Permit C ITY - OF TI GA RD ELECTRICAL PERMIT
_ PERMIT #: ELC2003 -00676
:; DEVELOPMEN1 SERVICES DATE ISSUED: 11/12/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 104 BC -02300
SITE ADDRESS: 14000 SW FERN ST
SUBDIVISION: HANDY ACRES ZONING: R -
BLOCK: LOT : 023 JURISDICTION: TIG
Project Description: Install 320 amp service and 39 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 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: 39 PER INSPECTION:
201 - 400 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
NOLAN LAYS ROSE CITY ELECTRIC INC
14000 SW FERN ST 4012 NE CULLY BLVD
TIGARD, OR 97223 PORTLAND, OR 97213
Phone: Phone: 503 - 287 -6164
Reg #: L1C 3567
ELE 26 -1142C
FEES SUP 2127S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/12/03 $366.20
[TAX] 8% State Surcharge 11/12/03 $29.30 Rough -
Wall Cover
Total $395.50 Elect'l Service
Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty 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 N otification 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 1.801 32 -2344.
Issued By: /,,� . , �, ,./ Permit Signature: Q'Y1 r 4.0,4� �P/
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: owl a� S
Call 639 -4175 by 7 :00pm for an inspection the next business day
I ---
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Electrical Permit =Appii;,C tion lr'OIZGollr�lc:lUS>�.orl�Y
r' 11 `E9 um .v Received ll �� Electrical
�� DateBy: lif)e07 ►/ //�� PeenuemutNo. to
006
City of Tigard Planning n,,y, wal Sign
"( �oo� Date/By: Permit No.:
13125 SW Hall Blvd. ®�� 2 Plan Review other -
Tigard, Oregon 97223 Date/By: Pcrmit
` Y
Phone: 503 - 639 -4171 LF (503S9SQi9r60,u Post- Review Land Use
,> Date/By: e ase No.:
Internet www.ci.tigar • .o psoG DIVISION t i ('
::.',I• Contact leis/ S Page 2for
24 -hour Inspection Request 503- 639 -4175 " `' "
r Name/Method: j ee
(a Supplemental Information.
1
ITYPIE OF; WORK ■ I : _ ..:; I i 'P1LAN'IE W (Ple'aseielfeckallithat"ap00 ' "', ; - : ` 7 —
1 9 New construction _ ❑ Demolition ervice over 225 amps- 0 Health -care facility
Addition/alteration /replacement 0 Other: commercial. ci A c e va � '' 0 Building over 1
Q Setvice over 320 amps- ratirig of ❑Building over 1 square feet, \ )
i! `, .I:I ;: 'I',•' lili. , CAVtGORY OF CCON UCTION< 1 & 2 family dwellings " four or more residential Emits in ��ll
JZI4 & 2- Family dwelling '_ Commercial/Industrial 0 System over 600 volts nominal one structure
0 Building over three stories 0 Feeders, 400 amps or more
El Accessory Building [f Multi- Family I' Occupant load over 99 persons 0 Manuihttretl =lazes or R. park,
_
Master Builder 0 Other: 0 Egress/lighting plan 0 Otter.
: 1 .3':'.1 -1- • ,,t' -:: 0BIN i1i i INTORMATIOPF aidiLOCATIOLV Submit _ sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: '‘.40_70 (UC) l Jv -v &_ I E IIEVI $ /E"
Suite #: B1dg1Apt. #: (. i✓\ Number of inspections per permit allowed i
Project Name: ,� fC l� ) � Description Qty I Fee (ea.) Total + 1
Cross Street/nirectio t0 OU S1tC: New residential-Jingle or mold -family per
dwelling unit. Includes attached garage.
service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq_ ti or portion thereof' 1 33.40
Subdivision: Lot #: Limited energy. residential I 75.00 2
Limited energy, non residential I 75 "00 2
Tax map /parcel #: "` Each manufactured home or modular dwelling
D ESCRl1 : OF' RK service and/or feeder 1 I 90.90 2
n . ,/ Services or feeders - installation,
i - (rxsl1 - it alteration or relocation:
r 200 amps or less 80.30 02
201 adrpa t6 400 amn,.: ::y 3 ap9 - grim tom. ll . 10615 `C* 0 2 '
401 amps to 600 amps h ' • 160.60 2
.0 PRlOTX: OVEIt : , : p • ; I ! D 601 amps to 1000 amps 240.60 2
Over 1000 amiss or volts 454.65 2
Name: Reconnect only 66.85 + 2
Address: Temporary services or feeders - installation,
alteration, or relocation;
City /State /Zip: 200 amps or less 66.85 1
Phone: _ Fax: 201 amps to 400 amps 10030 I 2
I' 1 CONTp{ (T ]? L 401 to 600 amps 133.75 I 1
LIC AN T — Branch circuits - new, alteration, or
Name: extension per panel:
Address: A Fee for branch circuits with purchase of 3 •
service or feeder fee. each branch circuit A 7 ' 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.55 2
Phone: I Fax: Each additional branch =ctut 6.65 — — 2
E -mail: Ivfrse.(Service or feeder not included):
CO ACTOR Each pump or irrigation circle 53.40 2
— - Each sign or outline lighting 53.40 2
Job No: I Signal circuit(s) or a limited energy panel.
or extension page 2 _' ' 2 _ •
Business Name: DRYER ELECTRIC dha Rt'�2F.7 p on:
Address: 4 — NE CULLY BLVD CITY
City/State/Zip: PORTLAND ' OR 9 7 213 Each additional inspection over the allowable in an of the above:
Per inspection per hour (mm. 1 hour 62.50 _
Phone: 503 2 8 7 6164 Fax: 501 9 R 7 other. I l n 6 n - Investi "on fee:
CC'B Lic. #:153466 Lie. #: 6-1142- ". tfTllieerl _ ,
Supervising electrician ! /o—' -Cy Subtotal S
signature required ' q � - jai. V Plan Review (25% of Pest Fee) , S
Print Name: R L Go tham Lic. #: 71 27=s State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE S
Authorized Notice: This permit application expires if :t permit is nut obtain al In
Signature: Date: 180 days after It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i :\Dsts\Permit Foe'ms\ElcPcrmitApp.doc 01/03 ,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 3 , - / 2 q Date Requested `���'` AM PM BUP
Location /q0.06 Suite MEC
Contact Person 18ciA Ph ( 5 a s27--- 67 t o sz PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 440 3-0 7,
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
I PLUMBING \YIV1
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-1n
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL 42,t,
Service
Rough -In
UG /Slab
Low Voltage
m
� T=' PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: j Unable to inspect — no access
Fire Supply Line r
ADA r�nn
Approach /Sidewalk Date V Inspector A Ext
Other:
Final DO NOT REMOVE this inspection record from the Job s te.
PASS PART FAIL