Permit �,`TY OF TI GAR® ELECTRICAL PERMIT
PERMIT #: ELC2002 -00470
.,, ,,,,,. DEVELOPMENT SERVICE DATE ISSUED: 9/13/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112BD 00100
SITE ADDRESS: 07560 SW BONITA RD 032
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT : 065 JURISDICTION: TIG
Project Description: Fire restoration: Install 5 branch circuits.
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: 1
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: 4 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:
BOROS, STEFAN A + FIVIA KELSO ELECTRIC INC
PO BOX 1890 545 SE 3RD
GRESHAM, OR 97030 HILLSBORO, OR 97123
Phone: Phone: 503- 648 -6360
Reg #: LIC 116254
SUP 4270s
ELE 34 -433c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 9/13/02 $73.45 2720020000( Elect I Final
5PCT CTR 9/13/02 $5.88 2720020000(
Total $79.33
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
Permit Signature: C � � { Issued By: 6etAIA--(&(,(_ J / liC� -(!VU
/q9
U
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: 644 - DATE:
LICENSE NO: 'ya- 76 5
Call 639 -4175 by 7:00pm for an inspection the next business day
FROM : KELSO ELECTRIC INC FAX NO. : 0000000000 Sep. 09 2002 02:00PM P7
. . ■ . . I $ i
i \I /
. • •
SEP o c■ 2042 .
ElectimitAapiktion ,,,,,.,...,r,.,„,„„„;,,,,,t,
• ' ' ' ' • j fri z ; I. 1:15iAll , FOR oFFICE,usr, ONLi.'! r:, :"
wetrical
Buitilpi A.— ., t-t-i-,iis ct _947D_ e en-mitric•.1.-6.-.40 5 — 41.0 0
City of Tigard g Aov
T est est Form PluminT4aral
Date/By, Sin
g
rerrnit No.: . ____.
13125 SW Hall Blvd. 1:10 Yew Rai - Other
Tigare, talegail 97223 Datett3vi PermitNo;
Phone: 503.639.4171 Fax 503-598.1960 • , .••,,, Poti.ltiniow Land Use -
Internet; www.ci.tigasci.or.us . i m - ,. j tii• Detear
_FAN '.f..E.. =4,•.1./-4 swiz • 0 s., Puee 2 for
24-hour Inspection Request: 503-639-4175 - _ Nw.-rielMet.hod: , Supoierneitol In turm a tio D.
i;: :.:':` WORK :i -:r•-.., ;:i' ', ' :&!'i ' :-.:1', 111111MBERIMEgMMEritillall
0 New construction El Demolition a $creicc over •225 nolo- 11.11 Health-cm ficillty
ceroremial
• litisrdeus loatiOr,
rrl Additon/alteration/re.lacement F. i Crter 0 service ova 320 gu of 0 Building over 10,000 scout fet,
: • l;:: ;-!:''' R'ii',: .'CONSTRITOT.I9M;;,-,4::"4.;:r.41•;.;:•.:1 1 ,k, 2 Nerdy dWellings four or mre residal ur.i in
1 & 2-Fami1 dwellint ' - Commercial/Industrial C3 system veer GOO volts noiWnal ono arraoture
0 Accessory Buildin • lei Multi-Famil Dui 1ituilding over three statics
DI Occupant load over 99 persons ..M F M oodera. 4.0e amp or more
ID attUtUotUred Ctructures c3r RV pu7k
0 Master Builder M Other: 0 Egrelilligildni DI-on 0 Other
s'.. ' : :::.1013 SITEIST.OkkkTION.Ond 1.1DCATION' 2,1''';'...,..•.,:!:!.:, Submit Ids offline with any of tea above,
. The AbovO klill tiOt Applicable ;0 CitirpOriley construction i rvio•o.
I _rob sire , address: . , ap • . T, _ dr .";.':',' ''.','''' .':".' I. r .. rcItitr
-::::if'!''';:r!•!--:.-EzEt*r:seept.,; .t::Fr.f.]..i.'::!-...::....:.•..: .:41 .. : ,.
Suite #: re i Bid. ./Au: .. mb Or inspaettOiltper permit allowed
Project Na_rile: Dow/1.110n (NJ Ft* (...) TO
. New resletentiolainste or niuttr-l'arrifly par •
Cross stmet/Direetions to job site: .4v/rotas unit- InchWa■ mulch cd wigs. 1
Sovice 14.4:
1000 • ft or 1 145_15 4
500 • • ft Of ....,0 . •21 ./ : 1... . MIMMIllaggl NO
, - i.irnttett e • residenrial MN 71 EIMINFI
Subd• .
vision: 7 T. #:
INIMIEIM411: 2112Eli
Tax nut =net P. Each manufactured Wm or nodular dwelling I ;
90.90
•.. l 7. 7 . ,:'.' .'. • ..i ''''.' ,IDESCBTrZIOX:OF_WORt0 :::' ,.'2-: r* ! 4 s T r I ct. " . P or d16 ; filL'd/r_ insta2.601,4 1 2
W filfq-ZYrUCI_______ altoi-Aoo or ro1oontion: ! 2
ix en. or leis 300
201 arn • .... 400 ern ,,s ENE :06.15 2 I
401 Isms lc v &MI 0 MO 260,60 MOM 2
..1 - .,';' , ..-.•!,..: , *, , ,,:l' 6 ° 1 1 ° 9 ° "r."173 111=MCOMMIIIMMI 2
Over 1000 zxma volts Eil
. Name: Itc wee; • I IMAM
Address: Temporary set terriers - !natant:dna,
onaristion, or rtiOcaLloo;
CitY/State/Zip: 200 are •s oriels 66-85
I
Phone: I Fax: 201 seeps to 400 xr_ga III 10C1.30 2
. - . 401 os 600 srn 133,75 2 ,
•iPT,APP,ITC:itNT .. :,.•:•• • •iii:',.:F..:: : :ql•:.DICONTAG: 1-41 :ERV 31 ":'-;''''''H Brewt eteesita . now, alteratioa, or l
Name: le:tension per Natal:
—
A. Fee for branch circuiug with ptirOhlso of
Address! . 4rivite or feeder f etch branch oil' uit CO 2
-------
41
_ .
CiTY! _
StatCfZip:
._____
SIREMINFIMMIIIIMIL ol. 0 2
Plorie: Fax: Each redid:oat branch circuit LW
E-mail: Misc_(Service a feeder not included):
MI
:.".: :.:....-. ::•:5:: CONIRACTOLV :;%:.',.:.....'-'.': '‘. ,...,: :: •4 : • !..i.4 '''V ' ':. C ' r trrozIrmisnlimirSCI 5140 dill 2
53.40 wi
Job No: — sigma eispil* or a limited anew pastel,
— -
Plusiness Name: 1 - A 0 licari
* ,, i . o • • 4 • iens
. *11/0/eription; : 1 75.00 2
Address: 5.45 .., -t-r. _ _ • (
L
- :
Lath addltional Leaved:on over the alkiwible la any atilt abcvs■
Ci IStatelZi • : d 1 A tk: ' ■Ao. --•-,-------
-.., Pa ;. • • • - hour • rnia. i hour T : 60
1.6 I
.
I Phone: i/ 1 ' 0 A 1 t• Fax: 4.1 - .., . • i 1. . Ilion fcc: . .
l CCB Lio. #: I Ita9 Lic. #1 ,
; • •1:•:i;•• ..: •,• ... - -:. -;• ,-xseetricA:?ir-teitTi4get': 1C' -f r , , ' + -:• '. • :'
I Supervising electrician sitetaiMI , -I5
I signature required! , / .
' . . Plan Review mend Perttir Fee)
•
1- 1"rint Name: "-- 7 - 01I 1 -
,. , r:p Lie. *: st • ,
-_-- 1
, st S e SU of Permit Fecl_.; 5 5; 5 3
TOTAL PERMIT FEE l 5 7C-i,
Author:zed , ..- ( 5 ..... /q4 ci tieor ibis prit appi eris i l mmp
reatierrnIt is not obroloc mtbin
SionarL7e: MIL LI ... ., .._. Dale : 1 d a
*Fee rerthociolooy sot lay Tri-County Building /ad:tarry Service P.a and.
. Memo:gill; tanx)
•
000Toacene 72,4 t.T:tT 7007./97/R0
CITY OF TIGARD 24 -Hour
• - BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /t ) AM PM BUP -
Location 7 5 i S-/ 13G n / Suit 3 �" MEC
Contact Person / Ph ( ) 713°' 7Z-7- PLM
gets, e / '5 //r74 Ph ( ) SWR
BUILDING Tenant/Owner ELC '( 7 U
Footing
ELC
Foundation
Ftg Drain Access: ELR '
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors I
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm I r_
Susp'd Ceiling "
Roof
Other:
Final
PASS PART FAIL l
PLUMBING '/ Y
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
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
in El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line •
ADA Approach /Sidewalk Date DC �� Inspector � ��-c� /' Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL