Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00419
41 DEVELOPMENT SERVICES DATE ISSUED: 08/15/2001
°° 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639 -4171
PARCEL: 2S 114BB -08300
SITE ADDRESS: 16358 SW 104TH AVE
SUBDIVISION: SWANSONS GLEN ZONING: R -12
BLOCK: LOT : 024 JURISDICTION: TIG
Project Description: Wiring to A/C
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 WIO 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:
ARMSTRONG, RICHARD K AND FRANC WEST SIDE ELECTRIC CO INC
16358 SW 104TH AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: W-15141306
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
5PCT CTR 08/15/2001 $3.75 2720010000( Elect'I Final
PRMT CTR 08/15/2001 $46.85 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 ordirect questions to OUNC at (503)
246 -6699 or 1-800- 332 -2344.
Lia
Permit Signature: Issued B y: ` -al `
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: (5 ( ) / JAL (ti i/ i ) DATE:
LICENSE NO: ) CO 1./
Call 639 -4175 by 7:00pm for an inspection the next business day
r a 10 /2 4%00 L'Ur: L1.3i 1;:i1 503 591i loll ;:I''.']' Uf 'f1G_tiw a002
1 ((1 %
Electrical Pe it . plication .
Date recervedc- ' , ) CE
K � ) �; City of Tigard Projcct/appl. nt .. Espira date;
City ofTigwd Address: 1312 SW Hall Al. d, Tigurc'. OR 97223 Hutt: issued: By: • t Receipt
Phone: (503) 639-41%1 -
Fax: (503) 598-19C0 C-..tssefiteno.; Pay., nitypc:
Land use approval:
TVPL,OE PLR:41IT • .
• l & 2 family dwelling or accessory J Commercial/industrial Cl Multi- family ❑ Tenant improvement
Nev constluetlun 3 Additio ,tfalterntinn'r^,Placctrent ❑ Other; J Partial
lob address: , 3 J ; .,J I r 4 - fy Bldg. no.: Suite nu.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
_ Project name: 4. - ,•• „„., / S rt1� 7 eScrip ion and location of work on premises; — A c_
Estimated date t'hCantpir•,1iotr ospcclion• -
. COM ItACtOR APPLICATION ' FEE SCHEDULE -
Job no: . a Z. 122.— ,r Fee Max
Business name: r ' a t 1 r3 c-4./ l c. (•- cU Dercri tLtlun Qty. (ea) Total us. iltsp
Nest residential -
Address: 7 anplo or mull - family per
y S . +,•. Q rhrellisgunit . Includes attached garage.
City: [ .a. � -t-1 u.. � ] State: (�„'r= _ Z• . . Y 7y 4 r.t ( Seer cc' itu
J S ++-re►ut '� 4f)U0 x. rl. or k �s d
' Pltone.�;cS -i3 t 154 Ir - ' 7 ;L 06'1]1 G n)�(�'+�kk� Eachndditi un aiSWsq .ft.nrpnrtinn - - - -�
CCB no.: 1 • b ` I Elec. hug. l.c_no:.2 6- J t' (� limited energy, meidential 2
City/metro lie. no.
Y L'�uitcdcraxgy, non- residunuul — c0 gig — —
1 I 2
• O rrm,ufacturr� home or n,adclar dut - I
LLL r7 --1 � "'O 1 Each
SGI.•icc itndlor fr der
i Sigt to Ur nine a • title trrquirrdl Date _1_ 2
8errteet orfeedet s- Iosulladon,
Sup ,.J„,. rrantr.lpri n!1; . Z K , �„,� ,i::n;r. no, a 6 — s �lrntl
• PROPERTYOVkNER' Zan amps ur less 2
--
Name (print): /sn„ ..� f o r 201 malts to I00 omp -- z
_Mailing address: ( 6 3 �J a LI - 9iti out to 600 Nip 2
( b0i snarl to 1000 amps 2
City' t � 4 State- ' LIP: Z Z. L J
L + ) 2' - 7 Over 1000 gimps or role 2
Phone t1(...ti_ 5 -f - I Fax: I E.tmiil: Reconnect only
Owner instillation: The installation is being made on property I own Temporary servieer: or feeders -
which is not intended for stile, reuse, n:nt, or exchange according to iirsteilatioth akrrnflon , urroluealiue:
ORS 447. 455, 479, 670, 701. 200 amps or leas j z
all amps In gal smps I 2
Owner's signatt re: Due:: 401 roti00amps f
• L.NGINEER • . Snatch circuits- new,alteratlen, —I
Name: or exteaaiurr per panel:
_. A. Fee tot brnuch un:aita with purchase of
Address: • service or feeder fee, eaj 1, bra: icli circuit 2
-
City: I Slate: 'ZIP: B. Ice tut brantdt circuits witotutpnrcbase p
Phone Fax: E -mail: ofscrvizeor feeder fee,first brauch circuit: L 4f��ii �.i. S 2
ii,tch adJi lion A br••tnch ci twit:
PLAN itIVILW' (Please elreck' all :Iliac M ite .(Staricoor feeder nalincluded):
❑Serviw over 225unye camnreiat ❑ Health iocltit.• 'End% pumper irrigation circle - - - -_- 2
CI Service aver 320 amps - raring of 1&2 0Haerrtouslocation Each ,t ign er outline likhting 1 - -- 2
family dwellings ❑ Building over 10,40squ.'u Signal crcul Bs) or limited energy panel.
3 System over 600 vein :minim] mote residential units incite Mille' itre alteration,arextension• 2
O Building over throe stoties 0 Feeders, 400 arnr LIT ILIUM ° Dcectiptioo __ _
U Occupied load over 39pawn! ❑ Mtt .•,ufnulurerstructurrr'orRV a
EacY adtllt[ortnl Irttpeetlor over the sillmrabtc lo any at the abate:
O Egress/lie tang ;Awl U Crdier: -- Per Mepection L I I I
Submit _ sets of s nifh any of lire above. it ves
Awn un fee _
The above are not applicable to temporary construction service. Other
Nol all jurisdiction, rCept credit curb, Piet..: oral jt.ri,dicrito Cot mote lnfnrnrui� Notice: This permit application Perrot fee $ (t .
❑ visa U MasterCard expucs il' a permit is not obtained Plan review (at _ I:) $ ,_._ _ ___
Credit end number: L with 180 days atler It has been State surcharge (8th) .... $ -___ 3 7 5 -
MIMIC - - Fa tee accepted as complete. TOTAL $ n, - 4- p _
Nae d cardholder as aaown en =tilt card
$
Cudnalu' slanaiwe Amain' 44C -1015 MIMI /M)
I' LL9O 9ELCEOS) •03 of -14oaT3 ap'S 4sapl ego =LO IO ST 2nd
CITY OF TIGARD BUILDING INSPECTION DIVISION MsT
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 '
/ BUP
Date Requested F ' AM PM BLD
Location ! 6 3 4 ( 41,./‘-e-- Suite MEC
Contact Person // Ph / 2-0 - _S6 ((3 PLM
Contractor t[,Ir° S r1 C Ph SWR
BUILDING Tenant/Owner ELC , - / Y/
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: c---7)10_e__ l—�
S SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation �f
Drywall Nailing / l ✓ CtI4 iC f 6 4 L° Y
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final Hn 3 o /3
PASS PART FAIL � Y I c /
PLUMBING
X
Post & Beam r�I Cc �
Under Slab � l 6-
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
Service
Rough In
UG /Slab
Low Voltage
Fir
n-
- • S P•RT FAIL
SITE
I /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: 41, ] U • -ble to inspect - no access
ADA
Approach/Sidewalk , �
Other Date b '0 / Inspector • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - wilding Permit ELC - Electrical Permit
J 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 6 -O
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
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
Structural observation Mechanical final
Fireproofing Lab Final
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 ,f 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 #: ELC2001 00419 -
w 1' DEVELOPMENT SERVICES DATE ISSUED: 08/15/2001
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S11466 -08300
SITE ADDRESS: 16358 SW 104TH AVE
SUBDIVISION: SWANSONS GLEN ZONING: R -12
BLOCK: LOT : 024 JURISDICTION: TIG
Project Description: Wiring to A/C
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:
ARMSTRONG, RICHARD K AND FRANC WEST SIDE ELECTRIC CO INC
16358 SW 104TH AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: ( -15$06
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
5PCT CTR 08/15/2001 $3.75 2720010000( Elect'I Final
PRMT CTR 08/15/2001 $46.85 2720010000(
Total $50.60
1
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: L \
OWNER INSTALLATION ONLY `
The installation is being made on property I own which is not intended for sale, lease, or rent. I
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY a
SIGNATURE OF SUPR. ELEC'N: ?PI 6(11 ) Pi (Alt l DATE: t
LICENSE NO:
3 S
Call 639 -4175 by 7:00pm for an inspection the next business day IN4