Permit .CITY OF TIGARD- ELECTRICAL PERMIT
PERMIT #: ELC2004 -00790
1 ' DEVELOPMENT SERVICES DATE ISSUED: 12/10/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102AA
SITE ADDRESS: 08915 SW COMMERCIAL ST 21
SUBDIVISION: CASCADE MOBILE VILLA ZONING. CBD
BLOCK: LOT : JURISDICTION: TIG
Project Description: Reconnect.
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:
DAVIDSON, WILLIAM G AND DIXIE L PARKIN ELECTRIC INC
8915 SW COMMERCIAL 14001 FIR STREET
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503- 349 -4826 Phone: 503 - 657 -4959
Reg #: SUP 4241S
LIC 35151
FEES ELE 34 -4C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/10/200' $66.85
[TAX] 8% State Surcharge 12/10/200' $5.35 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: 6 dr- -CL, / Permit Signature: (0A
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
12/10/2004 00:17 FAX 5036574958 PARKIN ELECTRIC 0 001
qllectrical Permit Appl' - "r � FOR OFFICE USE ONLY
'`r"ity of'Tigar p / Permit No.' y 0 I '
13125 SW Flail Blvd., T i g a r d , OR 97223 �, ` _'
Phone: 503.639,4171 Fax: 503.598,1960 DEC 10 200k ., . f % ail , \ Dat ° other Permit:
1 .
Inspection Line: 503.639.4175 Date Ready/Hy: Bin H Sec Pagc 2 for
Internet: www.ci.tigard.or.us CITY OFTIGARD Notified/Method: Supplemental Information
1 ", ' ` - . '7fT . 72;;7 ' 1 �F%": ^" m. - .1Ci;. 7: !:•, - ^•r_ '°d - •. y.- „i r. ':!;:7'''''''''''
•'1. r. f r : i` t4.cr4 }.. Kt,J Ri i � I. ",tt ti f1 t� �L ' "'.r:..:a• e
1 ' ,i 'n :1 J �, 2V.:Aw� w:, i4 ; t �r 93..,}�y� } ry'r . : ;, ;1 d , n a '��,i!_ar. �,�p� t�S t�� : C..LI i 4"497;;54171.2'. ' �C 1:4='",-.2` : �� ,�.J.. 7 - �'W-,a ' SS r6!..1.::Y:�. 1,. - -- ci;rva+x_ a.� n :,t- . v - r,Y r. , �ltitw - ''',AA''''' - . �_
❑ New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition. ❑Other 0 5ervice over 225 amps, Comm'l Hazardous location
'.,:1? ,x.t c _ 4 ;r�r = twr;:: ,- ,_ r� ; a a , T ❑Service over 320 amps -rating ❑ Buildng over 10,000 sq, ft„
n1r�R,..±...•%:,...d1,::::..' i,,T E f g i' n e'7, li ife5 ' .i' rfZ' it4 rfcf � f;'-J ,nffk t - ; E }; 9 of I - and 2- family dwellings 4 or more new residential
!1 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Multi-family OBuilding over three stories ❑FCCders, 400 amps or more
y ❑ Mast builder ❑ red structures or
V ..� . iFr - '� „r _ _ persons s c
er er Other: ❑Manufactu
. j -r ':'Saw w u. . "?3F;' -•,:17.'.' z:,: ;$ :,•rfl� 7- ;,,.t..; :rrn;; ❑Occupantloadover99 e
(� r,r.. - af A .7r -., t 1- , i`f,U ••s4. q • ;t, ;. �yM•r .t 'd^tl✓i!tfiI t 4 ;in a'•:i ril`. '!':.� ,• :; I rw ,•,.., RV. park
�.,�k c:r?'�l! . ta.: �Z: 16'' t:.: '. ?�T: %!�j-"•� ',fi':.r_'J:i�i:..: % ��al.'�. , r' .:gt.�,: - r.�..' � s _ ❑ E g �'es s/lighti ng p l an p
Job no.: 1 ebO Job site address: eq (S 4 tif�
(oftei (Gt J Olit alth care facility the above.
/� Submit 2 sets of plans with any of the above.
City/State/ZIP: f/l , 00 - The above are not applicable to temporary construction service •
Suite/bldg. /apt, no.. I Project name: .' :i L "i .�:':r _. y j _ _ _ e b • ".
Description Qty. Fee. Tool
Cross street/directions to job site: 'L, I 0 4 'c W T
- G 5 -1 New residential single - or multi- family dwelling unit.
Includes attached garage_ •
a *O 11.■ I1 /„r
■ i 1,000 sq. R or less 145.15 4
Subdivision: Lot no,: 0 Ea. add'l 500 sq. ft. or portion 33.40 t .
- Tax map/parcel no.: Limited energy, residential 75.00 2 •
, : v- ��ti, i.c t�zr.. -,� �.,i::. ,,.�� y er =�. % � .: r . a N q t . .a» : �_rr: �;r. non 75.00 2
_ _! Li energy, non r 'dential
;�.�T.fao,•:,.F - "� 2 5g. ";' a
:`..,P1 -• . 4 :i fi ,.:� `I T , J} I:, :' ., :7 : ; 1r. _a tl >.ry,.;.r)T12 :.g ti ..l f. _
•rir'hd -:n, 1 . 4, . .,. r � si.:..: ,.r •..:'U,.,_ !_S'L�.,'i .,1.....� 1 ? . _ . .._`1„ : ::`:Z ..::tip? f,'� . ;_ 24,,d. a':: :* Ea manufacGned or mo
nn , re: + dwelling, service and /or feeder 90.90 2
'rl
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 1 2
^':T"i' -r'tV. : - �. 17-f':,,.��,,��
r -� , , >} , :i:, �,l t ',7 C C r i. ; - :gyp" :�-t; rfiyy ;a li 1g,a;r 201 amps to 400 am -
ps 106.85 Z
"C i ,r , a� it {r* �: ,� t • .. '! 7., i7t
�` 2 c� l 'T �`.. W'F 3
' � :_.�: °' . t. _ _, 1:� t., �=t ry Y ? t1A,:,.7. ��i � �.d.. .* -`� 401 amps to 600 amps I60.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
- Reconnect only 66.65 (�(p 2
City/State/ZIP: Zk Temporary services or feeders installation, alteration, and/or
Phone: (5 0. 11 ,. L c((, I Fax: ( ) relocation •
200 amps or less 66,85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 .
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
�Y;er:r": ;�, ° t? ,i , , . s�� ` `''ISi:.,., 'lx:• i " , :�a:5 ±''• ;�•s A.Fce for branch circuits with
tit. .. 1i...1. ,.,. r . 1,1f_i73:,it 6i : end . :lc!. ,tad ..,72 : • ` �9�": - - rli l ., ?.' ,', �•
��'�.11�L_: S:. .L:f,�i.�;=.��r,,...'_'..LL:.1r °a.c:1,. _ .._...,.'.. °. :;� " ..... .7 �.�._, i ,
CL., !r r, ".
service or feeder fee, each 6.65 2
Business name: branch circuit
S. Fee for branch circuits
Contact name: without service or feeder fee, 46.65 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or (ceder not Included)
Phone: ( ) I Fix: ; ( ) Pump or irrigation circle 53.40 I 2
1 Sign or outline lighting 53.40 l 2
E -mail: _ Signal circuit(s) or limited-
. ar. .s •l;" '..;;
m ,c;Wti °ttr'- /i-It:.i ,: 'a l(' : ..: x .� t
. •i - r ,t . :r!7a;?7n1- i
rl; 't ., energy panel, alteration, or
s t'ar E Inc. 1 1 rtr jtrect extension. Describe: Page 2 2
Oregon City, OR 97045' 503 - 4958 fax: 557 - 1059 •
Contractors License #: 34 exp. 07 - - Each additional inspection over allowable in any of the above
Supervisor: 4241 -S exp. 07 -01 -06 Per inspection 62.50
Contractors Board Reg #: 35151 exp. 10 -12 -08 Investigation per hour (t hr rain) 62.50
Metro # 2416 exp 11-01-05 Industrial plant per hour 73.75
;r ter : 1•_.:,,., ...,
Owner: ^ : :.57. :- E .F ', A (�,(t. 7. ui� n,�, l �i r;t_'_ .n ^ . :
Subtotal l9 (,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: / Date: State surcharge (8% of permit fee) --. 5
r /. TOTAL. PERMIT FEE 72 , 10 Authorized signature; /� . This permit a pplication expires if a permit Is not 0 within 180
'-•• y /� days after it lies been accepted as complete
Print name: p// f/a) 0../94K4eix./ "Date: • Fee methodology set by Tri.County Building Industry Service Board
' - . ° Number of inspections per permit allowed.
is 1Building \Persnits\ELC- PmaitApp.doc 12/03 440..16151(10/02/CCM ED
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / - 2 3 AM PM BUP
Location Sul t MEC
Contact Person Ph ( ) 6 5 7- g5.ce PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ ELC ° `Z O p 4-- 616)'261
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING_ r
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
ELECTRICAL
,Acri
Rough -In O�
UG /Slab \}
Low Voltage
Fire Alarm
PAS PART FAIL [11 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW.Hatl Blvd.
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line •
ADA D ate /Z 029 / Inspector ✓ t•L Ext
Approach /Sidewalk ` � P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL