Permit C ITY OF TIGARD , ELECTRICAL PERMIT
PERMIT #: ELC2004 -00145
,, i DEVELOPMENT SERVICES DATE ISSUED: 3/23/04
- �"" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 103RD -10200
SITE ADDRESS: 11533 SW ELTON CT
SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: Kilnenvirovent exhaust receptacles
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:
JIM O'REILLY GARNER ELECTRIC
11533 SW ELTON COURT 2920 SW 247TH AVE #A
HILLSBORO, OR 97123
Phone: 503 - 624 -9942 Phone: 503 - 648 -4552
• Reg #: LIC 121159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/23/04 $53.50.
[TAX] 8% State Surcharge 3/23/04 $4 Wall Cover
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 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: Permit Signature: Am �► ���,� /,_ ,_
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
05/07/2002 02:03 6427925 PAGE 01
r • .
Electrical Permit Application
Date received:-.,Ai Permit nolee.T2 0 • -06 /
V "4'1±: City of Tigard ttlt . R c ® Project/appl. no.. Expire date:
City of Tigard Address: 13125 SW Hall Bl a " - Date issued: By: Recei +t no.:
• Phone: (503) 639 -4171
Fax: (503) 598 -1960 MAR 2 3 2004 Case file no.; Payment type:
Land use approval: CITY 04- TICARD
•
. lYP1'. (ii P1(1tM1'1' .
1 tot 2 family dwelling or accessory O Commercial/industrial ❑ Multi family O Tenant improivement
O New construction ❑ Addition/alteration/replacement ❑ Other: O Partial
Job address: l l' 13 Sul ff axe C.4 Bldg. no.: Suite no.: Tax map /tax let/account no.:
• Lot: !Block: !ubdivision: ,
Project name: I Description and location of work on premises: vev - fr ek RNs
Estimated date of coon letion/ins coon: r
Job no: Fee : .Max
Business name: bite. NE. GF:re l C, Description - . Qty. (ea) ; Total no. Imp � a ,c1, 2 7 -- e_ NervngunitI Includes atachedPar garage. eper
Address:
� � dwelllnQunk .)(ncLrdesattachodgw�g
City. i � le t'/1 - 1 State/)' .t ZIP: q ` Jf " Sertloeincludedt
Phone ..- • ` $ 7 Fax ,- 71 .:- maiil: 1000 sq. ft. or less 1 4
CCB no.• f 2 ii 5 - Elec. bus. lic. no:3 -3
Each additional 500 ag. ft. or portion thereof
Limited energy, residential 2
at m- • o lic. no.: 4 . Limitedener, , non - residential 2
W 317,te Each manufactured home or modular dwelling
��y► Cr: Service and/or feeder 2
• S1 a ,.,ti+*`_ tri,,, r '. .,yttil , U l red Date
Services or orders - installation, ---T
Sup, elect. name (print): AIMMIgrAgral License no :3 7I -S alteration or relocation:
PROPERTY OWNER 200 amps or less • 2
Name rint : t 201 amps to 400 amps 2
(1? ) ) � l' I 401 amps to 600 amps '- 2
Mailing address: 1 601 amps to 1000 amps 2
City: State: ZIP: Over 1000 am s or volts , : ` 2
Phone: 4 I Fax: E -mail: Reconnect onl f I
Owner installation: The installation is being made on property I own �' Tempornrrservices or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocatton: •
200 am
ORS 447, 455, 479, 670, 701. 201 • a or less • 2
201 amps to 400 amps 2
Owner's si I nature: __ _ _ Date: 401 to 600 amps • ' 2
IiN(: Branch circuits - new, alteration, .
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: l ZIP: B. Fee for branch circuits without purchase p /
Phone: Fax: E - mail: of service or feeder fee, first branch circuit I t i iF P 7 2
Each additional branch circuit: to ac
PLAN REVIEW (Please c i ch all that ripply) MEse . (Service orfeedernotIncluded): I '
O Service over 225 amps - commercial ❑ Health-care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1 &2 Q Hazardous location Each sign or outline lighting 1 2
family dwellings CI Building over 10.000 square feet fout or Signal circuit(s) or a Limited energy panel,
O System over 600 volts nominal • more residential units in one structure alteration, or extension" 2
O Building over three stories ❑ Feeders, 400 amps or more •Description:
O Occupant load over 99 persons D Manufactured atrucmrrs or RV park Faca additional inspection over the allowable in any of the Above:
O Egress/lightingplan Cl other: perinspection 1 I ; I
Submit sets of plans with any of the above, investigation fee •
The above are not applicable to temporary construction service. Other �7 t 7 --
Not all Mile: actions =apt credit cards, please call jurisdiction for more infon t/tloe. Notice: This permit application Permit fee $ 5 . ' *'
O Visa 4 MasterCard expires if a permit is not obtained Plan review (at __•, %) $
Credit card number / / within 180 days after it has been State surcharge (8%) $ • d
aspires accepted as complete. TOTAL, $ • �j '7 D
Name of caniboldet as mown on credit card
$
Cardholder signature Amami 4404613 (6/00/COM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received �) � ‘ D ate Requested T�"� ?`-AM PM BUP
Location 1' 3 3 F /z1)2 C-7 Suite ,o MEC
Contact Person n�1n� Ph (5)3) 4P 'V�1 'VS 5 2. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner QUO ( ii -- vv/ V s
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 1 1J �Z 'A(ZAV i
Firewall
Fire Sprinkler
Fire Alarm ZO A . 1CQC , ,ApPC. \l‘b
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
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
arm
CA PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 4 (" 1 Inspector . %a Ext
Other: .
Final DO NOT REMOVE this inspection record from the Job site. -
PASS PART FAIL