Permit r CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�I
DEVELOPMENT H B s SERVICES 2 C' ES ) 639 -4171 DATE R MII #: E 6/25/02 2-00114
- 13125 SITE ADDRESS: 11399 SW IRONWOOD LP PARCEL: 1S134AC -01600
SUBDIVISION: ENGLEWOOD ZONING: R - 4.5
BLOCK: LOT: 044 JURISDICTION: TIG
Project Description: Install All Encompassing Low Voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
NELSON, ROBERT 0 SUSAN S THEN THERE WAS LIGHT INC
11399 SW IRONWOOD LOOP 24085 NE WILDWOOD RD
TIGARD, OR 97223 NEWBERG, OR 97132
Phone: Phone: 503- 538 -6645
Reg #: LIC 142987
ELE 36 -93C
SUP 4526S
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 6/25/02 $75.00 2720020000 Elect'l Final
5PCT CTR 6/25/02 $6.00 2720020000
Total $81.00
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.
Issued by Da4.4 4 6i Permittee Signature 01 O-'
OWNER INSTALLATION ONLY
0
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: al / 4 / DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
`2 :05 5382728 EDUCATIONAL TRAVEL PAGE 01
' Electrical Permit Application
Date received: 6 --I but no.: i• ' it Q0 / , el
City of Tiger d' O 0,`� 2 Projecdappl.no.: Expiredate:
City of Tigard Addr 13125 SW I�al B1 * t QR�97223°) Date Issued: By Receipt no.:
Phone: (503) 639 -4171 Payment t
Fax: (503) 598 -1960 ZoOZ t G NCI Case file no.: ype;
Land use approval:
-1 IA 11 "_tl Cf`,'r"' tilt
r pl.: OF Yh :IZ 11'f
1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family 0 Tenant improvement
• New construction 0 Addition/alteration/replacement O Other: 0 Partial
JOB S1'1 h: l:NFU1t1%1ATIt)N
Job address: \ ar 5 aJ2carJ t. -zoo o Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot; Block: Subdivision: ' r
Project name: �. ,. ' $,p, N (._.(co Description and location of work on premises: e / ' L t/ Dk l oax'isV-
Estimated date of completion/inspection: — L. A - i-' a
• ( ()N I RA(' FOR :%I'PLI(':\'l ION 11 suil11)i l.EE.
FLe Mmx
Job a0: a . (btal no. ins
Business name: 'r�,e. t', _1,4, , r ,l-%�' + �w.rY�leorr�Mi= irhtib'per
Address: Z oFf` i - 2 L AD, 1a c, c Iz...x, dwelling wit. Incltider attached game.
City: ' ip , Slate :c5 ZIP: 7/3Z Serviceiaclvaaoik
1000 sq. ft. or leas 4
Phone: ��'r cj�8r .•`E' Fax: E-mail: Each additional 500 sri ft or portion thereof
• . v Elec. bus, lie. no: C� z
Cat no -: Zi D - Limited energy, res _
City/metro lie, no.: /0 er — Limited energy.non- residential _ 2
/ m t ufactured home or modular dwelling
- / " Gnenu 2
Signature of supervis15 electric an (required) Date /Q 1.0 / Service and/or feeder 1 .
` Services or feeders - lnstal>atldn,
Sup, elect. name (print): j ' 1/t its i• License no; I.52 / alteration or relocation:
200 amps or less 2
i � 2 ,� 201 amps to 400 amps 2
Name (print): a /ti,v 401 amps to 600 amps �� 2 ,
Mailing address: 6 01 ant to 1000 stn s 2
City: Statr Over r+ am s or volts 2
Phone: Fax: E-mail: Reconnect only n 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
Installatioia, *Remitter, or relocation:
which is not intended for sale, lease, rent, or exchange according to
200 AM a or less 2
ORS 447, 455, 479.670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of Z
Address: service or feeder fee, each branch circuit _
State: • ZIP: B. Foe for branch circuits without purchase
Cit of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: .-
additional branch circuit;
I 1.,‘N 1tI:N Il`%V (i'lea'.t• check :III 1ltat apply Misc. (Service or feeder not included): 2
al ❑ Health -care facility
O Service over 225 ampa�omnw�i . Each pumerirrigation circle Each sign or outline lighting 2
❑ Service over 320 amps rating of 1542 GI hazardous location
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 2
❑ System over 600 volts nominal more tesidential units in one structure alteration, or extenaion
O Building over doge stories Cl Feeders. 400 amps or more *Description: - l v .
Q Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/lightingplan D Other: Per inspection I 1 1 I -
Subaplt sets of pima with any of the above. lnvesti : ation fee
The above are not applicable to temporary construction service. Other •
Permit fee ..... $
Not an ]+utsdt tiom ac ept credit rands, please call ludadictiao fa Mara Inft a aiumt Notice: This permit application Plan review (at _ %) $
CI Visa CI MasterCard expires if a permit is not obtained
• Crow* card climber: / within 180 days after it has been State surcharge (8%) .... $
�
accepted as complete. TOTAL $ r3 I
Name of cardholder as shown on credit card
$
i;aadholdcr alanature - Amount 440-4615 (6100/C01.9
CITY OF T14RD 24-Hour ,,
BUILDI4GW Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISI':N Business. Line:. (503) 639 -4171
BUP R,
Received Date Requested AM PM BUP
Location G / 3 9 ! _ ti ��11 -d' 1 /. J rt z, Suite MEC
Contact Person — yh.� ( moo . � Ph ( ) 7 6 — C¢ �� PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner ELC
Footing -9 J of S S, st j f7,R. 14 11 0 ELC
Foundation Access:
Ftg Drain X 0 41 (4' ELR ' ° I l
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ) • WI 0 g )-..1 b4 )-..1 �� G gr5
Shear Anchors po S�f , v 1f tf \� y S 1f "r
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall C �
Fire Sprinkler ��� S J� -�J
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
-! l \ /` \,(
PLUMBING PASS PART FAIL
� l.S`1 G � � ry � � � C'v
Post & Beam
Under Slab • . l `
Rough -In ° /Ptik r iK gh 1---� D
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole 1 11 AM
Storm Drain 1 5
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC A L
Service
Rough -In
UG/Slab
olta
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A S PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA Approach /Sidewalk Date g - .2.- - O "2--
Inspector ' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL