Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 00470
y pN fi .�� DEVELOPMENT SERVICES DATE ISSUED: 7/29/2004
' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 115AD -00600
SITE ADDRESS: 16740 SW 108TH AVE
SUBDIVISION: WILLOWBROOK FARM ZONING: R-4.5
BLOCK: LOT : 030 JURISDICTION: TIG
Project Description: Service change, remodel.
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: PER INSPECTION:
201 - 400 amp: 1 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 20 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:
MAY, MARTA T & T ELECTRIC
16740 SW 108TH AVE 4120 SE INTERNATIONAL WAY
TIGARD, OR 97224 SUITE A -105
MILWAUKIE, OR 97222
Phone: 503 - 380 -1693 Phone: 503 - 652 -7610
Reg #: LIC 150973
ELE 26 -1105C
FEES SUP 2184S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 7/29/2004 $338.30
[TAX] 8% State Surcharge 7/29/2004 $27.06 Rough -
Elect'l Final
Total $365.36
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: 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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
4
--
Electrical Permit Application ri
City of Tigard Received 7 ,zg _aV Permit No.:(...,, L Ce U7 "CQ y 1�
Date/By:
131 SW Hall Blvd., Tigard, OR 97223 Plan Review
.4171 Fax: 503.598.1960 ;,( O j' " ., 1 " ,` Date/By: ocher Permit:
Phone: 503.639
Inspection Line: 503.639.4175 ., O \ � G ,.. .'' I J Date Ready/By: - � /+ See Page 3 for
www ct,ngalyd onus '5V \ \, Notified/Method: 'f--j
Supplemental Information
Internet
� X s , . `:F, .. . a 9: ' ?' ,�}ix I .. "a'Sr� � l ry t ld } f l 1l ' tit - ��- i c, i , ',tt5�rr.,7 3 } k yia f
,i 1 '- t14 i' -t } � t '.` -, � {�: � ,. r ..! . lrc, '�'� f �+s' °x'x�, i9�i?lt � h ti x!�e; �!b� `Sr`r''n� il ... r �, ? ra . c.. .. r . :-
tS o ti z .:. U.r•k.w :: �. -k
El New construction I Addition/alteration / replacement Please check all that apply:
❑Service over 225 amps, comm'I ['Hazardous location
❑ Demolition El Other:
_ ¢- }, ,.� N 77,•,r. , `'' 'P'N� '' { f '-'''''''3-, rr ['Service over 320 amps - rating ❑BUildng over 10,000 sq. ft.
- a iti , B< < a , '. ;,3na: r islx�r . tr,a. „ i 1 ,,,I A fu. of 1 -and 2-family dwellings 4 or more new residential
� g ib €. .
0 I - and 2 family dwelling ❑ CommerciaVindustrial ❑ Accessory building ['System over 600 volts nominal units in one sdructure
['Building over three stories 0 Feeders, 400 amps or more
❑ Multi family ( ❑ Master builder 1=1 Other: ['Occupant load over 99 persons ❑Manufactured structures or
1.- is j u `i t . t 1 r x,t r d , er d er
._? l
` FnA f,. eT � 'd,La'ia Jt ' = ..,. , ai . , ' _ .. ❑Egressllightingeslan RV park
Job no.: q . Job site address: U0 SW Ip$114 ❑Healthcare facility ['Other:
Submit sets of plans with any of the above.
City/State/ZIP: t o T 'b 0 12. 1---\ Q 4 7 Y The above are not applicable to temporary construction service.
Suitelbldgiapt. no.: I Project name: 1��� *� f " � 'h
Description Qty. Fee. Total
Cross street /directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no,: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
i �z' r 1 �'a �.� a . n,-u=nr� t? +„„ 3a. rn b.,r1.tz, t t p1 't
*s - : ? :r ; triA 's'� t,:, § .a 3 ,, , ?a Each manufactured or modular
SERVILE 1 LE 04-41 I - it G e R Et ,Ot&i� Services or service f ee d and/or feeder
installation, _ an, alteration , and , 2
c.JG 1 (.�"1't"ir'N f `•'► Seri feeders and /or relocation
200 amps or less r 80.30 t30, 2
.,� „. A'la t fit Nj ' A F stet �,1 i 201 amps to 400 amps / 106.85 ` 2
.'', k n 4 " a , , : ; ,, .i4J 4:1'i'drr r s.! ° .W1441 *IV . 1 1 7 ' 3 4 Eig . � _z 11 � it p amps 1 60.60 2
p ! /
4 01 amps to 600 am
Name: Mta\1 t cz5Y 601 amps to 1,000 amps 240.60 2
Address: , i -t 0 3' \ A \X,-- c / Over 1,000 amps or volts 454,65 2
Reconnect only 66.85 2
City /State /ZIP: '' Temporary services or feeders installation, alteration, and /or
Phone: (5Z'Y ) /6 t2 I Fax: ( ) relocation
200 amps or less 66.85 I
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 exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
,z.4 51t r e . .b.,tt(e , ; _� t3 x �s.J ii .n } m ! w , ,c<e a'kY U e �sR a " t f -
a - .ill i , ,i i l� ULt ,i.<a l,� � '1 -,1 4 l � / „, g A. F ee for branch circuits w ith
"" '"�'''`"-° ' ' "�"�"' it ' - service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: Each add'l branch circuit 40 6.65 13 -/10 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 _ 2
E -mail: Signal circuit(s) or limited-
. r ; a V E ii msfif C' 1x,11. +. energy panel, alteration, or
Bus T & T Electrical, LLC extension. Describe: Page 2 2
- 4120 SE International Way
Add Each additional inspection over allowable in any of the above
- Ste. A105
Per inspection 62.50
Ci f' Milwaukie, OR. 97222 )nvcsti h ga on per hour (1 hr nit) 62.50
Phoi Phone 503/652 -7610 1 Fax Industrial plant per hour 73.75
Fax: �2 rl�ol� r �,�,.
15011 � 9 M7.7` .� L�.; . n-'...
CCB Lic.: ?' I Electrical Lie.:2 X105 I Suprv. Lic.:+'G Subtotal
Suprv. Electrician signature, required: h . A , 1 i / / Plan review (25% of permit fee)
Print name: 9/ Date: �i 8_ State surcharge (8% of permit fee) 7, /
D. �✓ yy) � t/ � •'l � t /- ` 04 TOTAL PERMIT FEE 34:5 Authorized signature �^ This permit application expires if a permit is not obtained within ISO
�f y� days after it hag been aecepted es complete
Print name: 7 ) 7 fi S Date: 7r $ • • Fee m ethodology set by Tri- County Building Industry Scrvicc Board
" Number of inspections per permit allowed.
i.\ Buildina \PermaslELC-PermitApp.doc 12103 440 - 46157(10 /02 /COM/WF.B
£ ' d 2 T 9L2S9EOS 0 1d3I x10313 1'81 T is s ib T 1'002 Bz T nr
CITY OF TIGARD .
BUILDING DIVISION - PERMIT #: ELC2004 -00470
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/2004
Phone: (503) 639 -4171 : °bli'N�I�I'I
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7:07AM PAGE: 45
SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: WILLOWBROOK FARM LOT #: 030 TYPE OF USE:
PROJECT NAME: MAY
DESCRIPTION: Service change, remodel.
OWNER: MAY, MARTA, PHONE #: 503 - 380.1693
CONTRACTOR: T & T ELECTRIC PHONE #: 503 -652 -7610
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
- Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002852 -02 503 - 969.8839 Y
Corrections /Comments/ Instructions:
'] PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ap .�.,/ Date:, ? ` � Phone #: (503) 718-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (50 639 -4171 MST
BUP
Received Date Requested , j — j M �PM BUP
Location �v 7 7 O /6 g `�►''^-� Suite MEC
Contact Person P ( ) 6 S J 7(0/ 0 PLM
Contractor h ( ) _d /60 9 3 swR
BUILDING Tenant/Owner
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam f� CR
/����
Shear Anchors /
Ext Sheath/Shear `( a .
Int Sheath/Shear ��
Framing • A-II E A / ' •
Insulation •" :g
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
Service
oug -
UG lab
Low Voltage
Fire Alarm
Final
ART FAIL l
El fee of $ required before ne ' pection. Pay at City Hall, 13125 SW Hall Blvd.
P A
SITE 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA r Approach/Sidewalk Date �/ Inspector Ext
Other:
Final DO NOT REMOVE this inspection record fr a Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: • (503) 639 -41 MST
i BUP
Received Date Requested //6/0 AM if
PM BUP
Location - 1 frY0 V dviA / vi Suite MEC
Contact Person firper4r. in, Ph ( ) l bY3 PLM
Contractor ■' It_ / Ph (,q2_ ) qW 387 SWR
BUILDING Tenant/Owner ELC 1 ($7
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ' p _� SIT
Post & Beam ��`T -g��/
Shear Anchors
Ext Sheath/Shear • 4444�litiif / flip
Int Sheath/Shear
Framing + (�
Insulation 9 �i1- 04 1' ;\ . 1t ) 0 V\' i o �9-Q1 0 c
Drywall Nailing 4 yy�� 1 ) Firewall ��MN& 1r(, of � , ' \cat N'ACJi
Fire Sprinkler "' \--\• {� }
Fire Alarm \ (f\ . V 0)( � T 10\ i/ o 14 �LC- o c d p 1 \K S
Susp'd Ceiling y /'1 �'
Roof El 011%1. W �'1s'04,� t 1r) R,1 ()I 1IS .. NVA\A.5
Other: `,�
Final c: ` Li, V t.A Nrr 1 `c N\ \O" • Is k, t hl 1 1 1?,l� -
PASS PART FAIL di
PLUMBING c~ s-o ► esizcA Au, d c=v4tAiixtb NO u,yl s
Post & Beam { , `t-S'-\- \ , L 0 J,X1i (7 DV CO t\1 I) g N 3 A I b s- 1 J it if\ j)
Under Slab
Rough -In
Water Service
Sanitary Sewer i \ ; _
4. 4 V\A '9 t W p () Ok-(k
Rain Drains
Catch Basin / Manhole'" ° 1 NCS 1 E- - 6 ` r C� 6y ASS 1$41 _ o D � l `'� r\(
Storm Drain �
Shower Pan
\ 1\t,--4-1 b 11\1 S t 1 ` y )� \A t'c C� S
Other: F'0\
Final
PASS PART FAIL
MECHANICAL
k '-------
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
IErTRICAL
rvice
u - nJ & 2____.) 4-.-vim c >.j ,
UG /Slab
.
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART F 1
SITE El Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date / - %S ---- 0 Inspector L 4; y `' Est
Other: L
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL
Hap Watkins - New pictures 035.jpg Page 1
5
•
l : 1
k
G
4f 9
if_ . •
..,
...
.,_..
..,,,..7.....„,...„.
• ._�—^ w� � "dl's ....
„...,,.
, ..„....„,,, C
F
...,
1 •.
. . ...,_,
:„,„....t,....,..,,,.......,.. ._ el
•
V.
i - ,a
i. a
z1
* . ,
-_ -..
to ?�
•
•
Hap Watkins - New pictures 036.jpg Page 1
CC ''
i 1111011111.111 . - .. ,
n
ir
I. .
t . 4.
i �,; 1 '
a .
..., . i ;
.
Hap Watkins - New pictures 037.jpg Page 1
/ ;, - ti. � ;
;Ti _. : .. I
it' 1 /II , / i . i,
^.
• .
i
t 1 , ° !ems , - — air— '" '
• c
•
. a ., +» , - � F 41 e f i ' _ , 6 ' \ 7
41 .« rQ� «
-
t :
•
4 s''k .. - l �y
� {,
� e i
J
�' aw L "'�•. .ry
...-',-,,iqff' !_, '1 __ '
jil
y es
r
1 _
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 4503) 639 -4175
INSPECTION DIVISION Business Line - (5G3) 639 -4171 MST
BUP
Received Date Requested /c — 7 A PM BUP
Location — 741 7 6 162 / Suite MEC
Contact Person Ph ( ) - b /( ?3 PLM
Contractor P ) SWR
BUILDING Tenant/Owner ELC i - O
Footing
Foundation ELC
Fog Access: Du '�I 4wt , 08
Drain ELR
Crawl Drain
Slab Inspection Notes: fi SIT
Post & Beam HA L_ °^
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear _ - ---
Framing r
Insulation Z O- ! • , 4#11. mr cA 10
Drywall Nailing
Firewall F K D f'1 l ' P4Al C5Z
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Mtn Z 1 1,
Other:
Final
PASS PART FAIL
PLUMBING 1 S
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
UG/Slab
Low Voltage
Fire Alarm
4 0 - Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
— PA SS PART
SITE J Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA +~
Approach/Sidewalk Date /2 '' Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record fr t the Job site.
PASS PART FAIL
T_ v
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171
1 BUP
Received / Date Requested (Z 2-7✓ AM PM BUP
Location /(D 7 �3 �i14J / 7 Suite ' / MEC 0 -- d G a3
Contact Person (� Ph ( S �) q 71 O p `/ ?7 PLM
Contractor .1 : / / C. Ph ( ) SWR
BUILDING Tenant/Owner ELC 2904/-1a97o
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: r , -, ,, SIT
Post & Beam !l 'I �.����!
Shear Anchors
Ext Sheath/Shear 0 Z 1&4
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling n p � \, y � l , / � S
Roof 1 Q' �,,Q `�1 v Mk f o "QJ -I V Y b I-- ���� '+� 6 vyh J '
Other: C-.4\_\--D 0 To N o PO & �� QJ CAI- 1 W C l(JVf )
PASS
PLUMBING FAIL 14 sb P ` x\fG 1-1M \-Cst-Ni CA*N413 u\,
Post & Beam �1 .
,(� \ ^ 1
Under Slab ` "V C} 1 +n (. % 1 C5 V018
Rough -In
Water Service
Sanitary Sewer ' 1K^ !y Cr-411-
1- q
Rain Drains
Catch Basin / Manhole - ; rl I ^\ do u -cj ,
Storm Drain ,
Shower Pan W'4• GI S £ \c2r
Other:
Final
PASS PART FAIL
MECHANICAL 11 \ 4 0 1 -1t) By
Post & Beam I
Rough -In �� � 3 (� r °
Smoke Dampers C Ai LL t N ; '� 2TI c� `:,5 ''\'m 1 CA a, \-\ � �. Q� �,
Final
PASS PART FAIL
2ii-
Service
ou h-
Slab
Low Voltage
Fire . - rm
PART ILA El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS SITE f
Please call for reinspection RE: Unable to ins
❑ p ❑ Ubl inspect - no access p
Fire Supply Line (/02
ADA Approach/Sidewalk Date Inspector A�
Other:
Final DO NOT REMOVE this Inspection record from t ob site.
PASS PART FAIL
L -