ITE INFO - to*
{ Job address: t (1 _ o s R 8 I Bldg. no.: I Sulu no.: ITax map /tax lot/account no.: I
Lot: I Block: I Subdivision:
r '
4
Project name: J Description and location of work on premises: Qp( Acp P pl 2 CyG+.+
Estimated date of completion/inspection: ecru se oP FIRS
. CONTRACTOR APPIJCA1elort • '
Job no: /O i 9— 0 1 FEE_SCl6tFDULE: .
I Fee Max 1
Business came: Poe _G� - T ��, ( S 1 G j Description Qty. (ea.) Total no. Map Address: 6(5 (4 f..- St � - IV Ne»' trsidendd singleortnulti fatnilpper
City :MM�� dwelling unit. ;nc lodes attached garage.
Opedie .0 i StateOQ I ZIP:Ct 7G 5 Sertice includ HI:
I
f fPee:65/stil.6 no.: fi -GS7 - %3'$I E -mail: 1000 sq. ft. cr iess J I t
L OS 9. CB �2 . G E ach addition d d00 so, ft. or P ortion thereat I I
(Elec. bus, lie. no: 7 e , { i
Limited ene, - c., residential I ' 2
I City /metro lic. no.: CN:De0e. V '5
Litai red energ;,non-residential I ! I 2
Each manufactured home or modular dwelling
o
I Signature of supervising electrician lrequir Date 0 Serviceandic feeder { _
I - Sup. elect. name( Reri.vE I License no: S Services or ft eders — installation, '
alteration or •elocution: • ' PROP RTy OWNER- 200 amps nr , I` ss I 901`% 2 •
Name (print): 201 amps to =)0 amps I 2
Mailing address: 401 amps to 6)0 amps 2
I 601 amps to 1)00 amps 2
City: i State: ZIP: Over 1000 arrps or volts i
I Phone: I Fax: E -mail: Reconnect on y F I I 1
f l Owner installation: The installation is being made on property I own Temporary s'raiccs or feeders -
which is not intended for sale, lease, rent, or exchange according to lnstallaon,ateratton. or relocation:
ORS 4=+7, 455, 479, 670, 701. 200 amps or l as
201 amps to 4 )0 amos '
Owner's signature: Date: I I f I 2
301 to 600 ar•, ps 1 2
ENGINEER Branch circu.ts - new, alteration, ..
!\TaI11e1 or extension rerpanel:
A. Fee for hr; nch circuits with purchase of I A �� 3.
Address: j service Cr .`eeder fee. each branch circuit - elf f I 2
City: State: ZIP: B. Fee for br :.non circuits without purchase
Phone: I Fax: E of service :: feeder fee, first branch circuit: I 2
Each additional branch circuit:
I :PLAN REVI Check, Al that apply) . Misc. (Semi' feeder not included):
❑ Service over 225 amps - commercial 0 Health -care facility Each pump of irrigation circle 2
❑ Service over 320 amps -rating of 1 &2 0 Hazardous location Each sign or c utline lighting j 2
family dwellings O Building over 10.000 square feel four or Signal circuit s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or t xtension' 2
7 Building over three stories U Feeders, 400 amps or more
0 Occupant load over 99 persons 0 Manufactured structures cr RV park D a i
❑ Egress/iiehting plan LI Other: Factli ' d ditlottal inspection over the allowable in arty of the above:
Perinspectiot + I
Submit sets of plans with any of the above. Investigation 'ec
I . The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more informarioo " Notice: This permit application Permit fee $ l
❑ Visa 0 MasterCard exp if a permit is not )brained Plan review at _ %) $ 1 9
Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ _
Expires $ 1
Name of cardholder as shown on credit card accepted as complete. TOTAL r r
S_
—
Cardholder signature Amount j "
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP •
Date Requested / — Z v AM PM BLD
Location /1 ? 4 D S'' 5 ' Suite MEC
Contact Pers Ph X74 G G PLM
Contractor ( o Ph SWR yf
BUILDING Tenant/Owner ELC ,�Id O J3
Retaining Wall ELR
Footing Access:
Foundation / p _ FPS
Ftg Drain C c% -z�,., ,z.r c t .a �(/ 7 O SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PAS PART FAIL
ELECT
Service
Rough In
UG /Slab
Low Voltage
Fire • - rm
• ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin �;.
Fire Supply Line �
ADA .0011
ease call for r- nspection RE: [ • 1rbIe to inspect - no access
Approach /Sidewalk
Other Date - fi Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 .rHourInspection Line: 639 -4175 Business Line: 639 ,
BUP
Date Requested / 2 - / ( AM PM BLD
Location /1 7 G 0 Y) 9r /T'-ez4 Suite MEC
Contact Perso Ph 651 g& PLM
Contractor . Ph SWR
BUILDING Tenant/Owner -& S-r CC(-- - 6+A' ELC L w-GU ( �3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
�.ELECTRI(:Atj
Service
ou
G /Slab
Low Voltage
Fire Alarm
Fi
PART FAIL
SITE
Backfill /Grading
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
Approach /Sidewalk
Other Date / Z ' 7 ` Inspector _ _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Ms
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP _ •
Date Requested /A-1 -- Ilnn C AM PM BLD
Location / ( , 0 ' t) 9.4'x` Suite MEC
Contact Person Ph l G} — a9g PLM
Contractor 7JL2rt. €4 Ph �(5'2 - -is SWR
BUILDING Tenant/Owner ELC ‘14'.2
Retaining Wall ELR
Footing Access: FPS
Foundation —t - p y
Ftg Drain T SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear 4 l ���I l- "r 7 C(/z_
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
is
UG7STab
Low Voltage
Fire Iarm
PASS •
PART FA./
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain ] Reinspection fee of $ required before n inspection. P_, at City Hall, 13125 SW Hall Blvd
Catch Basin ,� ,
Fire Su PP Y I Line Please call for reinspection RE: ,��T1 0 ' - e-- '� ` [ nable to inspect - no access
ADA
Approach /Sidewalk A.1 Other D 670 - � Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By I Inspection Description Date Passed ' By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in / 2 I l - 00
Slab Electrical service Z / / -�
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
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in •
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP - Fire Protection System Permit 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
4 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 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP PLM SWR, ELC, ELR, MEC SIT PERMITS
-CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00673
4'14001'." � DEVELOPMENT I Tigard, ) 639 -4171 DATE ISSUER: 12/6/00
PARCEL: 1 S135CD -02000
SITE ADDRESS: 11760 SW 98TH AVE
SUBDIVISION: GREENBURG HEIGHTS ZONING: R -4.5
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Fire repair, replace panel and (2) branch circuits. Job No. 1019 -01
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: 2 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:
DAWESM, UNA JESSIE PIONEER ELECTRICAL SERVICES IN
11760 SW 98TH AVE 615 14TH ST
TIGARD, OR 97223 OREGON CITY, OR 97045 -1610
Phone: Phone: 657 -9666
Reg #: LIC 105484
SUP 4083S
ELE 3 -376C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover ,
PRMT CTR 12/6/00 $93.60 2720000000( Elect'I Service
5PCT CTR 12/6/00 $7.49 2720000000( Elect'I Final
Total $101.09
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 a• : • -•• • the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain •• •ies of these ru or direct questions to OUNC at (503)
246 - 1987.
PERMITTEE'S SIGNATURE ISS D BY:
x-f . /A 0 4_ :;1 ` .
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
4
SIGNATURE OF SUPR. ELEC'N: ✓ --e DATE:
LICENSE NO: 4 / 08 35
Call 639 -4175 by 7:00pm for an inspection the next business day