Permit A., CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00629
4- 7.01' 0 ^ DEVELOPMENT SERVICES DATE ISSUED: 11/13/2000
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111CD
SITE ADDRESS: 15975 SW BRENTWOOD CT
SUBDIVISION: SUMMERFIELD NO.9 ZONING: R -7
BLOCK: LOT : 510 JURISDICTION: TIG
Project Description: Installation of one (1) branch circuit.
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:
PEGGY ZEITZINGER SHARPE ELECTRIC INC
15975 SW BRENTWOOD CT 22605 SW RIGGS
• TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: 503-624-1925' Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT CTR 11/13/200C $46.85 2720000000( Elect'l Final
5PCT CTR 11/13/200C $3.75 2720000000(
Total $50.60
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 Nofrfication 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 ✓) 6 ,t - 711--- 4 x4, -- ,..w o ; 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
c Electrical Permit Application , OFFICE USE. ONLY
5
,� — r /3 i Permit no.: L-2C Zoea —O & ! 9
-� - City of Tigard
t� Pru no.: Expire date: •
Address: 13125 SW Hall Blvd, Tigard, OR 97223".
°REG Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case tile no : Payment type:
Land use approval: •
- TYPE OF..tP RMIT' .
Atl 3: 2 family dwelling or accessory L Commercial /industrial 9 Multi- family 9 Tenant improvement
0 New construction Addition /alteration /replacement U Other: 9 Partial
- JOB SITE INFORMATION,.. ; .
Job address: /57 7 S Set) 3te i lac CT City: .7 .1 Bldg. no.: I Suite no.: 'Tax map /tax lot/account no.:
Lot: J Block: N/A I Subdivision:
Project name: Description and location of work on premises: e4 4 - 1 4 .
Estimated date of completion /inspection: / ///
CONTRACTOR APPL[CA'ION • FEE SCill DULE - .
Job no:
/ �'� Fee Max
name: S f� rP Description Qty. (ea.) Total no. insp
Address: � .(� C J S(_i) R/64,5
New residential - single or
ttach family per
dwelling unit. Includes attached garage -
City: 4:Q.4..{,/,.t. 4.4 State: 0,0 ZIP: q J00 -7 Service included:
SC
3) Phone: &,;46). 1 Fax:e e _ y73--71 E - mail: (000 sq. ft. or less 110.0E 4
CCB no.: ' / 5/ s,. E lec Each additional 500 sq. ft. or portion thereof 1 30.001 1
Elec. bus. lip. no: a/
Limited energy, 1 ez 2 Family I j 30.001 I 2
City: metro lie. no.: Ni.A /0/0 //0
Limned energy, Multi- Family 1 1 15.00
: Lz . / // 310 0 Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Ser: ice and/or feeder 75.001 2
Su elcct.name (print): i Services or feeders - installation.
Sup. (P L oil /4.,e /itr- 1 License no: 3 3c.1 y _5 i
alteration or relocation:
. . . PROPERTY ' UNt,it{ER : ; - -. • x 00 amps or less 55.001 •
Name (print): I �99`! 5e / '��/ ��� 201 amps to 400 amps 35.001 1 _
/ / ,
401 am s to 000 amps
Mailing address: j$ .975 SW �ewet,uood Cr p I 1 I _
601 amps to 1000 amps � 1195.OL'I 2
I City: T yo I State:0 e I ZIP: �--a -3
y 7 Over 1000 amps or volt; 1365.001 '
6 03 Phone: t4I-1 Q 9.5 I Fax: I E-mail: Reconnectonly I 55.001 1 I
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
installation, alteration. or relocation:
200 amps or less - 5.00 2
ORS 447.155, 1 479, 670. 701.
201 amps tp 100 amps I ; 30.001
O
-
wners signature: Date: I S01 :0 500 amps 110.op I
1NCrIN EI :R Branch circuits -new, alteration,
or extension per panel: I 1
Name: l I
:\ roe • for oranch circuits with purchase of I
Address: i service or feeder t__, each branch circuit 5.001 1
' '...:I I State: I ZIP: 1 2,. Fee for branch circuits without purchase I i
ne: I - mail: of ser: ice or feeder fee. first branch circuit: 10.001 I 2
Fax: E
Each _d:.ii oral branch circuit 6.0d I
' PLAN-.• REVIEW (P(�as :- c heck: all- that apply) - Misc. (Service or feeder not included):
:grace over =_.: amps - commercial Health -care faciliy I Eace :;time or irrigation circle I _5 001 1 2
j 5 001 2
per :ice over dr ; ") amps-rating of 1&:: :, _ f iR71rCOn5 location n or outline lighting
''t":` .:..,,.tins _ 3uilding over 10,000 square feet :our cr '3i; "a! _Irculu ;) or a limited energy panel. i
. _. _r.) kr`i's nominal more residential units is one •.truc:u:e ..eiA. nr :erarcn. or e.sranslon j , 2 -5.001 -
....:.aree stores . F =00 amps or more ,,,
.__._. ,,;au ever °o _ >.lanutacrured stn.:creres or RV par:: Eacn adaitional inspection over the allowable in any of the above:
_. , _ ..., _ Jther: ec: o:: 5.0Oi
:!)nm:: _ ; •:t ohms with lil lithe above.
...c .:, , ve ire .u)r lnntit: ::big :u [emnordr.' constriction sets. ice. u p
- -- - -- Permit tee 5 /� , es
x: ;Les Plan re at _5 °-% ,
- - -- t .,. 3, vc trtt ate • lerchar,
— — — ,ta.s .',•e--: -. t is u n .5'0 • A 0
7J 3 0
/ ?. 90
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MSS
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested 1 Z � 4� AM PM BLD
Location f J ) sw Dioatezet - `/ 4 Suite MEC "
•
Contact Person // /3 Y-Pn1 uJUVcJ Ph ' 2G i� (/ 3 PLM
Contractor 7 S 1 h v—r - -_ Ph SWR
•
BUILDING Tenant/Owner ELC ei) –&a (i Z
Retaining Wall ELR
Footing Access:
Foundation u 2 / (, `moo FPS
Ftg Drain VI"4 -�'v� _ ` SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ��/
Susp'd Ceiling 7 /(J / ` 1t'
Roof
Misc:
Final
PASS PART FAIL _
PLUMBING
Post & Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS RT FAIL
.MEC
Post Beam
Rough In
Gas Line
Smoke Dampers
Final
, f PART FAIL
5ervice
•
Rough In
UG /Slab
Low Voltage
Fire Alarm
• i ASS / 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 (!J D / - // ! Inspector _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.