Permit CITY OF TIGARD ELECTRICAL PERMIT
P ERMIT #: ELC2000 -00658
r,c�Jl DEV w H Hall Tigard, SERVICES ) 639 -4171 DATE ISSUED: 12/04/2000 OR — 13125 PARCEL: 2S101AB -01502
SITE ADDRESS: 07565 SW HERMOSO WAY
SUBDIVISION: HERMOSO - PARK ZONING: MUE
BLOCK: LOT : 022 JURISDICTION: TIG
Project Description: New electrical service drop. Job No. 79351 -201 - Lowes Project
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: 1 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:
ANDERSON, ROY W ESTATE OF ELECTRICAL CONSTRUCTION CO
7565 SW HERMOSO WAY PO BOX 10286
TIGARD, OR 97223 PORTLAND, OR 97296
Phone: Phone: 224 -3511
Reg #: LIC 049737
SUP 2986S
ELE 26 -45C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 12/04/200C $80.30 2720000000( Elect'l Final
5PCT CTR 12/04/200C $6.43 2720000000(
Total $86.73
•
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 BY: 40A -21 44. 7677<___
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
11/29/2000 14:29 15032953012 E C COMPANY PAGE 13
, _ : +,.a
, io i X963 D,S0”. .
Electrical Permit Application
/ Datereccived: /�Zy/� P
ermit �GeZo00 - Lt7(o5p
J :,..,i,' ",'l�jiU
City of Tigard �� �„�/ Project/appl.no„ ;
City of Tigard Address: 13125 SW W Hall Blvd, b , D ate issued; Receipt no.:
Phone: (503) 6394171 � . Fax: (503) 598 -1960 �� ���' 0 t ! / 4 Ca s e file no.: pe:
Mil CC to: C •
Land use approval: .. #' Goff
TYPE OF ITRIVIIT
O I & 2 family dwelling or accessory f' Commercial/industrial 0 Multi- family Cl Tenant improvement
0 New construction O Addition/alteration/replacement 0 Other: 0 Partial
• • JOB SI'IT INFORM
Job address: • . >� It t10 ,ip Bldg. no.: Suite no.: Tax map/tax lot/account no.: '
. Lou Block: Subdivision:
Project name; LOW<, S Siam, ek (Description and location of work on premises:116W a Car t' 1504111 CC drop
Estimated date of com+letion/ins , ction:
. ..01- 7'14A(':1;1/!(,. P 1•11<; t!(! ..:.. :... .. .... . 'I': 11),I.*,lr .J. , :k • • .
Job no: et -2O ( Fee ' max
Business name: l L rl L � �5 ( h � 0"� [,a Description Qty. (ea) • Total no. inap
7 � " New residential - single or multi - family per
Address: p � &0 • dweuinguNF Includes mulched garage.
City: 14 .H d I I State: we I ZIP: 4 i .sy CP Serviceincludct6 •
Phone: `f _ `4 �I Pax %dY - a2('* mail: 1000 s•. ft. or less 4
Each additional 500 sq. FL or portion thereof _
GCB no.: • ` ?a B - bus. lie. no: a t, - 46 G Limited energy, residential 2
' Clty/me[io 1 . � o.: a / / • I iT l'o c.
� LiroiteJi energy, mn- residential 2 _ _
1) .∎ 14, . J�A [-e.�f s5 d leach manufactured home or modular dwelling
Signature of :upervrsing electrician (required) ate Service and/or feeder 2
Sup. elect.name(print): License no: / O, Servtces orfeedera— Installation,
alteration or relocation:
PRO PERI Y OWNER 200 amps or loss i 7,0, s 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: State: ZIP; Over 1000 amps or volts 2
, Phone: !Fax: I E -mail: Recennecionly _ I I
Owner installation: The installation is being made on property I own Temporary services or feeders • • •
which is not intended for sale, lease, rent, or exchange 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: Date: 401 to 600 sin's 2
ENGINEER Branch circuits - new, alteration, •
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each blanch circuit 2
•
City: I State: I ZIP: B. Fee for branch circuits without purchase
. of service or Feeder fee, first branch circuit: 2
Phone: Fax: E -mail: I
Each additional branch tlrtult:
' 1 11 ,AN RI ?Yll•AV (Please check all that apply) MIsc .(Service or feeder not included): '
0 Service over 225 amps - commercial 0 Health -care fatdity •Facts pump or irrigation circle 2
'❑'Service over 320 amps•rating of l &2. U Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, oree.tension• . ' - _ 2 • O Building over three atones ❑ Feeders, 400 amps or more *Description: _ - ..
Cl Occupant load over 99 persons O Manufactured structures or RV park ,Filch additional inspection over the allowable in any of the above:
O Egresa/lighting plan O Other 'Perinspeoiion 1 1 1 l
Submit sets,of plans with any of the above, Investigation fee
The above are not applicable to temporary construction service. Other pp
'Not all Jurisdictions Kcapt credit cards, please call Jurisdiction for n ore :information.' Notice: This permit application Permit fee $ O
O Vlsa 0 MasterCard . expires if a permit is not obtained Plan review (at %) $ +
Credit cord numrter: I I within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. • • TOTAL $
Marne of cardholder as shown on credit card
$
\ Cardholder aignaiure Amount l 440-4615 (6/00/COM)
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hoer Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested • / Z- / 1 AM PM BLD
Location Z 5 #84Atn 0 5 6 wc„) Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC 77vcdv - UV
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: r� "/�
(T
Final
PASS PART FAIL
•
PLUMBING - a..
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
c _.--EL - ECTRIC M.)
Rough In
UG /Slab
Low Voltage
Fir- larm
�' • • PART FAIL
ITE
•
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 / Z — /9 - Ge�
Other Date Inspector _ �� _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.