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Permit C I TY F ib F TIGARD ELECTRICAL PERMIT PERMIT #: ELC2002 -00307 11 DEVE H PMENT r (503) 639 -4171 SERVICES DATE ISSUED: 7/10/02 SW PARCEL: 2S 104 DA -04500 SITE ADDRESS: 13303 SW 129TH AVE SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT : 031 JURISDICTION: TIG Project Description: Install 3 branch circuits: Lighting for putting green. 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: 2 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: TOM WILLIAMS OWNER 13303 SW 129TH AVE. TIGARD, OR 97223 Phone: 503 - 579 -3886 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 7/10/02 $60.15 2720020000( Wall Cover Underground Cover 5PCT CTR 7/10/02 $4.81 2720020000( Elect'I Final Total $64.96 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 an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952,011 -0010 t . h OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to Permit Signature: 'J \ r ° ' Issued By: / • vv 1 OWNER INST ° LLATION ONLY The installation is being made on property I own which is -: ntended 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 s e • • • l iI i)iii- (,F' l!i 1C)NI 1''i, l 1 t Electrical =�,� t,t � Il ► I �� .� I,tlti Iles t II.t,wilu tit , Date received: _ /0 _Ci Permit no -:L .g ; - Oxj ;.0.1 4 City of Tigard Project /appl. no.: Expire date: City o,fTigard Address: 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: II . t lI I r J `. , �. - t - MIT r � ,,.��, j _ - ' "i � �� "1 L'�, 1 ��.3�� I � , . ! - T��PE OT PIR 1 : I {�_! 3�r - r ` i l� l .li + iE • fd � l & 2 family dwelling or accessory 0 Commercial 'ndustri 1 0 Multi- family ❑ Tenant improvement ❑ New construction I ,9�Additi /alteration/ lacement ❑ Other: O Partial • '► II1I 1 Ill t r 1 .3 : ; • F I` a 1'►�111 k) tF•i I i i 1 ' • JOB SITE INFORMATION , 'I' II Hit bl lt{i!►llti 1 11 ' P1111i1 11'11 ' i 1 i •' Job address: '530 'A..) 1,94=1 wU / Bldg. no.: Suite no.: Tax map /tax lot /account no.: Lot: ►Block: (Subdivision: Project name: ► Description and location of work on premises: i4, O Ll (..X.► 0 Estimated date of completion /inspection: f F 1 II i €I I , �1 ,, 1 (() fRI1(NI .�:�Pl lit � ► I i ° . � I k Job no: ©l» i ' Fee Max Business name: Description Qty. (ea.) Total no. insp Address: New residential - single or multi- family per d wellingunit. Includesattadt ed garage. City: ► State: ► ZIP: Servicemduded: Phone: ► Fax: 1E-mail: 1000 sq. ft. or less 4 CCB no.: ► Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro ltc. no.: Limited energy, non - residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and /or feeder 2 Sup. elect. name (print): License no: Services or feeders— installation, 1r t iI a r t , !!i.1 alteration or relocation: ,11 `, '1 t , i li 1i 4,-,'1- i PR - Tl- OWNER 200 amps or less 2 Name (print) 1 _ ■ 1,41 201 amps to 400 amps 2 ^ Mailing address: 191 rte) l ?q • ill , �„ i 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: �, %, State ZIP:/ 0 I` • ver 1110 amps or vo is 2 Phoneg l ii j Fay {• E -mail C ,, v . ; . 1 1 Owner installation: The installation is being made on property I own Temporary servicesor feeders which is not intended �r sale, lease, or exchange according to t, installation, alteration, or relocation: ORS 447, 455, 479, d�I, 701.' 200 amps or less 2 3 201 amps to 400 amps 2 Owner's signature: ∎ A I_ L_1 Dater _ 401 to 600 amps 2 i i'i' i ht r l.r ill:-7.1 �s , - 1 ,�- f , .�,� _ t , _ i ,,. Ik ,t ,:1 ti 1 ' ► l� F � . I ■ j t Branchdrevits -new, alteration, t or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 3 2 City: ► State: ► ZIP: B. Fee for branch circuits without purchase Phone: Fax: E of service or feeder fee, first branch circuit: 2 Each additional branch circuit: Ii1t►iI 'Rf lI'% ( . ; Pl'e`ase died all that aplil ,)k Misc. (Service or feeder not included , ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps - rating of l &2 0 Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 601) volts nominal more residential units in one structure alteration, or extension* 2 O Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress /lighting plan ❑ Other: Per inspection I I I I Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other r Permit fee $ (cp. /5 Not all jurisdictions accept credit cards. please call jurisdiction for more information. Notice: This permit application ❑ Visa 0 MasterCard Plan review (at ___ % ) $ expires if a permit is not obtained Credit card number. I I within 180 days after it has been State surcharge (8 %) $ - 5 ' I Expires TOTAL $ r 4. GI6 accepted as complete. Name of cardholder as shown on credit card Cardholder signature Amount 440 -4615 (6 /00 /COM) CITY OF TIGARD / 24 -Hour - BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION'S Business Line: (503) 639 -4171 'MST BUP Received Received Date Requested '! I AM PM BUP Location /3 3 0 3 /4?- f V- / Arti-e_ Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 5 79 - 3 7 ELC , C 9 ✓ ® 7 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT & Beam Shear Anchors . Ext Sheath/Shear Int Sheath/Shear • Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm -- k fi ■ 0563 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 ice Rough -In UG /Slab Low Voltage Fire Alarm `PAS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA n Approach/Sidewalk Date 7 — 7 `" Q — Inspector /` Ext Other: Final DO NOT REMOVE this inspection record from the Jo ' site. PASS PART FAIL CITY OF TIGARD _ 24 -Hour 73 BUILDING < Inspection Line: (503) 639 -4175 INSPECTION DIVISIONV Business Line: (503) 639 -41 - -MST r BUP Received Date Requested �-", "'L Z� AM PM BUP Location 73 36 3 5 /2-9 / 44.9 Suite MEC Contact Person 11-M'(\ 64//l u-. Ph ( 5 ),577 3 ?t C PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 0e-t, 2--do 56 7 Footing ELC Foundation Ftg Drain Access: ' Ft +0 trf + ELR Crawl Drain 4 Slab Inspection Notes: SIT ■ Ilk Post & Beam 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 MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers • Final PASS PART FAIL Rough -In o C Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125.SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date l' Inspector _ t Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL