Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00151
S DEVELOPMENT SERVICES DATE ISSUED: 3/16/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CA -02000
SITE ADDRESS: 13460 SW 121ST ST
SUBDIVISION: WOODCREST ZONING: R -4.5
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: A/C and furnace
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:
JERRY HAWKINS GRF ELECTRIC
13460 SW 121ST AVE 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: Phone: 503 - 829 -4146
Reg #: LIC 76751
SUP 1655S
ELE 3 -484C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT CTR 3/16/01 $53.50 2720010000( Elect'l Final
5PCT CTR 3/16/01 $4.28 2720010000(
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE in (&6 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
Mar 16 01 06:39a GRF Electric 5038295747 p.1
Electrical Permit Application
Date received: Permit no a OD / /S(
.16..:,.., t ) t :i,
A 1, . f City of Tigard Project/appl. no.: Expire date:
Ciry of Tigard Addr 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
s 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE IN'FORIIIATION
Job address: / 3 s ( C•) JL'v / a l S 1 /3-?,,p Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: IBlock: I Subdivision:
Project name: ft A td iL r v i _ [ Description and location of work on premises: , •
Es.tmated date of completioniinspe - rion: D ... C /POW ---- OIVTRACTOItf`AP f 7"iciN '-:_ -r -_ _-_. ,..t- - c F" ..e iEU E -7-1'." r _` L
Job no; Fee Max
Business name: G 2F ei eea�•-Y'[� Description Qty. (ca) Total no.insp
1 . New resid ential -single or multi-family per
Address: 9 LI-. t Q S. l ( lie C r S L A in e. dwelling unit-Includes attached garage.
City: M tit I f et D ¶ State: Of ZIP: qr.') 0 kf-2,_ Service included:
y - y ; Phone: t i p Z u . 1 _ 1 ti' f p , I Fax: glq _ ri - s E -mail: 1000 sq. ft. or less 4
-7 5 I l Elec. bus. lic. no: 3 - Lt C Each additional 500 sq. ft. or portion thereof
CCB no.: IO Limited energy, residential 2
City /metro lie. no.: 3 1. Limited energy, non- residential 2
/ Each manufactured home or modular dwelling
. 3/P ev�1 1
Signature of supervising elec 'clan (required) Dal Service and/or feeder 2
Sup. elect. name (print): a 1 • t. ., License no: i ( s 5-S Services or feeders - installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
201 amps to 400 amps 2
Name (print): .J e, r f J f_.; ,,t> /Z. i i"
401 amps to 600 amps 2
Mailing address: 1 3t f , 5 J A-- ' y 601 amps to 1000 amps 2
City: • r n ,)c_ State: [ZIP: i - 72.3 , > Over 1000 amps or volts 2
Phone: 57`1 -fr,et y� I Fax: E-mail: I Reconnect only
Owner installation: The Installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to 'uaaO ", alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: , .
A. Fee for branch circuits With purchase of /G� /� '(�
Address: service or feeder fee, each branch circuit LTV ✓s" '^' 2
City: State: ZIP: B. Fee for branch circuits without purchase •-""
of service or feeder fee, first branch circuit: t if 6:, '.> 2
Phone: Fax: E Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial O Health-care facility Each pump or irrigation circle 2
O Service over 320 amps-rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over600 volts nominal more residential units in one structure alteration, or extension' 2
0 Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egtt ssllightingplan 0 Other Per inspection I I 1
Submit sets of plans with any of the above. Investigation fee
The above *renal applicable to temporary Construction service. Other
Not all jurisdictions accept edit cants, please call jurisdiction for more information. Notice: This permit application Permit fee $ 3 V
credit
0 Visa 0 MasterCard expires if a permit is not obtained' Plan review (at _ %) $ T , 2_
Credit card number: I / within 180 days after it has been State surcharge (8%) $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
Cardholder signature $ Amount 440-4615 (6/OQWCOM)
eiG7 7
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24aour Inspection Line: 639 -4175 Business Line: 639-4 71
/' BUP
Co
Date Requested ' 24 AM PM BLD
Location / 7 (y 6 )1 /2- /S f )l v4 Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC 2UV /'1) /51
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
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 2 /` — � CJ 1 /
Misc: <
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam C
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
PASS PART FAIL
SITE
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
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUJ - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By I Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final i A,q/
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing / Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical fmal
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation I Inspection Description Date Passed By
Drywall nailing Post/beam mechanical
Suspended ceiling
Gas line
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final.
_ Duct work
Bolting Lab Final _ Smoke detector
Fireproofing Lab Final
Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP/backflow preventer
Fire alarm fmal Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
. 4 Inspection Description Date Passed By _ Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils J Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS
CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00"i 51
� I�; DEVELOPMENT SERVICES DATE ISSUED: 3/16/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CA 02000
SITE ADDRESS: 13460 SW 121ST ST
SUBDIVISION: WOODCREST ZONING: R -4.5
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: A/C and furnace
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:
JERRY HAWKINS GRF ELECTRIC
13460 SW 121ST AVE 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: Phone: 503 - 829 -4146
Reg #: LIC 76751
SUP 1655S
ELE 3 -484C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 3/16/01 $53.50 2720010000( Elect'l Final
SPOT CTR 3/16/01 $4.28 2720010000(
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. IN
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
IN
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those I\
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 -1987.
PERMITTEE'S SIGNATURE in I /di ISSUED BY: --- 7'
OWNER INSTALLATION ONLY
/ R,
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: N.
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day Nia.till