Permit CITY O F TI GA R D ELECTRICAL PERMIT
P ERMIT #: ELC2001 -00008
4 DEVELOPMENT SERVICES DATE ISSUED: 1/9/01
I
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102BA -00800
SITE ADDRESS: 12155 SW GRANT AVE A
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: I -P
BLOCK: LOT : 059 JURISDICTION: TIG
Project Description: Fire repair. Job No. 43410
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: 4 W /SERVICE OR FEEDER: 40 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SEE -ZER PROPERTIES FRIBERG ELECTRIC CO
26785 SW NEILL RD 4636 N WILLIAMS AVE
NEWBERG, OR 97132 PORTLAND, OR 97217
Phone: Phone: 288 -5161
Reg #: LIC 1329
SUP 2543S
ELE 26-51C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 1/9/01 $587.00 2720010000( Elect'I Service
Elect! Final
5PCT CTR 1/9/01 $46.00 2720010000(
Total $633.00
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 - 01 -41 0 through OAR 952 - 001 - 00 0. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
� c c , - 2� c
Permit Signature: ` i �' 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
1A CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00008
DEVELOPMENT SERVICES DATE ISSUED: 1/9/01
anual 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102 BA -00800
SITE ADDRESS: 12155 SW GRANT AVE
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: I -P
BLOCK: LOT : 059 JURISDICTION: TIG
Project Description: Fire repair. Job No. 43410
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: 4 W /SERVICE OR FEEDER: 40 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SEE -ZER PROPERTIES FRIBERG ELECTRIC CO
26785 SW NEILL RD 4636 N WILLIAMS AVE
NEWBERG, OR .97132 PORTLAND, OR 97217
Phone: Phone: 288 - 5161
Reg #: LIC 1329
. SUP 2543S
ELE 26 -51C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 1/9/01 $587.00 2720010000( Elect'l Final
5PCT CTR 1/9/01 $46.00 2720010000(
Total $633.00
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE / ISSUED Y:
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
i
SIGNATURE OF SUPR. EL TUN: -A ! %:• � DATE:
LICENSE NO: 015 5
Call 639 -4175 by 7:00pm for an inspection the next business day
■
12=15/00 FRI 11:04 FAX 503 598 1960 CITY OF TIGARD (j00
• q e(''
Electrical Permit ;pp
t Datereceived: /a /7-0o Permit no.:
•
.r .� of Tigard Pro ccVa 1 no.: Ex iredate:
r•"
Address: 13125 SW Hall Blvd, Tigar,i ' OR 97223 1 � J pp p
City of Tigard Date issued: By: Receiptno.:
Phone: (503) 639 -4171 ��� •
Fax: (503) 598 -1960 �� Case file no.: Payment type:
Land use approval:
. ' , : TYPE PERA _.: ".. .
0. 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction 0 Additic n/alteration/replacement ❑ Other. 0 Partial
• ,. JOB SITE INFORMATION - -
Job address: 12155 SW Grant Bldg. no.: Suite no.: Tax map/tax lot/account no.:.
Lot: IBlock: (Subdivision:
Project name: 43410 Descriltion and location of work on premises: Electro static refinishing
Estimated date of completion/inspection: •
', CO \TItACUOR APPLICATIO , . n .. FEE SCIJI:DULE
Job no: 43410 Fee Max
Business name: FRIBERG ELECTRIC COMPANY Description Qty. (ea.) Total no. insp
New attached Address: 4636 N. Williams Avenue rage.
dwelllnguait. includes attached garage.
City: Portland I State: OR 21P: 97217 service included:
Phone: 288-5161 I Fax: 288 -1930E -mail: 1000 sq. ft or less 4
CCB no.: 1329 I Elec. bus. lic. no: 26-51C Each additional 500 sq. ft or portion thereof
Limited energy, residential 2
City/metro lie to.: 4663 Limited energy, non- residential 2
�_ ' Each manufactured home or modular dwelling
' . attire of supervisin: ectrictan (required) Date 12/15/00 _ Service and/or feeder 2
- Scrvicesor feeders - installation,
Sup. elect name (p n i' 0 „, ' I it •. case no- alteration or relocation
PROPERTY OWNER 200 amps or less 4 321 z
Name (print): • 201 amps to 400 amps _ 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: 12 SP: Over 1000 amps or volts 2
Phone: I Fax: I E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchangy according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: D2 e: 401 to 600 amps 2
ENGINEER • Branch circuits - new, alteration,
or extension per panel:
Name: .
A. Fee for branch circuits with purchase of
•
40 266
Address: service or feeder fee, each branch circuit 2
City: I State: I 'e :IP: B. Fee for branch circuits without purchase
Phone: Fax: E of service or feeder fee, lust branch circuit: 2
Each additional branch circuit:
' PLAN REVIEW (Please check all tha apply) '. M[ sc .(Serviceorfeederuotincluded):
O Service over 225 amps - commercial 0 Health -care facilit y Each pump or irrigation circle 2
O Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,1100 square feet four or Signal circuit(s) or a limited energy panel,
O System over600 volts nominal more residential u nits in one structure alteration, or extension* 2
CI Building over three stories 0 Feeders, 400 amp i or more +Description:
O Occupant load over 99 persons O Manufactured stn ctures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other Per inspection I 1 I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary consti action service. Other
' Not an jurisdictions accept crodit cards, please call jurisdiction for more infi rmation. Notice: This permit application Permit fee $ 5:81,11:11._____
. O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ i6 00
Credit card number. / / within 180 days after it has been State surcharge (8 %) .... $
Esp res accepted as complete. TOTAL $ _633.00
Name of cardholder as shown on credit card
$
Cardholder signature Am( out 440 -4615 (6t00ICOM)
■
/,7 iF
- CITY OF TIGARD BUILDING INSPECTION DIVISION . MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested � �/ 7 AM PM BLD
•
Location / Z / J S 5' Suite / MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 1 �� n _
Slab (/ I ? SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing, _ /� ,,
Firewall L �l l F �`+ F� — 26- d / AA
Fire Sprinkler pl j4/4. I/7
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL /
PLUMBING; . ( ! '^ F / » /
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains _
Final
PASS PART FAIL '
MECHANICAL-;'
Post & Beam C r
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
F larm
SS ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before ne spection. 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 Date 7
/ Inspector .4 V Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION ySY F _
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
BUS'
Date Requested AM PM BLD
Location / Suite L3 t". MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC 2O o eZeD
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain 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
Roof G� l/ f >
Misc:
Final •
PASS PART FAIL
PLUMBING . b
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer 1
Rain Drains \ ■c)
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Fin-
S • FAIL
ELECTRICAL
Rough In .
UG /Slab
Low Voltage
Fire Alarm
40 1 PART FAIL
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 — 2‘ D /
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 -
BUP
Date Requested S, Z r AM PM BLD
Location /2_150 $4- f`6, d 5 Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing • Access:
Foundation FPS
Ftg Drain 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 •
Roof
Misc:
Final
PASS PART FAIL
•
PLUMBING M/Z l/ 5 r:
Post & Beam
Under Slab ✓✓
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
- Final
PASS PART FAIL
(EC CTRI.CAA
Service ■ C
Rough In
UG /Slab
Low Voltage
Fire Alarm
®
� ART •FAIL
4/W
ART
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required bef• e next ins,ection. :t City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: i' able to inspect - no access
ADA
Approach /Sidewalk Date ' / / D, Inspector a• j / � � Ext
Other Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
• BUP _
Date Requested 4. AM PM BLD
Location / Z��� ski ) ?" I Suite 5 MEC
Contact Person J Ph 2. �'� I PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC »t)/ o ) '
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain 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 r 4 A
Roof
Misc: •
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer •
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PA$ PART FAIL
IkLECTRIC
J S�
UG /Slab
Low Voltage
Fire Alarm
. a
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA Approach /Sidewalk � /Inspector Date ° A 4 _ 410. 4.4 .. Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.