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Permit !ice CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00329 ��� DEVELOPMENT SERVICES DATE ISSUED: 6/6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133DD SITE ADDRESS: 12739 SW DANBUSH CT SUBDIVISION: VILLAGE AT SUMMERLAKE ZONING. BLOCK: LOT : 113 JURISDICTION: TIG Project Description: Installation of (2) branch circuits for a/c unit. Job No: 03 - 403 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: 1 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: ALBAUGH, JAMES B + BOB'S ACTION ELECTRIC INC MUNRO, JUDITH E 2700 NE BURTON ROAD 12739 SW DANBUSH CT STE A TIGARD, OR 97223 VANCOUVER, WA 98662 Phone: Phone: 360- 254 -7200 Reg #: SUP 4322S LIC 53136 FEES ELE 37 -431C Description Date Amount Required Inspections [TAX] 8% State Tax 6/6/03 $4.28 [ELPRMT] ELC Permit 6/6/03 $53.50 Rough -in Elect'I Final Total $57.78 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 t . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth i AR 952 - 001 -01 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -80 - 332 -2344. / r Iss ed By: 1 � t \ 1 Permit Signature: Qfe__ OWNER INSTALLATION ONLY The installation is being made o property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: X0-0. 4tIp DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day f%;6/27/01 WED 14:44 FAX 503 598 1960 CITY OF TIGAItt) f�J(I /_ - • Electrical P e r �< ,� k oiii t � Dare received :�A 0 Permit nu. : Zze , i9eb;3- e A City of Tigard f ( g 9 Project /appl. no.: Expire date: Cir3r nj7'i,�cud Address: 13125 SW Hail Blvd,'1'ivarit. o' 9'72 Dale issued: By Receipt Phone: (503) 639-4171 CITY OF Fax: (503) 598 -1960 BUILDIN p VI Case file no.: Payment type: Land use approval: TYPE OF PERMIT - Gg I & 2 family dwelling or accessory ❑ Comma rcial /industrial 0 Multi- family ❑ Tenant improvement ❑ New construction ❑ Additica/alterauion /replacement ❑ Other: 0 Partial JO111 SITE INFORMATION - Job address: 12739 SW Danbush Ct. Bldg. no.: Suite no.: Tax map /tax IoUaccount no.: Lot: Block: Subdivision: Project name: Description and location of work on premises; 2 circuits for A/C Estimated date of completion/inspection: CONTRACTOR APPLICATIO .`-"'''",,. - FEE SCIIEUULE . Job no: 03 -403 fee m:i Business name: Bob's Action Electric Description Qty. (ea.) Total no. Insp , Address: 2700 NE Burton Rd. " Newvresidential - singleormulti- family per dwelling milt. Includes attached garage. • City: Vancouver State: WA 2W: 98662 Seniccincluded: Phone360- 254 -7200 Fax: 254 -82191 E -mail: 1000 sq. ft, or less 4 - - 5 3136 Elec. bus. tic. no: 3 ] -4 Z 1 C Each additional 500 sq ft or portion thereof CCB no.: : . Limited energy, residential 2 City /metro lc. no 00003861 Limited energy, noir- residential 2 6/5/03 Each manufactured home or modular dwelling Signature of supervising electrician (required) Dare Service and /or feeder 2 Sup. elect. name (print): Kevin Broselle Li :ease. no: 4322S Services or feeders—Installation, 20 amps or less ' PROPERTY OWNER • 200 amps or less 2 Name (print): - Judith Albaugh -- • 201 amps to 400 amps- 2 401 amps to 600 amps 2 Mailing address: ,12739 SW Danbush Ct. 601 amps to 1000 amps City: Tigard State: OR :;IP: 97223 over tom amps orvolts 2 • Phone: .524 - 804.7 'Fax: Entail: , . a Reconnect only . • I Owner installation: The installation is being made on property I own Tcmporeryservlcesorfeeders - which is not intended for sale, lease, rent, or exchaunre according to instnllnuon ,alteration, urrelocation: ORS 447 455, 479, 670, 701. -. 200 amps or less ? 201 amps to 400 amps _ Owner's signature: Dale: 401 ro 600 amps 2 • ., • • ENGINEER 11111.11111.1 Brunch circuits - new, alteration, - ' or extension per panel: . Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ..lP: 13. Fee for brunch circuits without purchase of service or feeder fee, first branch circuit: 1 46. b 5 2 Phone: Fax: E-mail Each additional branch circuit: 1 6.E5 PLAN REVIEW (Please -cheek all lb 1 apply) Misc. (Service or feeder not lncluded): O Service over 225 Tulips- commercial 0 Health-care facility Each pump or irrigulion circle 2 0 Service over 320 amps - rating of 18;2 ❑ Hazardous locati' +n Each sign or outline.lightiug _ 2 familydweilings ❑ Building over 10000 square feet fouror Signal circuit(s )oralimired energy panel, • 0 System over 600 volts nominal more residential lairs in one siruclure atltem;dion, or extension* 2 O Building over du e.e stories . . 0 Feeders. 400 amps ormore ''Description: . CI Occupant load over 99 persons 0 Manufactured sir uctures or kV pink Each additional inspection over the allonrnble In any of the above: O Egress /lightingplann 0 Other: Pet inspection Submit sets of plans with any of tin: above. Investigation fee ' The above are not applicable to temporary construction service. . Other • • ' Not all jurisdictions accept credit cards, please call jurisdiction for more is brrnatiou. Notice: this permit application Permit lac $ 46.85 ❑ Visa 0 MasterCard expires if a permit is not obtained' Plan review (at _ %) s Credit card number: . __L I within 180 days after it has been State surcharge (8%) .....$ 4 _ Ca tires TOTAL $ 57.78 accepted as complete, _ Name of cardholder as shown on credit clod $ _ Cardholder signaller An oust .140.015 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (5M) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested < 3 - t( AM ✓ PM BUP Location / ^ 7.39 40-a-n .L4- L Suite MEC Contact Person l Ph (_sue) as'{ 7a h PLM Contractor Ph ( ) S BUILDING Tenant/Owner C ( 7 L,i Y�►vv - I a v '` 0 J3 ELC 3 - D 3° Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain - -- Slab Inspection Notes: /� -'�— - _,Lisk SIT Post & Beam • Shear Anchors `y 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 Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL t) ),, Post & Beam r \�Rough -In G Gas Line 1 \ \ J _ Smoke Dampers �1�� l ~� 1C \ l9� Final PASS PART FAIL ELECTRICAL Service Rough -In V '' es UG /Slab Low Voltage Fire Alarm ap PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI El Please call fo rein section RE: ❑ Unable to inspect — no access Fire Supply Line ADA © Ext Approach /Sidewalk Date Inspe or Other: Final DO NOT REMOVE this inspection record from Job site. PASS PART FAIL