Permit .,� CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00138
11 DEVELOPMENT SERVICES DATE ISSUED: 3/22/04
AO _.� I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134DC-05500
SITE ADDRESS: 11770 SW 113TH PL
SUBDIVISION: MUTTLEYS ADDITION ZONING: R
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: (1) 200 amp or less service and (1) branch circuit.
Job No. R 62 -56
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: 1 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:
BRUCE MITCHELL ABC ELECTRIC CORPORATION
11770 SW 113TH PLACE 135 NE 9TH
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503 - 524 -0648 Phone: 233 -7551
Reg #: LIC 288
SUP 1241S
FEES ELE 26 -2C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/22/04 $86.95
[TAX] 8% State Surcharge 3/22/04 $6.96 Rough -in
Elect'I Service
Total $93.91 Elect'I Final
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 181 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in 0' - • 2- 001 -0011 • ough OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -801 2 -2344.
•
Is- ued By: / , , / • C �Ga1� 1 ' Permit Signat ,tai% -„„egeiow /
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 INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: i!'' ' i421 %r DATE:
LICENSE NO: /2'/ /-5
Call 639 -4175 by 7:00pm for an inspection the next business day
MAR -19 -2004 02:16 PM P.02
• 1 ectlrical Permit Application FOR (1FF'1('l I ONLY Received ■M' ,wtrical c,
,
Dateia . l ..it No.: -- CZ v ? .
City of Tigard Planning App .val Sig„
Date/By. Permit No.:
13125 SW Hall Blvd. \ � � Plan Review Other
Tigard, Oregon 97223 C te/By
Da: Permit No.:
a
Phone: 503- 639 -4171 Fax: `` $ Post- Review Land Use
Internet: www,ci,tigard.or.us r �` ' 4' 1 .{s. Datc/B : Case Na.:
'� . —.- A --. Contact P: � Sec Page Z for _
24 -hour Inspection Request: 503-63941% � ;, - - Name/Method: Supplemental Information.
{ OF ,\',�`0;.
t ■
► ; . • -': : . '. r} " ' :- ' :J °rf; '. ' PL AN' REVIEW(P.lease checkall that apply)
T YPEhbIT �VOII
New construction Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial 0 Hazardous location
Addition/alteration/replacement v Other: . , ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
``.,' CATEGORY OF; CONSTRUCTION '. I & 2 family dwellings tour or more residential units in
F.. 1 & 2 -Famil dwellin' I Commercial/Industrial ❑ System over 600 volts nominal one structure
ill Accesso Buildin• IVlultl•Fami!
:I Building over three stories Feeders, 400 amps or more
1 ❑ Occupant load over 99 persons Manufactured structures or RV park
■ Master Builder Other: ❑ Egress/lighting plan ❑ Other: -
' 'JOB SITE INFORMATION: l. d:LOCAT'ION" Submit oats of plans with any of the above.
The above are not a + dicable to tem. orar construction service.
Job site address: //' in 0 tO LL3 P_J Q c,4.... . . ; ; . . :r :.'. . , FEEh CRZ' L1LEX-. ?.:': ':r -0, I; c' ; ,
Suite #: I Bid , /Apt, #: Number of Inspections per permit allowed
Project Name: , jrle e 0_ / ( r ' 7L/,, /1 Description Qty Pee (es.) Total
Cross StTeet/l�1TeC Oils to job Site: New residential - single or multi- family per d
1 dwelling unit. Includes attached garage,
-171O0'/6.45 (,(f eft Service included.
1000 sq, ft. or less 145.1 -
4
6 . 55" Each additional S00 sq. ft. or portion thereof 33.40 1
Subdivision: L ot # : Limited ener residential 75 2
__ - Limited energy, non residential 75.00 2 -
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF;WORIC''' , , service and/or feeder 90,90
Servkes or feeders . installation,
alteration or relocation: ■ n
200 amps or less . I $D.30 glJi�0 2
201 amps to 400 amps 106.85 2
_ 401 amps to 600 amps 160.60 2
.73 PROPERTY OWNER' ? ' s: 1 Q TENANT' . ; . •• r ." . ! • ' 601 amps to 1000 amps 240.60 2_
- Over 1000 AMA or volts 454,65 2
Name: • • Reconnect only 60.85 . ' 2
Address: ' , 1`7 cl taC 9,...„, temporary services or feeders - Installation,
City/State /Zi � alteration, oaf 00 amps o r le ss
relocation:
2
0, 9 7 72:3 00 amps or less t
1 201 amps to 400 amps ---- . 2
Phone: Wit, 0 c.. • Fax 401 to 600 amps 133.75 100 2
0 0 CONTACT PERSON'. ' . • Branch circuits . new, alteration, or
Name: extension per pastel:
A Fee for branch circuits with purchase of ---
Address:
service or feeder fee, each branch circuit 1 6.65 (p .65 2
Ci /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: J Fax: 2
Each additional branch circuit 6 .65
E -mail' Mlsc,tService or feeder not included):
s.',:" . ' , . Each pump or irrigation circle 53.40 ?
— - , Each sign or uutline_lighting , 53.40 2
Job No: .. 1..a - Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name: 0' L. , / _ \1 Description:
Address: • ; Eol 4 • - - .
C1L /Stale /Zl e : Each additional Inspection over the allowable In anyof the above:
_ � - I' Per inspection ter hour (min. 1 hour) 62,50
Phone: - Fax: investi fee:
CCB Lic. #: other:
�.d;��i�ma i i , - ��r ; !. .r:.!F. ,; ::4'.EIectrlctdPerm] FeMK - .•i. .';.:.. -
Supervising eleetri •� Subtotal $ $(e , q _
si_ .0
nature re •'r . �_, _ �,�.% . Plan Review (25% of Permit Fee) $
Print Na/fie; , /, T /r� �� d State Surcharge (8% of Permit Fee) S � Lt
TOTAL PERMIT FEE $ ,
Authorize ./ y Notice: This permit application expires If a permit is not obtained within
Signgtture;...'- '( 4: ,. ♦ , - _ , Da C 180 days after It bas been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
• k MOR ,
(Please pri Hart )
i \Dsts \Permit Fomts ■ElcPermitApp. • ! .3 '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received � 2 ` ' Date Requested 2- 9 AM PM BUP
Location // / 70 l'3 ,"/ Suite MEC
Contact Person Ph ( ) PLM
Contractor ,4„6 (i. Ph ( S ) 3) 233 -9 57 SWR
BUILDING Tenant/Owner 4/-0
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot - r�
-A - S 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
J e
Rough -In
UG/Slab
Low Voltag
ar
Fi ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE El Please call for reinspection RE: LI Unable to inspect — no access
Fire Supply Line
ADA q (� 6Q
Approach/Sidewalk Date 3 f 2 ' t Inspector ll��- Iv `"'Dp �= Ext
Other:
Final DO NOT REMOVE this inspection reco rom the Job site.
PASS PART FAIL