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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00338 'l' DEVELOPMENT SERVICES DATE ISSUED: 6/11/2004 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103BD -03500 SITE ADDRESS: 12970 SW 121ST AVE SUBDIVISION: ZONING: R-4.5 BLOCK: LOT : JURISDICTION: TIG Project Description: (2) branch circuits: GFI outlet and fan. 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: 1 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: DOYLE, ROSS HILLSBORO ELECTRIC 12970 SW 121ST. 21185 NW EVERGREEN PARKWAY TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: 503 - 997 -4031 Phone: 503 - 439 -9666 Reg #: ELE 34 -4399C LIC 134481 FEES SUP 4941S Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/11/2004 $53.50 [TAX] 8% State Surcharge 6/11/2004 $4 Rough - Elect'I Final Total $57.78 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. ,�, ,,,., /�1 Issued By: Permit Signature: f g �l1�Lf', 1 or 4 4pc s 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 From:HILLSBORO ELECTRIC LLC. 5036013680 06108/2004 15:26 4093 P.002 06/09/2004 12:41 FAX 5035981960 CITY OF TIGARD ZI From :HILLSBORO ELECTRIC LLC. 5036013680 06/07/2004 11:00 4050 P.002 Iectr'cal Permit I1VED F4 RCITT'IC-'I lr•l_ t :�: CitY of Tigard q • -.C2 0 / ..0 ParmuNo.:� ,� -0O3 :! 13123 Sw Halt Blvd., Tlgerd. OR 97'1 Ufl 7 LUU4 t?tFar '''''r""'' Phone SO3.639.4171 Fag 503 f9 Q, '-'t ` . r ^r,, L'; • .. . . _ l ee =ion Lint: 503 - 639.4175 . I 1 1 O; TIGARD ,,,7. 1 thf. fttt.nr „ ar• 3�h�Z roe irurntt: WWW.ei,tilardesr.ue BUILDING DIVISION NotUlodtMcesad: $1 t d etas iciness :rate TYPE OF WORK . ' - - PLAN ttltVICW t . J ❑ blew construction �AdditionAltcrstiorVroplBCement Plaess e}sck tilt that apply Q Other ❑S ervieo over ns • mps, wurrn'I ❑Hassardaue ite4tfen O Demolition =Service aver 3.7:0 ernpi eating Muildno ovor 10.000 eq, R., CATEGORY OF CCNSTtlUCT1bTN' -. . " . '•..:. al. arid 2.ramifydwcllinwc 4er more newrmidrntiaf r ❑ yearn over 600 vpl>u nominnt unite in eon Onourn i. and 2•Pamlly d�+ailitzg Commercial /i,tdu #tC1aI Act eesory building ❑Building or them Nodal ❑Po dera.400 amps or mars ❑ Must {AtnJly ❑ ■sstar builder ❑ Ot1Cr: Qneeutmnt loud over 99 parsons OMB.nufantmcd sty iclurao or • JOB S Offset_ E INSt'ORMAT/ON Arab L . 00,bTiorg' -' •-' • '- - DS16etheI16hlingplar RV parr; ❑Health -acre: EheElfcy I iV ,sob site address: N tf 1.. Lti S anti! .1 secs cif plans wills etty OM. ricers- • = - ? Ths above ore not applicable to temporary ean/lruQfvtt service. /f# � ,j / 'FEE "'. f3CHEPIAX „1" •' • Slsita/bidg_/apt nn.; IP Project risen ro. oelt011110 I'RV I rise I 7 I -" Cry StretWdireerdOnl to jub Site; New residmtial siny)e -ar mulei•faroi y dwd:Sing unit_ eaduds st c hCd $sears . 1.000 s FL ar Isis 145.15 1 Lot no.: 15a. ad i 5005. ft. or petiten , 33.40 1 5ubtiivisiotr Writhed me , residential /SO 2 ' Teti ms• • • col Ala_: • Limltcd army. non eeaielordial 75.00 2 A � : ' ? ,If, : _ _ pFSCRX'TJON OF WORD : #.,,,t1a'e' "y +.'u'. L' ierrr •'' 'Eaeatto'fseimSidormodular '- It 1�1 f Ott :. f. d alLeti feeder 9D.9p 2 i �fis�f�r� r1 ery Sloca or r feeders Io lrststtstiom s 4toradati.r+ea/or relo®to 4I 4 arc c r i es 80,70 2 1si114A—. . ict1 , „ _, , 201 amps to 400 iii 9 s 106,133 2 . : •1; fh ; Y t It / L ` • OWNER -' ' � jl; :Y' N; i e:' t. ' �1 T6riaN7`•r"t'l••', 'l . -_ 4 tunes to 600 seas 160.60 2 Name: _So . 601 alnpa to 1 000 al ms •60� , Z „ (-4 ) T � Guar 1.004 amps or wit 454,65 2 Address [� �r � Reconnaatonly 66,8: 3 City /BtaxdlI P; Temporary servless or friars ltutalladon, atmrat ion, and/or raloo boa Pitons: , ./P ,. ..LA fax: ( ) Na amps ar lets a. Fro I i Owner iust*lKIt Ian t lit fl;lellntI0n IS be g m :.eon pi r that 1 own which is not 201 amp; to 400 amps 100.30 2 inttzttdlxl for sale, !case, rest, or e;chuage., ace rdhtg to ORS 447, 449, 670, slid 701 401 amps to 600 snipe 13 2.75 2 Own.. eignantrr. W _ D a t , _ Dm ech circuits— terw alts =s tlnn. ar ta tamale n, per Panel '''';'r‘:::.+:. At' CAI�T' 1-i' : - ' :r 'i'lli:04 :'in . oNr pERSDN';- t,' l"';' = A Fat ter l'eseeh sircu( swith F Q LI . ht o "! se via: e - feeder free. h 6.65 l BitiiRSto6 name: ' r� �� P for arusil ,,, vet ... " "" B- ,nah circuit remit t r Catit6Ct name: wlllr sevino or feeder fits, ( 46.85 , " tt+' • Z bane, dtsuft Ad drt:sB: _ _ E chadd'1 branch sin uh US ll7 2 — City /5tate/ZIP; hu scenisicoolccerelooar fertile eel Inc iudt :d) _ Denny or leer tan a ir ala J3.a0 2 Fax :: ( 1 ' 53.40 2 Phone: ( ) _ Sign or outline 1leaf • 1:- steers!: Sfgrral cisvnit(e) or lie tad- . r s' 4- . etwr�y penal. altetttio -, or i. GUhtTRA.CTaA', ......',:...z_. ri; i{N "'., \', 1..,:.: ,l `L rs Ciaeurlbe: P4C 7 2 BOIi='Urn: :liiz15bor0 E lectric L i.L.Cra - Loch additional i isrectina tr oy ello le Silty or the ebovn Address: 21 185 NW EvargrreeA S #1 10 Per inore tIoe 62.50 e l City /StatP; Kt Ilsbor0 OR. 517124 111.ns ,,6tlonperhourtl'errmh I 62.50 j-- . rhyme: C503) 439 -9666 Fa -(5Q3 )5O1 -366 r. lndtrER+alpltyN per hour I I 79,75 . E LECTRICAL PE AM1f ptesft _ CCB Lia71 344 B1 Ebelrie*l Lic.:3 -4990 S uprv_ Lie: 4941s sumosai • L-% Suprv, Eleattiaian eiplartiro. relquirre l t t 4 A. v 7 te plan vlew 1 o[ pcnnit ltei Seta =rein:rue Mt or petmtt ferl � '; Print tenter JOey VjtaCCa d° � � TOTAL PERMIT FEE " a_ Authorid signature; rids psrmk s tl pplimaa,,zni+rs era pannic Is net obcnl�ned ••:the `ao� days alter a h9c bean accsprsci s• gomoiem Print Warne: ] ©Bt i _ ' rs mnthaiola' y et by 1r+•Cavaty Puadina industry 9.r.4. oar '. Number er IneaaeLions per perm;r.tle•.ed al isilStirOstaf ftTet.e•P•ngiAppaka WATT +Nn- tor.'rtrrMrarorewati CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested If PM BUP Location I aq 70 ( Z ( S f Suite MEC Contact Person f T Ph ( ) 39 -qcoC. (E-, Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC -4:D 4 —OV 3 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain -. (5 N' . 1 1 9 - Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear , 1 F Int aminath/Shear -- � �, _ N,aV L - tw N o rq A wr� r C- \ 9 ��rJ 1 Insulation Drywall Nailing Firewall Cb NS e � �G o'RI G') ON N aL„ fir Fire Sprinkler T� W Fire Alarm K:t -1 L t S N/ a w i i �ntri Susp'd Ceiling (---\16 Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In 77- , 4-***--------'-. Water Service Sanitary Sewer > L Rain Drains C kO Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL \ _ l MECHANICAL , \o I�'Es eat r - GJ A b ^1 • • Post & Beam �� Rough -In e I O wIsm Gas Line l + E - c k Smoke Dampers , Final Cy-- (uQ�LR PASS PART FAIL ' �[ = RICA_ V _ ____ ,.....„,...._____i ervice Rough -In UG /Slab Low Voltage Fir- ' larm 1 • PART ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIT Ei Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA (_. N Ext Approach/Sidewalk Date �^ I 1 I nspecto r' ' � ` i _ Other: Final DO NOT REMOVE this inspection r ord from the Job site. PASS PART FAIL