Permit ELECTRICAL PERMIT
�. CITY O F T I�4,R D PERMIT #: ELC2004 -00391
All ik DEVELOPMENT SERVICES DATE ISSUED: 6/28/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112CC -16600
SITE ADDRESS: 15870 SW AVON PL
SUBDIVISION: DURHAM OAKS ZONING: R-12
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: 1 branch circuit for a/c unit.
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:
BUENA VISTA HOMES ROSS ELECTRIC INC
6932 SW MACADAM #C 2870 SW 221ST AVE #203
PORTLAND, OR 97219 HILLSBORO, OR 97123
Phone: 503 - 443 -6033 Phone: 503 - 642 -2800
Reg #: LIC 157891
ELE 34 -436C
FEES SUP 4232S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/28/2004 $46.85
[TAX] 8% State Surcharge 6/28/2004 $3.75 Rough -
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -66 r -8 I- 2 -23, ,.
Issu d By: ;� ji �� i Permit Signature: X 3 4.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
-- _ vv�iVV1V HUSS ELECTRIC INC PAGE 01
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Ele tr$� 1 P
�rt �a��tg�ll� � ��' �� -_ � �i ��� t�fr -�rcZ� i s:��nNtN_,A —zf� =z
ReeCived ♦ Electrical
Ditch . Permit No.: C.- „err —rI y
Cit of Tigar Planning A ... . : sip,
13125 SW Hall Blvd. Plan ' Permit No.:
Tigard, Oregon 97223 i Plan Review other
Oaten : Permit N..:
Phone: 503 - 639 -4171 Fax: 503 - 554 -1960 Post- Review Land use
Internet tvww.ci.tigard ot.us ! N i i - Dat .. :: Case No.:
24-hour Tnspectt equest: 503 - 63944175 e ` , " Sec Page 2 for
So lemma! Information.
f
I cans +'�.� a"ti: , u,: �. ,
New �CGS�L �� �i.�Z..�i ri+ . C J.. L tl.��.�, _I 11i .( -�'�: � _Y`,n��h1 >�ln' •.
Demolition „ 1 Service over 225 a eal ^� a cit 1 1 �:_ �i:. +.: ;�:. .
lit :
------ �' r Health.carC facility
AdditioTLlalCt~I 3tlOn/r r lgp , Other:
commercial 0 Hazardous location
: =:: J ""'- _ 0 Service over 320 amps-rating ❑ Build' over 1 square
i. �p ,t':- ?a e 3 t'1+ r:t • '77: 'n, y rt.; g174:' s;. ; ■ ..t: :!'' l Cat 2 farm dwell pf r 0.0 tare feet.
1 . ; - cirri • we family cgs Four or Mere residential units in
I.. e " =>• C ° et 0 Sys over 600 volts nominal one structure
p Access B • u e D Building over three
— - -- ti Farm1 8 stores 0 Feeders, 400 or more
imi Mager j Builder Is fir. El Occupant load over 99 persons 0 Manufactured structures or Rv park
:,4 Egress/ftghting plan
. u+tt o) n"a --" , 0:1-"' a 4 �v a, s Vie , w, ❑Other:
"W . �1 ; ;�,. • , ' •, w. S ubmit sets of plane with any of the above.
Jab site address. - • "n i R The above are not a
Suit H1 / 4 A ,! .f. , 1` ( -.. 3��� :H �,,,.,r•+ �Iicableto ism ra construction service.
VtitW #: Did_Jrii .tf. ' ;�VIi∎i i- 10"1 - •-Ziff '4 7 y.Sa M r1 A -
x
_P ect Name: N ✓ a w, �! Number of Inspections per permit allowed , ) Description Qty T Fee {ea,, j Tatet d
j
Cross street/Directions eetlUtrech `u ans to job site: r New rwtdentia{.staele or muttl- ismIty per 1 •
� ` .v a' , J dwetting unit. Includes attached garage
I Service Waded:
1000 sq. ft. or less
145.15 4
Each additional 33.40 500 ft. or portion thereof
33
subdivision: _ i Limited 75 00 . I
2
Lot #: mew, resid ential
Tax InaE %paroel #: l — Limited ems, non residential 75.00 2
:.., • - -, _ _. , Each manufactured toms or modular dwelling service miler feerier i - '° Services or feeder 90.90 2
Servi
s • 1d9taflaHon,
alteration or refutation!
or less 8030 2
, 20t antgs to arias
ej 40l
ILf a m 1 64 .6 0
b urm1 l �se�t °$ , '' a;i 6 to x000 aria ?qp ap 3
'Taome: Over tore ar voitx 454b5 Z
Address: �� t west only 66. 2
(^� �+�..,¢� /+� 1 Temporary services or feeders - installation, .
�.+a3 .` �i�:! bl: -• - alteration. or retocotlon:
200 o, leer 66.85 t
Phone: ax 2 01 to
F . amps 400
q_ ' ;lg I h . r : .. y : �� to amps ,t8t.75 2
'' - . . it` , g ��5.,_te. ^ +' , , 4pl to
Name: t . �.�� Bra 133.75 2
eitseuita -new, altcratSon, or
per panel:
AddreSS: "' — A. Fee for branch circuits with purchase of
C uUia t3tP,�ZD p i service or feeder fee, tach)rwtch circuit 6.65 2
J i H- Fee far trench circuits without purchase of
1 ..1e: F : ax i
" -- �mke or feeder fi first blench circuit
4635 -mail: Each additional branch circuit 6.65 P,1 A( � , Misc.(Smice or tireder not included):
� "�'� ...... r = - 47,= .Y0� e` Each}"tmp+lt irrigation circle 53.40 2
Job No: Each slim or outline lighting 53.40
Signal circuit(s) or a limited -.
2
Business N energy
5.� . �1 alteration, or oxtat
Address: ¢ �.isrJ:. Descried= - -- Page 2 2
= 320 Sic) J t .Vic` t:" (?•
�ity�st3te/�lp: l Ft rfj — Each additional Inspection over
II `S 101.) e t2 ! 7L 3 P „We allowable In : of the abov Per Phone: y 3 G .(Z Z X 6)9 c`� 1 esialidlat hour mint .ur 62.50
CCB Lie #: �S X89 Lie #: ;
1 Fax: c3 V-1/34.e.. — °�° ,
supervising el�r,�o -- ! / /J,r.� �j7�/Y. r;;. i.' ,..„i9„..:;40,_,,,.,:„.. ' �2 .��• ,1e _. - ...
signature tilted . Z e t . !� iMwt. Subtotal � nak �3. r tk
Print Name: } e OC S OS SJ Li¢. # Plen Review (35 of Permit Fee) S --
i123 a S Slate Surcharge (8% % ofPennit Fee) S
Attth0ri2cd TOTAL PERMIT FEE $
Signature Notiee This permit application expires if a permit is nor obtained within
Date: - 180 days the It has been accepted as complete-
'Fee methodology set by Tri- County Building Industry Service Hoard.
•
(Please print name)
i:knsts1Perrnft From s\ElcPerrnitnpp,doe 01101
CITY OF TIGARD 24 -Hour _
BUILDING Inspection Lire, (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
‘° BUP
Received Date R equested �! �� AM PM BUP
Location 70 �fGc) Suite per,, MEC
Contact Person .r Ph' ( ) ZO ctc/ — PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC Y — 'd7)39 * /
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab • Inspection Notes: SIT
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 C
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
RT FAIL
LECT
Service
Rough -In j
UG /Slab �i
Low Voltage
;_=.alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA h
Approach/Sidewalk Date J Inspector . 1 1 \1 B Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL