Permit C ITY OF TIGARD ELECTRICAL PERMIT
.+. PERMIT #: ELC2004 -00081
A � 4, DEVELOPMENT SERVICES DATE ISSUED: 2/23/04
I
C. am 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 101 AB -01501
SITE ADDRESS: 07555 SW HERMOSO WAY
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT : 021 JURISDICTION: TIG
Project Description: Job #1031 -14 (1) temp service. 200amp
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: 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:
JOENS, JOHN D MARJORIE A GREENWAY ELECTRIC COMPANY
7545 SW HERMOSO WAY 15145 SW GULL DR
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 503 - 579 -8054
Reg #: LIC 153421
ELE 34 -617C
FEES SUP 5025S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/23/04 $66.85
[TAX] 8% State Surcharge 2/23/04 $5.35 Rough -
Elect'I Final
Total $72.20
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- 2 -23 .
Issued By: / /0 ���� Permit Signature: &
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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
02/19/2004 15:51 FAX 5035798056 l] 001 /002
rmitA li oar •
• VE 'll , etc receive& a o Permi IIO G :01)1/1---000.
)1,1 City of TigarSEGE i
city of7Ygard Address: 13125 SW Hall Blv t 1 4 Date issued: /appl. no.: Expire date
Phone: (503) 639 -4171 �� L�23
`I Date Receipt rio :
Fax: (503) 59 8 - 1960 Case file no.: payment types % /Cv
Land use approval: CITY N G DIVISION
13UtLDl
IIIMMIIIIIIIIIIIIMIIMII IIIMMIIIMBIIEEMIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMI
❑ 1 & 2 family dwelling or accessory El Commercial/in lustrial ❑ Multi - family ❑ Tetuint '
•
la New construction OAddition /alteratian/replacement ❑ Other _O Partial
Job address;
7545 SW Hermoso Way, Tigard Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot 1Block: I Subdivision:
Project name: Minute an Press 'Description and location ofwork on premises: Temporary Power for new constntt{{pn
Estimated date of compl: ; on/inspection:
(O \ R ‘C TOR .APPLIt it l ION FEE S( Il[DI I.I
305 1031 -14
Fee ', blact
Business name: Grant y Electric Company Qty. (era) ,Tom eo.;asp
Address: 15145 SW Gull Dr. NewresiiealW'deq�aQtir�yPu
. dwei rralLIndudesattanhed
City: Beaverton J State: OR I ZIP: 97007 Se rvieeinehadei: >
Phone: 503 - 579 - 8054 I Fax: 579 - 8056 1E jim_rooncy,(alveriman loo° sq- it a less 4
CCB no.: 153421 I Elec. bus. lie. no: 34-617C ► additional 500 sq it portion thereof I
ited City rr aft) lic. no.: 7470 � , Kside�al ` 2
g • limited son-residential. -residential. 1 2
.' �r . _ V L ' tl Each manufactured home or modular dwelling I
t._„ 7 n • o f . • . eloarician (required) D Service and/or feeder I
I . 2
Fete t name 1 -",): James V Roan License no: 50255 Sersirerorfeedtrs—is511.utejon,
altcrldiaaorreinestim
200 amps err less 1
Name (print): 201 amps to 400 amps , 2
Mailing address: — 401 amps to 600 I: 2
Gi 601 amps to 1000 amps 12
ty : I State: J ZIP: Over 1000 amps or volt I. 2
Phone: [Fax: 1E-mail: Reconnect only I.1
Owner installation: The instatiation is being made on property, I own Temporary services or - 1
which is not intended for sale, lease, rent, or exchange according to ,
ORS 447, 455, 479, 670, 701. 200 amps or Less 1 6626 61325 1 2
201 amps to 400 amps
Owner's signature: Date:: 401 to 600 . .,. 12
ENC 1.N F E12 Breath circuits- sew, aberatioa, •
Name: ear esteedoap rpsael:
A Fee for branch circuits with purchase of
Address: service of feeder fee, each branch circuit 2
City: I State: I ZIP • B. Fee for branch circuits without purchase -
Phone: Fax: E - mail: I of service or feeder tee, first branch circuit 2
Each additional branch circuit:
PI. 1N 121 1IE11 (Pleas check all that apphiI Mise.(Serrtrearfeeierantio.claiedh
❑ Service over 225 amps-commercial CI Health -tare fau lt)' 1 Each pump or irrigation circle 12
O Service over 320 amps-rating of 18x2 Cl Hazardous location I Each sign or online hgh80g — - 2
family dwelliogs O Building over 10,000 square feet four or signal cina4s) or a Inufed ene4O, pal el,
O System over 600 volts nominal more residential s iu we structure alteration, err extra 'r
2
B Building over three stories O Feeders, 410 amps or came 'Description:
LI Occupant load over 99 persons O Manufactured strucstructures r or RV pads over the allowablein asp oftbeabeam
Plan O Other:. I per inspection i I I I I
Submit sets of plans with any 011ie above. Investigation fee
The above are not applicable to temporary co lbn service. Other �.
Not all jmicdigions accept audit mds pleas= call jurisdiction .. u. . Permit fee ................ -.: $ 66.E
N V� CI MasterCard furmoreiofom,am Nohee: This permit application
/ i expires if a permit is not obtained Plan review (at t%) $
credit c,,,,d mmmb, 4856 2002 0624 4421 • .: p i � , Ai j within 180 days at it has been State surcharge (8 %) $ sus
v. rtm,er Expires TOTAL complete. TOTAL $ 7220 I '
accepted
Name of older as shown on credit card
a- ‘1" d $ 72.20
atdhotder signature Amount I 4404615 (&eWCOM)
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
,��� BUP
Receive d� «� 7 Uate Requeste• .° 2 . 5 04 AM PM BUP
Location iceA uite _ MEC
Contact Person ____�����' Ph ( ) 2 7 7 - �'5 S PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner
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 l
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 .
FrP arm
Fi% ❑ Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
_" ART FAIL
SIT Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date--2
_ Inspector -! /L / . ���� Ext
Other:
Final DO NOT REMOVE this inspection record from the job = ite.
PASS PART FAIL