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Permit CiTY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00124 DEVELOPMENT SERVICES DATE ISSUED: 3/2/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115AA - 09400 SITE ADDRESS: 16260 SW 108TH AVE SUBDIVISION: SWARTWOOD PARTITION ZONING: R-25 BLOCK: LOT : 001 JURISDICTION: TIG Project Description: 320amp service. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: 1 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: 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: SWARTWOOD, JACK & GRACE OWNER 16260 SW 108TH TIGARD, OR 97224 Phone: 503 - 639 - 9203 Phone: FEES Reg #: Description Date Amount [ELPRMT] ELC Permit 3/2/2005 $106.85 [TAX] 8% State Surcharge 3/2/2005 $8.55 REQUIRED ITEMS AND REPORTS Total $115.40 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in O 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- - 2344. ,, i Issued By: / r � ��� Permittee Signature: � �.�` ■�` . �, .� _ , • OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. r OWNER'S SIGNATURE: ii._ `!.. J� -* — " = DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639-4175 by 7:OOpm for an inspection the next business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit App ? EN E I :, FOR OFFICE USE ONLY ` C it y of Tigard Date/Bya d06 • Permit Noll OS —e0 /, 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 MAR 0 mndi• t3\ Other Permit:: Date/By: Inspection Line: 503.639.4175 1 !'.' Date Ready/By: 8 See Page 2 for Internet: www.ci.tigard.or.us r Notified/Method: Supplemental Information a !'s'Y`+ .�35 47. ..1 ". �'z'Sx _ - '.t' ,-_ ; - # S�3 :.'+i�2:F Q -.:.5, ;: 3 _ jaw --, g q y -S# .s,,,, '_ -- . ' . � ° -- •` ; ,t ,::: « v r i y xK. :y: ��L4, ,¢nr;'ru±: :s ^ • �jJ_�j� �j. ' x , ?� `* . , R . - ° ' i Ott. o a ' 4 ' ' -t - S s i ' ' & *. ,C ' 4 ' ;xR6`F„' = 3� ,.. '[ , +' v b k� T E:rS w `' s q '' F 3liJ� tk.��y.'? ..'.�"�,.,..; ' . g- aww�s ru— , ,- sr ?'_ a„- :.s,.. - 4 , _ ; � `; 4M ,,V .,,4,v -$., < _ . e1.... , 'n ,' r,,, .._�_ r, ❑ New construction ❑ -'^ ' . ' .. -ration�eplacement Please check all that apply: I ❑Se vice over 225 amps, comm'l ❑Hazardous location ❑ Demolition [+•}'Other: Caret 11ie mud „ ervice over 320 arnps rating ❑ Buildng over 10,000 sq. ft., :r `'` 1.sr; iu a •k., ... 4.... x ,;.^s;s�.�_ . ;r4 rfis,.. 0 0 :s• .,, '`z�:: s - + ' „: ., -� . c,, , of 1 -and 2- family dwellings 4 or more new residential „ , �_ "i C T 4 0 � CrON . .,,. - © '�1„„ � A . - : �, �� tt53�i�r.'�`�:a�..;�u�.- -,%?ar - ,. .• ��, �, u`.: �,. r� S}�;:��r.. >: ' „ � cry:.°;: � ���' t .S�",�:xr3�y:�.a�. >rmz:^:i~-X [e1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more l ti - # y „ , .�, _ r= Occupant load over 99 persons EManufactured structures or s x . l O i`It O�ii 'M , A` 7u a A£P 6 -.,' ❑ E ess /li htin plan RV park _ TS ,4 .ma .zs_•, o.. �,u �a J .�....' u4 s ,> : . -, !p g g P Job no.: Job site address: / 6,ZG 0 SO /0 f4 re ❑Health -care facility ❑Other: • f Submit 2 sets of plans with any of the above. City /State /ZIP: a / () tZ 6,7 2 Z 1 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: u 1 r Project name: ri >t ' u F, E* S'CHfD. )sE ;_, n • • • Description Qty. I Fee. Total Cross street/directions to job site: T i4 r (1 ) d 0 4-zre New residential single or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. fl. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 _ „ -� , ,,, , Limited energy, non - residential 75.00 • 2 i= A °a'`R ''e''•4 w o4. F xz*: . :' ,- ;tag, -Tf .i:,a. .' :', r r: s"i;2` r ; te a' t r " rei ' 3 E CR.�PTI ,J,1,4 0 isirw, 4- , , lam- ���?�:. , �, `�.�??P���..,�,�,�.�..,��. ..�,e.:i::, �.. �.:., � .�°.,wna` .. Each manufactured or modular dwelling, service and /or feeder , 90.90 2 Services or feeders installation, alt ation, and /or relocation 200 amps or less 80.30 2 �:v:. t.:o-: .�,,,.« r.? .:;: r;,c x : ;r:�,;"_- :, , „ .'t : ?2: ,,. ; , n , i , ; < f.€ rt 201 amps to 400 amps 3d" 106.85 /04 2 tW ilk �7 , . kRO) t N M WN -- M ! o - .. it t 7 -m =' s �` r � - - snw. . >� ,: �..:r ,.t 401 amps to 600 amps 160.60 2 . , Name: C K J Gr ee S'W 4 (.ol my " amps to 1,000 amps 240.60 2 .Address: /4 o 5k) 7 MA /� ,, Over 1,000 amps or volts 454.65 2 —t--; Reconnect only • 66.85 2 City/State /ZIP: a r 1 d72.2-y ' ` �/ ` '' 9 Temporary services or feeders installation, alteration, and /or l/ relocation Phone: ( j C I _ 9 0 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease rent, or e % ange, . cording to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: I jri - 4 , , /L., - z..„ Date: 3 I L/0 5— Branch circuits - new, alteration, or extension, per panel c"= }.. `�; q "_-°�73:� x� r a .,�' > ..�'�.� ; �. �,• xr�• �' �, �. �. ra '���,� , . . ,, .r��,r:•��.�1.esav; .,xi�r ° - 13, „ *. y . KA IT A, W W so: , . ' 's,�' „�„l arn—"I' STRB( A. Fee for branch circuits with service or feeder fee, each Business name: S 4 141 L branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 ' 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - - , =«., _ ostf wr som, N RA °a :, tt.' ati I `3Y- i p m energy panel, alteration, or .. :� . extension. Describe: Page 2 2 Business name: mA nti.2�� Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) F ax: ( ) Industrial plant per hour 73.75 uiIEG IIZLCALER_VI Ir'A5.'''_ ::s' i:, CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal /06, QC., Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name : - Date: State surcharge (8% of permit fee) , ._.- TOTAL PERMIT FEE i 1 5 , q Authorized signature: L �� /� < �� ■ _ _ ih..e Th i s permit application expires if a permit is not obtained within 180 �( Print name: r . 3 C days after it has been accepted as complete f\ � a c e \�� Q , Q O 4 Date: Z 0 ✓ * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: iffig ta ^x ^°t' �a ms may:i..rusr+i- ._n�w:�a.;sz,. y in W Vi Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alanu n G arage Door Opener* T Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* Other: ;:�« :r.,.�en�rc. n��++,� iz �'= , ;r : { +u�r...�- vesa: ,�,�"... _ r , y ;� CO RCW ® Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: • ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Fl D ata Telecommunication Installation ❑ F ire Alarm Installation ❑ H VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ L andscape Irrigation Control* n M edical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t:\Building\Permits \ELC- PermitApp.doc 04/03 CITY OF TIGARD ` DUILDING''DIVISION PERMIT #: ELC2005- 00124 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/212006 Phone: (503) 639 -4171 �m�nn�'nq�my�ii�pb; �i� +� Inspection Requests (24 Hrs.): (503) 639 -4175 % '__.. INSPECTION WORKSHEET FOR DATE: 5/4/2005 TIME: 7 :16AM PAGE: 63 SITE ADDRESS: 16260 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 001 TYPE OF USE: PROJECT NAME: SWARTWOOD DESCRIPTION: 3203mp service. OWNER: SWARTWOOD, JACK & GRACE, PHONE #: 503 - 639.9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 006052-01 503 - 639 -9203 N 1 Corrections /Comments /Instructions: (41 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL '1 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: 14 c *(77 Phone #: (503) 718- 1 CITY OF TIGARD . : ,• ' BUILD1NGbIVISION PERMIT #: ELC2005- 00124 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2005 Phone: (503) 639 -4171 Aka 4pii�plf��hl Inspection Requests (24 Hrs.): (503) 639 -4175 ` -- INSPECTION WORKSHEET FOR DATE: 4/6/2005 TIME: 7 :10AM PAGE: 25 SITE ADDRESS: 16260 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 001 TYPE OF USE: PROJECT NAME: SWARTWOOD DESCRIPTION: 320amp service. OWNER: SWARTWOOD, JACK & GRACE, V PHONE #: 503 - 6399203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 4t6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 003859 -01 503 - 639 -9203 Y Corrections /Comments /Instructions: - 1'k.W P . , a 1 � 4 , : 'iii r:/ . Well / pfrti/( fi) cf1 / 1 ,. / _ LINNIMM- 11,0 It0711MINTASEMPTi.._i _ / V "da f i/ tJ /. -I r/ is //./4` A rF X . ' I , : / ' , / � A J ` X . ' .1// /' / .. ' / . Z zoos �/ 2 // 4 ✓e 00�°125�-n1 1K '10 /1.14) 0b31 --o2- 1 PIS . ❑ PASS Fl PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS x FAIL 1 1 ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / Date: &I #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: .. (503) 639 -4175 • INSPECTION f�VISION Business Line: (503) 639 -4171 MST 3 _ --- BUP Received Date Requested 'O AM PM BUP Location 44' a' 61) S Vv 1 d "v Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR 'PA BUILDING Tenant/Owner ELC - , , JS d i Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain = Slab Inspection Notes: Post & Beam Shear Anchors / Ext Sheath/Shear 1 j� Int Sheath/Shear Framing 1 ` \ 1 � Insulation �" \- \ (..D \ C L� i -'B s� W `r\ Drywall Nailing , \ 15'a Firewall O W 1 -2 L � Y� Ztt 0 m1L 1 Fire Sprinkler � Fire Alarm % � �L c� 2 Q , S vAD '1 Susp'd Ceiling Roof Other: 1� y � (_(� nn ��, !� Final ��.J 1Z1 ✓ V`, D t' � w ri D 11 '�U 0 PASS PART FAIL PLUMBING - ° �;„ \ . ` 1 ` A t Post & Bea Under Slab � � \.. chi \. , C 1J S V\ ∎) \ 1� V w -} -4 Rough -In \--\.\ 0 ‘ \- Water Service OA' ) a I Sanitary Sewer ` / I p vL � . Q sn ∎� u\ L- i:3 of Rain Drains \� : : _ (� Catch Basin / Manhole ) \ �/ �\. N 1/Y)) W N 7 6 kA)--LQi' � 1 1 J (-< Storm Drain • Shower Pan 1 11 V' V ! )% L, ( t1V 1 \() (A>-'0\\A\,\)- Other: Final , 't�l- A) \V _ ' \rn4 I r ct L' PASS PART FAIL ` 5 1"( (� / MECHANICAL. , , , C7 Lb �"'Ptw ) l Ui`A c - An gs Post & Rough-In Beam ('CI v \V \�� 4. j N 6 Y D Gas Line Smoke Dampers I � rr CC ) c r 1 Final PART FAIL I ve V -� jJ S �" l 'J . C/0 I ( I N b � 6 � L J l [CT'RICAjL `, Rough-In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall,-13125 SW Hall Blvd. PASS AIL SITE - ❑ Please call for reinspection RE: ❑ Unable.to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 3 -4 "-G Inspector ,,,....4T -� Ext Other: Final DO NOT REMOVE this inspection record f om the Job site. PASS PART FAIL