Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00368
vr' s • DEVELOPMENT SERVICES DATE ISSUED: 07/20/2001
" ..� 13125 SW Hall Blvd., Tipard, OR 97223 (503) 639 -4171
PARCEL: 2S 114BB -18000
SITE ADDRESS: 16285 SW 103RD AVE
SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7
BLOCK: LOT : 026 JURISDICTION: TIG
Project Description: Installation of wiring for NC. (1) branch circuit.
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:
SAMPSON, NORMAN J + ANN M WEST SIDE ELECTRIC CO INC
16285 SW 103RD AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: ektt-15f$06
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 07/20/2001 $46.85 2720010000( Elect'I Final
5PCT CTR 07/20/2001 $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 a re 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: or) - Issued 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: (7 1 C %t k !, . DATE:
LICENSE NO: b( � 3
Call 639 -4175 by 7:00pm for an inspection the next business day
— . . I'
I
Electrical Pernai A k tion
�� 9 Dote received: Pamir •r � . e /�ry 7 - 3
, City of Tigard / / RpJeeveppl, n , Eaplte dine:
Cap rgnn/
Address; 13125 SW Hall Ahd, 'Igarc 0 7223 Data Issued: By: Receipt no.:
Phone: (303) 039 -4111
Can: (5031 5911.1900 Ciro file no,: Payrncnl type:
L.arld use approval: _________ ,
T1I I... O1' 1410M 1
ii �' 2 family dwelling or accessory U Commercial/industrial strial O Multi - family I] TenulllC ltrfl+rovem4tlt
v conabuiQun U Additia tialterntir•.iireplocement U Other, _. _.... _.. _ , ._ -_ ❑, Patti
,11)11 SI I I. IINI 01111. I II)N ! 1
sloes — aJ \ ,) *. I1oL. Bid_ . no.: Suite no.: TtUI toss • me loV '
Lot: — ' Subdivision: _.._ i - - '
Prue name. „�,1 � Deselip 1on and l ocation of work Im remises: '—! „. A C
Estill' • I dare rrIA 1r IctFi tilts vvilurt' .
(l/7. I lutl- loft ,%111 if \IIU)N II I. !+s IIl nl 1,1
Job MINK ,
BugalrffMITUTTIFTP E to c..Z c ,�y Dried rt y or II
Add ,� dnei Iudu Inds an seatbeiarwp.
EIDINVIIIMMIP � _ �S��late Z :Ft ' 1 •� c eA •
MtOne : F'a ��''�`fl L bar's rt L? r.:uila _ rig •
l.' • - 1 Elec. bug. tic. n ti A t,- 1 Bach additional 100 s . ft, m • onion Our IIIIIII
Ci tro lic. no,: MIN L '
I:LvllCd ,non rotidontinl
.....•.. _1_ $ S .- 0 1 Cod nstufacenotl home or modulo diva ap
1 u 400 n1 su * , 1 e l ns . eev c1� s�stulwd)�� Dee ' 3en'ioe'waver nadir
I. nemctf iiiI): -. do I _ - — _ _ l,l::nse no, 2. 6 . 3 S t Services a or dos:
1'11 lt.eon,
1)1'1 it IV 1 /VVNl •R 200 r 1
C adap:
300 irnln ar leer
III •Cinl: - JR"%.1 J- .A � t -..._ a sfe�00mtu --- 111.11111 MrdUn eC -- �Olar • slu60pnt a l; x901Imppto 1Q00smos — I 1
City: WWII._ ' _ Sla►_e. /j„ 2� Z, 1 Otar 001.11111•10f Yu u .
tone
Fan* rE • midi : I,: `r 0MIIIIIMINIM
Owner installation: The installation la being made on property t own '1Mepersty molten et . -
which • nor intended fun Selo, lets, rent, or exchang• according to btrtelMellos ,aMseatbn,osrrloealienr
ORS . 7.455.479, 670, 701. 100 x less 2
201 am• Ito400ern.a 7 '.
Own I I - rinit'.re,' V11.e: 40 ea •.• ire 1 IMO •
F \IrINl 1.1t mac c -our.* Wailes,
Name: er valealoa pr p uett
A tan lot bra ch circuit. with purebsee or
Addre : 'VI vim or feeder feo, vich lere:tvIi t;lrcull Z
City: Stole: 11P: B. r o e lot brarafi tircults without purchase
°frorvl:a or feeJur fee first branch circuit, �• , ; 2
Phone Fax: F{ null: F „ .n r:m:h dims it: A
PI V\ Its c II 1$ 1I (:11r(k'1111 1110 npp11I • e, at M1•1111' OM vhr - •)1
O Sew) • awe 3L1 aasps.enunseelal ' Q health -cur feoUC' Cady . It . ut Int 'don clrnle _ — _ _� 2 .
CI Red over33O amps-raring ofI/la U Malicious Irc;tlimn Paehsl norpotlatcIl /hlirrg
langl dwelling OBudlns over I0,:OOsMm lt
squats fro Signet circultle ) ete Ilntlt.J v1erpypanel, -
i
U iysts over000volisno/Waist morererb!'ndd utduine allts:silon,eVeetmgfoo• 2.
U Pt.H p ova Ihrre studs U Peahra .if awls ur more •petal lion
UI *am eel IOW over 791c4IoIe UMamfwtnreJMntatarceurRVpat Foe atldllmel severlbsalloaWetn yerlheatrAn:
01 I1ghIe g dan LI Moe — Petba ling
Submit sets of plans '11th any of Ile sa.Ts. (avoid ',donfn
e above are ■ol applicable to Impala y tomrrection merrier. 0 r -
rte Wise/ seep) utodh ef/e, plum asp 11.014.11tet rot m aw wn "tee ) Notice:'liiie permit application P erhu t f oe .... $ , 45
CI Visa 1 .3 Maet,ZCs,d exphee Ira pellet( is not obtained Plot review (s[ -. %,) S _ --_....
credit co numb,': 1110 days after It has bean State surcharge tee% S _, •S • 7 .5
_ -- "�I1."-- accepted as complstte. TOTAL • S __. , d�p
ell a gotaoldae as mow n oo .rear —
` udeena rtjtrtiluia 21- Aint 410- 01tte nllcUAp
•
•
T 0 - d LL90 9£L 206 3I 2113313 311I6 133M Wd T Z: 60 TO -a t --lnr
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST r..
BUP
Date Requested AM PM BLD
Location G (? ��� AA) Suite MEC
Contact Person if I AL . ;•. Ph PLM
-- -
Contractor Ph SWR
BUILDING Tenant/2 ne► . — p -_ ELC ?C- / c0O 3(
Retaining Wall (Q 3 q 4 4 79' ELR
Footing Access:
Foundation FPS
Ftg Drain ;ff_ SGN
Crawl Drain Inspection Notes: � .
Slab ✓ �` . SIT
Post & Beam
Ext Sheath /Shear .,
Int Sheath /Shear s-
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam wJ
Under Slab / yl ! - gp y Y� CY
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
ELECTRICAL
R
Rough In
ough In
UG /Slab
Low Voltage
Fi
' y
'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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk FL -
Q I
Other Date / Inspect E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By -4 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 ,Q,9
_ 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
4 Inspection Description Date Passed By
Drywall nailing
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
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 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 TI GA D ELECTRICAL,PERMIT
PERMIT #: ELC2001 -00368
dot, DEVELOPMENT SERVICES DATE ISSUED: 07/20/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BB-18000
SITE ADDRESS: 16285 SW 103RD AVE
SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7
BLOCK: LOT : 026 JURISDICTION: TIG
Project Description: Installation of wiring for NC. (1) branch circuit.
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:
SAMPSON, NORMAN J + ANN M WEST SIDE ELECTRIC CO INC
16285 SW 103RD AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: al
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 07/20/2001 $46.85 2720010000( Elect'I Final
5PCT CTR 07/20/2001 $3.75 2720010000(
Total $50.60
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 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: n 2 G Issued By:
0
OWNER INSTALLATION ONLY 0
The installation is being made on property I own which is not intended for sale, lease, or rent.
VIP
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: /T.)/ . DATE:
LICENSE NO: 2 b(t2 3
Call 639 -4175 by 7:00pm for an inspection the next business day