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Permit ` CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00194 DEVELOPMENT SERVICES DATE ISSUED: 4/18/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110CA -00102 SITE ADDRESS: 15300 SW 116TH AVE SUBDIVISION: ZONING: BLOCK: LOT : JURISDICTION: KIN Project Description: Relocate exterior light 12'. Job No. 66366. 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: KING CITY, CITY OF TUALATIN ELECTRIC 15300 SW 116TH PO BOX 655 KING CITY, OR 97224 WILSONVILLE, OR 97070 Phone: Phone: 682 -2955 Reg #: LIC 00065650 SUP 3483S ELE 3 -268C FEES Required Inspections Type By Date Amount Receipt Underground Cover PRMT CTR 4/18/01 $46.85 2720010000( Elect'I Final 5PCT CTR 4/18/01 $3.75 2720010000( �ED 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: ' / fi r" �/ 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: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day It,c1- 8 -7 -I 1 Electrical Permit Application Datereceived: /,p, p Permit no.: 62C i i Z DD / „ll''•I City of Tigard Project/appl.no.: Expire date: City of Ti ;rd Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: Phone: (503) 639 -4171 Rtceiptna.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: O 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement ❑ New construction 0 Addition /alteration/replacement 0 Other: 0 Partial JOB SI I I' 1 \I ORM tilt/ \ Job address: :_) _ -? C; ! _ j G ✓ / i ' /A/6 ei Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: 'Description and location of work on premises: / co PBi-'" EX ero,e- Zr6 /17' /2' Estimated date of com letion/ins lion: Job no: to L.6 pce lwx Businesi name: `�" d , i Description ea.) Total no. .ta r-. E D New rceeeetlol- single ar midti-fuoily per Address: �S t‘.., �S dwellingtadt.Incla ealts ed City: Ni., ', \s,znv; Prate: t4:4 b`1 4 1 ZIP: `t — 1 Servicelocluded: Phone: 6Er; - aG � Fax: .. tin'(1 E-mail: 1000 9. ft, or less 4 CCB no.: 6s 650 ec. bus. lie. no: additional 500 sq. tt or portion thereof Limited energy, residential 2 City /metro tic. Ito.: Limited energy, non- residential 2 1. -- •- 1 - ( I Each manufactured home or modular dwelling Signature of aupervisin ectticlan (required -- Date Service attNor feeder 2 Sup. elect. name (petit): Services or feeders- instaliotlon, Qvt r Lic ense no: alteration or relocation: . 200 amps or less 2 Name (print): (' ✓ 7y /</A/6 C ` , T y 201 amps to 400 amps 2 / ^ 401 amps to 600 amps 2 Mailing address: /5"--3 /y) _Su) i/ 601 amps to 1000 amps 2 City: k //1_76- e r y J State: 07 J ZIP: 9 a a/ Over 1000 amps or volts A 2 Phone: C 3 L/0cF2 ; f Fax: I E-mail: Reconnect only R.° k " ) Th Owner installation: The installation is being made on property I own Temporary services orfeetkw_ n which is not intended for sale, lease, rent, or exchange according to hastalbt8oa ,atterattoaa,ttrrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's si ature: Date: 401 to 600 amps 2 Branch clrenits - new, alteration, . Name: or extension per panel: A Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: 1 State: • IMP: B. Fee for branch circuits without purchase J Phone: Fax: E-mail: of service or feeder fcc. first branch circuit l 2 Each additional branch circuit Mlsc. (service orfeedernotIncladed): Ca Service over 225 amps-commercial ❑ Health-care facility Bac po mp or irrigation circle 2 ❑ Service over 320 amps-rating of 1k2 ❑ Hazardous location Each sign outline lighting ' 2 family dwellings CI Building over 10,000 square feet four or Signal circuits) or a limited energy panel, - ❑ System over600 volts nominal mote residential unite in one structure alteration, or extension* 2 CI Building over three stories ❑ Fccders, 400 amps or more ❑ Occupant load over 99 persons O Manufactured structures or RV park Each additional kispecticat over the allowabk in any or the above: Cl Egressllightingplan Cl Other Submit _ sets of plow with any otthe above. Investigation fee The above are not applicable to temporary construction service. - Other Na aIi Jnrtedlcrloes *tear e.eeit cads, please can iwtaeeeioa AN more latoemaeiva Notice: This permit application Permit fee $ If 6.85 O Visa ❑ Masted expires if a permit is not obtained Plan review (at — %) $ Credit cord number: � I within 180 days after it has been State surcharge (8%) .... $ 3 35. Name o ' earefrolder es shown on credit rant accepted as complete. TOTAL $ �0 . 6 S Cardbokler die Amount 440-4615 (6nJolCOM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION • Business Line: (503) 639 -4171 MST BUP Received Date Requeste AM PM BUP Location L 3 012 S '! ( f Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR ? c�, ne c- BUILDING Tenant/Owner ELC . 1 1 f �I Footing `) 7�) �"�t la �p ,16 b ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam -Kk. I _1) (,T■rf Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation 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 EXPIRED MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In Low olt Voltage '} , ' �c� ' I t Low �`1 � 1-)"'� I) ►^1 � n-) L Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA I� Approach/Sidewalk Da t� b J Inspe r Ext Other: Final DO NOT REMOVE this inspection record rom = job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 1 l t9bq f7 Date Requested AM PM BLD Location 1 �3c�a Su) ''1&ft.' Suite MEC Contact Person C rrni 4 Ph PLM Contractor A Ph SWR BUILDING Tenant/Owner ELd 2,421:0( —m6 Lgl.i Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm , > ` /� 7- �� / Susp'd Ceiling (� /U G� �� G ` !Z Roof — Misc:� S Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final a SIVRT FAIL CL c - _ Ig • ab Low Voltage Fire Alarm PA • PART FAIL glITE 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 Other oach /Sidewalk Date c' / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.