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Permit '.4 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00543 VI III DEVELOPMENT SERVICES DATE ISSUED: 8/25/2004 " '`--' 13125 SW Hall Blvd.. Ticiard, OR 97223 (503) 639 -4171 PARCEL: 2S111 AB -06900 SITE ADDRESS: 09220 SW INEZ ST SUBDIVISION: PENROSE TERRACE ZONING. R-4.5 BLOCK: LOT : 014 JURISDICTION: TIC Project Description: 4 branch circuits for upgrade. 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: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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: BROWN, KATHERINE BOONES FERRY ELECTRIC INC • 9220 SW INEZ ST PO BOX 628 TIGARD, OR 97224 WILSONVILLE, OR 97070 Phone: 503 - 598 -2339 Phone: 682 -4936 Reg #: SUP 3170S LIC 88482 FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 8/25/2004 $66.80 [TAX] 8% State Surcharge 8/25/2004 $5.34 Rough - Elect'I Final Total $72.14 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By , p� . L C c .vL, Permit Signature: '� C-- f2..At.2 A, OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: 3/ 103 Call 639 -4175 by 7:00pm for an inspection the next business day Aug. 20. 2004 9:38AM BOONES FERRY ELECTRIC No, 1389 P. 1 El ectric .t rerinit H , G O. 9 v E D FOR OFFICE USE ONLY • 'l - .C.2itfof Tigard - Receive. , � • Date/13 ; t / Permit No.: n tt 4f •-�vU • 13125 SW Hall Blvd., Tigard, OR 97223 DateDate/I3 A �1 r Plan Revie Phone: 503.639.4171 Fax: 503.598.196A 2 U 2004 %a,hs' . ,.. : i \ O Permit 1al > Inspection Line: 503.639-4175 4 '.' _� Date Ready/By; pd See Page 2 for itcrnor www ci ttgard or us Notified/Method: Su lemental Information CITY OF TIGARD PP ormation 1 t ,L.g,P� ri 1;�. x � J X17 u'��3.� i2ASF ,o'�i'� :i- 2 .;7�;?tY.; ,pF-WW."1 IM:iir:�.a ?., � , it s„• e.�v Y4Ye�i.a f .' dfael p 1 . ,'".7 tl r�{ � th. ... - k l .,�' 2ii F sir' s b6: 1 � ' icr t ., t 7 .,.,,• a _ .�_,1 G...dJbia`�.Le..l. f�.r?��.. ..LAS ?.:^�i!?a7:.�.six"F;i2.uf �,$ '., ,�?:..'r.'3,o.E .d` �:"u`x3: ,10 5 �v •k j� ,� Af � S � �n ! u,•+�d �1 I• 1��5.31'�� Il � _ CWS, •.•�;..- .;.�;:�, , al:1�:d'Lr: v. .. J,cu }¢..::�i�iM;.� h��R1T Y �_t`,�r�-•'.:;•-, ,: i. ,.,• ❑ New construction A ddition/alteration/replacement Please check all that apply: ['Service over 225 amps, corrun'1 ['Hazardous location Demolition ❑ OtheI r' >� ,<•. Y yr; t �, Service over 320 amps - rating ['Bulldog over 10,000 sq. ft., '+a�i ''' y ti�"i� i� 1J OE, fn"'F' a 3'"''3..' i x i r r ° " "+` - ,��'" t''°' �., - tin? gi , ` r, za ,, � � e E .,i. „,2 w , r ' ,; � i of 1 and 2- family dwellings 4 or more new residential 1 and 2 family dwelling [l Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure i ❑ Multi family ❑ Master builder 0 Other: ['Building over [loos stories ©Feeders, 400 amps or more - ,t ; 'i iS M PJ,� , i 1 3� �� cF w� c { sF qv} � .�, ❑Occupant load over 99 persons ❑Manufactured structures or v v ' : e ;t7.� r fi..ir, m : t ,'�I teir! t'tt i (t �`x, , q51 } /tst� l 9I c l ° "- '," 9 { f t ' f't'`yzr s ue , ass" ,m._ > .::.•.. s..r>:, sl Vx: ,tht.. . n. - tr. „L-•t Job no.; 6 9 J ❑Egress /Ii plait RV. park Job site address: 9 LZp sl,,,, 1n e z S4 ❑Health -care facility ❑Other: City/State/ZIP: 'r ^ 0 Submit sets of plans with any of the above, o) o. » II R 72 The a bove are not `v � , app licable to temporary construction service. Suite/bldg. /apt. no.: Project name: 6r0 n . 4. fil .. rio.NAh ' .." 'iu,..i 3 ; L,..V,' e: S .,,,. :2 .._ Description Qty. P. Total '" Cross street/directions to job site; New residential single- or multi - family dwelling unit. _Includes attached garage. 1,000 sq. ft. or lass 145;15 4 Subdivision: Lot no.: Ea. add'l 500 sq. R or portion 33.40 1 Tax map /parcel no.: Limited energy, residential J 75.00 2 - ,' a�,, 7 te rr'' e � t e , r m k i , , : Limited non - residential 75.00 2 (( ,,p A � V . ik. Z Y � r�'N RI 'f ` 'Y� m i lli{[ �l th�"� 7 , 15 M r � v� Z iJ�r] " energy, rt�,rsN.. i.1= ..... ,;,1 1.. �, , . Tr. xsl�I,.. X.'. T.: w' 1 w , , , Swau�L "'+...��i.:.G_,�� 3 :v„1:,,�'�L�]'iSt, f :: "a7�'_t:ty Each manufactured or modular 7 Cr, S 'f o� � ► 1 d' R�c � �,Z : dwelling, service and /or feeder 90.90 2 n l Services or feeders installation, alteration, a nd/or relocation V i ∎, Q 200 amps or less 80 -30 2 n i u. • 7 )71.14 ' l 1 2r�'� • f.NiV,. irf, , ?� ' 1 X'. 3 ?` , 71 "1 t fig d` at i "'r 201 amps to 400 amps 106 -85 2 v--. Iw, a , ..ti aiV. .. 11'31 r » 4, t,51 :� .:- _."in n,. ! 4.ritom r. 1 401 a to 600 a NUM: �� amps 0 amps 160 -60 z r . wit 9.� .(4A. t- 601 amps to 1,000 amps 240.60 2 . / Lddress: 9 S w . Over or amps or volts 454,65 2 Reconnect only 66,85 2 l City /State/ZIP: vvv Temporary services or feeders installation, alteration, and/or Phone: - Sgg 'c:)3BQ l Fa ( ) relocation 200 amps or less 66.85 1 Owner installation; This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: bate r s t _ Branch circuits - new, alteration, or extension, per panel i °' z ` x 1�. ra `" 1 L t x cw M t �h f ri t 4 tikg F r;t:.7,,,, s xn ., ;r: tbf t. P p ..r,...r,._1 . 1,t . ra.... . , :.,.3.s hF;... 11 g : "yy. f/,, .L., =,... , ,l , Q st: A.F rviceo rfeede r fee , e each "" "' " service or feede fee, eac Business name: branch circuit 6.65 2 Contact name: B. Fee for branch circuits without service or feeder fee, , 46.85 2 Address: each branch circuit Each add'l branch circuit 3 6.65 - 1 2 • City /State/ZI': Miscellaneous (service or feeder not included) Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2 • Sign or outline lighting 53.40 2 E-mail Signal circuit(s) or limited- ' u Ft f'r'y MJt' ,� " ���rr^^ it� K' e �� � y R r a:�7� e < a' �..:.t ' �'?1,,: :, t � 3,`".,'rZ3.., ;�{�'�iz' �'� :'� li rr}It o y, 'dr •4,> i`.?IY1 sk +�Qf T' ri' energy panel alteration. or Business name: extension, Describe: Page 2 2 Boones Ferry Electric Address: P.O Box 6 2 8 Each additional Inspection over allowable in any of the above Per inspection 62.50 City /State /Z1P: Wi 1 s o n -'r 17- Z e OR 97070 Investigation per hour (1 hr min) 62.50 Phone! (5:0 3) 682 -4936 Fax: (5 03) 682 -7946 Industrial plant per hour 73.75 CCB Lie.: 88482 Electrical Lic.: 3 - C Suprv. Lic.: `� ` e ms s . 1! _ .''iq ` .1 ' l�ti a ;. :�," .r Sr i ' <,..,, s Subtotal t� g 0 Suprv. Electrician signature, required: • I Plan review (25% of permit fee) ...-- Print name: $ �� >h t/ D ate: State surcharge (8% of pet rm t fee) S ? C. Hbt.4on TOTAL PERMIT FEE 7 2 , /if Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: ._ Date: Fee methodology set by Tri -County Building Industry Service Board - " Number orinspectiosu per permit allowed. is \aailding\Pc nhts\HLGPamit pp,doc 12/05 44O- 4815T(10/02/COM/Wm CITY OF TIGARD 24 -Hour BUILDING Inspection Like:-(503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 • MST BUP Received Date Req steel e ' g AM v PM BUP Location 9°Z D Suite MEC Contact Person 7 Ph ( ) ( � g a � 3 3� PLM Contractor Ph ( ) SWR �/ BUILDING Tenant/Owner ELC b D 6 -D Footing ELC Foundation Access: "k - tt X73 g`" Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear 7 M r 0 6 , q 7 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 Service Rough -In UG /Slab Low Voltage Fire Alarm - Reinspection fee.of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL ❑ Please call for reinspectio RE: - . A I Unable to inspect — no access Fire Supply Line L Q - r 7 ADA 0 •Q Approach /Sidewalk Date Inspector jsrA1111. Ext Other: Final DO NOT REMOVE this inspection recor in the job site. PASS PART FAIL