Permit -+� 1v 'u IT. Y OF F T I GAR® � ELECTRICAL PERMIT
' PERMIT #: ELC2005 -00022
PE
A �4 . ?L?EVELOPMENT SER VICES DATE ISSUED: 1/13/2005
' 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S111AA -00401 #
SITE ADDRESS: 14145 SW HALL BLVD
SUBDIVISION: EDGEWOOD ZONING: R -
BLOCK: LOT : JURISDICTION: TIG
Project Description: 200amp serv., (8) branch circuits.
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: 8 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 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:
HALL BOULEVARD BAPTIST TICE ELECTRIC
CHURCH PO BOX 15009
PO BOX 230130 2139 SE BELMONT ST
TIGARD, OR 97223 PORTLAND, OR 97293 -5009
Phone: Phone: 503 - 233 - 8801
Reg #: LIC 166
SUP 2586S
FEES ELE 26 -126C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/13/2005 $133.50
[TAX] 8% State Surcharge 1/13/2005 $10.68 Elect'l Service
Rough -in
Total $144.18 Elect'l Final
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 -3 2 -2344.
A
Issued By: a_ �: Permit Signature: e)1 QAj . i _i ;c.�ry
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
01/13/A05 08:10 503 -872 -8290 TICE ELECT.SERV.DEPT PAGE 03
11/05! FAX 6035981860 • • 17-1.',C8 ut+ ;.tutu ii LitT 1 '<ru 01 1-1(.1. i. �i t)VI.Y
• ��C Ica nQTt Received ' _ I3 o d j PJ� ! c -000. A►
C; of Ti Dada rm
. 1 'c� [ other Pem,ir.
13l sW Hu11 B1vd., Tigard, 01 3 i J 2005 J , .. ,.. ,, 1 ■.{ . - • au a :: Ur er�lte b fo*
Phone: 5 Line 4171 Fax 603.598.1460 . � " • .!J.. Date • , /ily: .-- ' Sap.tcma.ttl leformatien
mc: S03.Ct39.4175 °' • Waned/ • invention 1-• l CITY O TIG AIZ� ..
Fleas; Op
• Inectrtet: wWU•.Ct.ti rd.or. NpOw •
I,
, . ' !'.t ads • ' �� 1 � ayardOlia 100ation
_ .. aback all that apply: •
m' >r1
• A :dditionfalteratiodtoplaccmInt OSsrvive over 225.amps Building over i 0,000 eq, ft,,
New i uccion totiag
Otltsr:.. ]2 - more new veoida al
Q Demolition 0 .. . G o o f I.. and d 2 ,o* d llings in one structure Gt)131at ,e Ce i6�I`ls °g over 600 volts nominal 400 amps a tarns
Accessory building °Building o ver three stance [Weeders, i 1 - and 3- fdmily.'3�vciling ❑ Commcroiollin'dvst * ia! 0 Other: [JOceuyant laud over 99 P�O� aManufatured structures or
(] Nlutti- family Master builder at tttny plan RV P —
f0 :61'T , Ii<IFORA3A 014ealth.cercfacility
e. address: 14145 SW Hall Blvd Submi i sets of plans with any of the above.
Job no,�� • 9533 Job to constr serv ice.
____,L.---_— -°� The above are not applicable to taanpO , ,
Ci (Srate'ZUP: Tigard OR 97224 — ' R .9 t. C ...... .
Pr oject nor all Blvd Baptist Church ' pcsori a elet. !•- 'fatal I
$pitefbldg.lapt: ne. : New residential single- or zitnit�fasaily dwelling Dill.
Cross atreet/dI1eCtiotis m Job site; Include, attached attl .
1.000 54 ft or low ®� s♦ 11011 �
Ee, 8dd'1 �- it of •*der.
Lot 7O -
residential 75 -00 urn
Subdivision: Limited ®clip+,
Limited ads, non rt:aidential 75.00 .1.110 'f ax t11np1ps .... ; no,: f d of modular •
iDES�f t1P370!I , 'Or WORK i orfaoder ,90 •
in : aervlcC et,dr 90 2
•r t 8,ervivos or fader* Installariolt, alteratlont sddlor relocation
. ' a- -�' • ...- � " - • •. •- -_ - - - - - 200 arttps or less 1 80.30'. BR In Z
secretar�7' S office ,_ a01 amps to 409 an s 106.115 z
p Arrr ; • ; • .. 160.60 2 , •
.. 0"FRA �tTX':OWN1Lit , , 40t atnpsUO600att�s
601 a to 1.000 240.60 z
Name: . 454.65 z r
- _ 4"6r 1 amps or `Ile
Address: _ . Reconnect oily • 66.65 , 2
• /State/ZIP: . . Temporary services or feeders iastaltntten, alurattoa, andlor
relocatiod
• Phone: ( ) . Fax; ( ) 200 traps or less 66.85 1
Owner installation: This' lnsiallataon ia'being made on propety that I own which is not • 2(,i Amps to 400anps 100,30 , 2
• intended for sale. 1e te, rent; or exchange, according to ORS 447, 449, 670, and 701, 40 I maps to 600 tops I 133 " 2
Owner signature : Dote_ Branca Circuits - new, alteration, or. extension, per panel
. ... A PEISS 53 0
Fee for branca o cs >h
Service or feeder f ee, ea 8 6,63 •2 2
• Buaine99 name: •• branch circuit - I
13 Fce for branch eir cuita
• • C ontt;rot trine: without aerooe ar f fee, 44 -8 2
-- cinch branch cirvu{t 1
• Addttesit: Eaeli 04'1 brrutch circuit CO 2
City /Stabel7.IP: Mteetuaooua ;Oervlee or leader sot included)
Porno or ittigation circle 53.40 2
• Phone: ( ) Fax:: ( ) P orn orovt]it 6n fir lighting 53.40 2 '•- E -main: • Signal circuits) or limited. .
1AC7O , mew P", alteration, or 2
COIV eatention. Dascribe: Page 2
Business name`. Tire Electric Co. __
B additional inspection weer' allowa amen
In any of the orn
Marcos: Marcos: rett ;n . _ n a e • . Per inspection 62.50 •
City/8tatef2IP: portland o • .. • 9729.3-5009 Invited getioa per hour (I he nna) , 62.50 •
• bnduth`1ot plans per hoar 73.75
Phone (5031.233 -8801 Fax: 03 ) 872 -8290 ,... .:;,, . Eli ' CJIi1, • •1P mss !:..'
CCB Lie.. a • . Elcotrieal f '• Suvrv" 1,4 c-2' 86S subtotal 133.50
Sttprv: Bleeirician sharer, required: ID • Plan review (25% of permit fee)
""°' ' 1 State stuNsrga (6^!b of permit foe) - - 10 �R
Psint mare: John . J Ma10n bats: 1/13/05 -
TCYf PlAlltMiT FEE 144..10 • Authorized 5igttaturei � . /' Y'hiap appitostte. Lipka If a permit ill not within 190
L,,roL.. -� dsys alter It boatmen aetaptod at tontine Print name; • J. J. - • oricy I)ato: /1 /Q • Pee methodology t011ootty Service Botrd
•a Number of in:paedoos per pencil fllavnt.
lapmalejotmeutP_LC- PermaApp 1947 r4+R f ST(tOOVCOM/WE'a
CITY OF TIGARD 24 -Hour
BUILDING --� Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Busirtess Line: (503) 639 - 4171
BUP
Received j Date Requested (_ 3( AM PM BUP
Location / `7 L 7 / S- fid li J Suite c /J MEC
Contact Person Ph ( ) 8 7? _ T �° PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner /d !�!/ �t— ELC 0 Oe-
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
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
rp
UG /Slab
Low Voltage _
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
I'AS PART FAIL
Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line 1
ADA Approach /Sidewalk Date ! ) `� Inspector /i�' L -, - Ext
PP Other:
Final DO NOT REMOVE this inspection reco from the site.
PASS PART FAIL