Permit QJ TY OF TIGARD ELECTRICAL PERMIT
�.. - PERMIT #: ELC2004 -00739
441i1 DEVELOPMENT SERVICES DATE ISSUED: 11/17/2004
AL
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S13300
SITE ADDRESS: 14170 SW BARROWS RD 15 -5
SUBDIVISION: SCHOLLS VILLAGE CONDOMINIUMS ZONING: R-25
BLOCK: LOT : 15 JURISDICTION: TIG
Project Description: Reconnect only. Apt. # 5.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PASTEGA, ANTHONY OWNER
14170 SW BARROWS RD #5
TIGARD, OR 97223
Phone: 503 - 260 - 3874 Phone:
Reg #:
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/17/200' $66.85
[TAX] 8% State Surcharge 11/17/200 $5.35 Elect'l Service
Elect'I Final
Total $72.20
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.
Issued By: rr_ Permit Signature: ,-e— 01)
V
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
•
FRDM : FAX NO. :5035218427 Nov. 16 2004 05:49PM P1
Electrical Permit Miniication 1.•()R mil( Ft iy. ONL1
City of Tigard i ECEiVEL)A R CCoIVd/J/(/w ' C- renith Nu. 6 VA) 719
13125 SW Hall Blvd.., Tigard, OR 97223 Phut .Revicw
Phone: 503.639,4171 Fax: 503.598.1960 Etate/By: MherPumrit
Impaction Line: 503.639A175 NOV nor Rer)dy/Byt - .....
• Juds: Lid tie* Pagr2 Ihr '—
Internet www.citinard.or.us 1 6 200 - 0 ., 41 .
Notificd/Isncthod: Supplemental inrermetioe ...........
nt na T IGN,R,D
' ' ----
Vf.4 f k .9 1 ql 0 NI . P1AN REVIEW
,. ..- ..... ..._
El New construction 0 AVa eillithilieFiti mem eat Please check ail that apply:
El Service over 225 amps, conun'l I:Hazardous location
0 Dcmolititni EdOther: 6 P EA.. -----•---- Cl Service over 320 amps . rifting ID Bulking over 10,000 ati. 11.,
--,...
CATEGORY OF CONSTRUCTION of 1 - and 241traily dwelling; 4 or more new reside-1MM
„ .. .. ......._.......
0 1 - and 2-thitilly dwelling 0 Commercial/industrial 111 Accessory building 05y51.etn over 600 volts nominal units in one structure
Building over three atoriai [(Feeders, 400 amps or more
0 Multi-Family . 0 Mester buildui ge)ther: Cialkit)( [' 0 D Occupant load over 99 persons 171Manufacturcd structures or
. ., . ,.
- .
IOU SITE INFORMATION AND LOCATION 0 Egress/lighting plan RV park
_ _.... . .
,.„,..,...
allealth-care facility ['Other:
Job no.: - JOb site address: IL/ 17 stj SA-Rkout-S ROIlt
.__...._. ... . Niihrnit a sets of plans with any of the above.
City/State/ZIP: - rt. &rxte_O OP, el 7 Q 3 The above arc not applicable to temporary contraction service.
„........
—. „ ..
. -
FEE'' SCHEDULE
Suite/h1dg./apt. no #. 5 I Project name; .
_ _.... .. D t v e r I n f l o n 1 Q 1
(74031s atrectidirtA.--tions to joh site: New regelentlid single-. or mulft-family (ymning unit.
- Includes attached garage,
Scliolis Pozrzy 1 ISARRoc,JS Loop sq_ fl_ or less 145.15 4
Subdivision: ccfqo 113 V; I In&E I Lot no.: . En. addl 500 aq. ft, or portion 33A0 I
• Limited energy, residential 75.00 2
1 map/parcel no.:
. 1.imited energy, non-residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
. dutelline,„ gervio . and/or feeder 90.00 2
(t I. P LA) t.74._
----,. . .--„... . .,-..„....... „ -.—. . .-. Services or feeders Installittlon, alteration, and/or relocation
200 amps or less — 80.30 2
Mr OWNER 1 . . ...
0 TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.00 2
Name: ,n ki - Filo , , PA s'T..-6A
601 amps to 1.000 amps 240.60 2
"'"--
Address: ILI I 7 co 8A tz p ob.) C rao /No tt C Over 1,000 amps or volts 454.65 2
- • r .. .. -^ , Reconnapt only ( 66.95 4 C . 9 5 2
City/State/ZIP: TI G/112. 6 0 ( " 4 -- 97a. 5 .
TeMpormy services or feeders I ishillation, alteration, and/or
I- „...
relocation
Phone: ( So 3 ) 2 t 0 - 38 7/
[ax:( 56 3 ) 5,241 - 0 5 ( i" -- /
200 amps or le 66.115 1
Owner inciillintion: This installation is being made on property that T own which not
201 amps to 400;nys 10030 1 2
mtended for sale, lease, rent, or . change, a • . rding to ORS 447, 449, 670, and 701.
s • - 401 amps to 600 umps 133.75 2
Owner Signature: j f . / ...C.-,2:*-gir..— -.. Date: _Z/ -14 - eV n.inckdrcuils - new, alteration, ur si
eatennn, per panel
. . ,....._. ...,.._ ..._
„ .....
1:1 APPLICANT . ID CONTACT PERSON A. Fee for branch circuits with
-."'” service or feeder lire. each
6.65
Business mune: Same a., 5 lo ra pe-* 0 w v branch circuit 2
,.... .
, ...- . . ) „. . _
B. Foe tor branch circuits
Contact name:
without service or feeder fec,
... „ ..
46.85 2
each branch eimuit
Address:
_.... __.__. . . ______ tid'I brunch circuit 6.65 2
....- ,...,-..
City/State/ZIP: MisicelialleOnS (service or feeder not Included)
• . ....
Fump or imgation circle 53,40 2
PhOile: ( ) [ . : ( )
- „ .. . .. Sign or outline lighting 5140 2
E-mail:
signal circuit(s) or limited-
, .._
CONTRACTOR energy panel, aberration, or
.... ,
extension. Describe: Page 2 2
Busineasi nnnee.7
_ .„ . .....„ . - ....... ,. _. _ _
• • " . .._
Address: Each additional inspection over alkwable in any of the above
- • • . .. . .— Per inspection 62.50
City/State/DJ':
-- investigation per hour (I hr min) 62.50
.... ,.. ..
Phone: ( ) j Fax ( ) Industrial plant per hour
.. . . 73.75
, ,...
.,- •••• . .- —.. ELEC"TRITAL PERMIT iF,ES•
Ce13 Lic.: Electrical Lie.: Suprv. Lic.: , .
Subtotal 6 6, g 5
----""-- .. .
Suprv. Electrician signature, nequired: Pim ruview (25% of permit f,_,)
._.....,
......
' '' — .... ....
Print name Date: _ ,.....,
State surcharge (8% of permit fee) 6 .3S
:
_........ , ,._ , • .... .. TOTAL PERMIT FEE
Authori.,,,cd s
This permit appiteatien expire% if o permit Is not obtained within SRO
-'' I .. • • • "' .-
days after it has been accept ed at complan
Print name, Date; * Foe methodology act by 'Fri Building Industry Service Dowd
-„, __ . . . . ** Numbor of imueetiun's nor Damn allowed,
"TIM OF TIGARD 24 -Hour
BUILDING In,Spectjon Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested / / `/ g AM PM BUP
�/
Location / _l (7 U Suite ,S MEC
Contact Person Ph ( ) -(' o - 3 8 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC � O 0 Li- CO 7310
Footing
ELC
Foundation
Access:
Cr l Dr ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors �,, Q Q
Ext Sheath/Shear (; 'C
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P ASS 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
*ART FAIL
.._ RICA
ervice
Roue - ArIL
UG /Slab
Low Voltag
"re Alarm
\\ ZtE s PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ;_ El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date ` i . Inspect ./.0 /J Ext
Other:
Final DO NOT REMOVE this inspection record fro the j ' ' site.
PASS PART FAIL