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Permit C ITY OF. TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00453 DEVELOP BENTSERVICES (03) 639 -4171 DATE ISSUED: 7/25/03 13125 SW ITigard, PARCEL: 2S112CB -13300 SITE ADDRESS: 14896 SW KENTON DR SUBDIVISION: ASHFORD OAKS NO. 3 ZONING: R -7 BLOCK: LOT : 142 JURISDICTION: TIG Project Description: JOB NO. 1886 Wire NC and add GFI plub 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: 1 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: EKBERG, TIMOTHY L + LILLY M HILLSBORO ELECTRIC 14896 SW KENTON DR 21185 NW EVERGREEN PARKWAY TIGARD, OR 97224 HILLSBORO, OR 97124 Phone: 503 - 684 -5092 Phone: 503 - 439 -9666 Reg #: ELE 34 -433C LIC 134481 FEES SUP 4240S Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/25/03 $53.50 [TAX] 8% State Tax 7/25/03 $4.28 Elect'I Final Total $57.78 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: Q Permit Signature: / 1? 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 FromfHILLSBORO ELECTRIC LLC. 5036013680 07/24/2003 12:57 #154 P.002 Eiectricai PermitApplication _ 11 I til 1 \l , n /� bate received: Permit no: ' ,..a1S1 -�• =_, � Tigard 1'ro ect/a 1. no.: City of 7 Address: 13125 SW HaIl Blvd, it i OR 97223 Date issued: Phone: (503) 639 -4171 BY: Receipt no.: Fax: (503) 598 -1960 gut_ 2 4 2003 Casa file no.: Fitment type: Land use approval: - - “-rV n F TIGARD m at • - ,_• -,avert N 1•1 rl•. of I'IrR;Nll l }(1 & 2 family dwelling or accessory D Commercial/industrial D Multi - family D Tenant improvement D New construction CI Addition /sIteration/replacement CI Other. C1 Partial .1UIt Nil I. F\1•1/11 1,j 1Y). • • Job address: ' , w - A Bldg. no.: Suite no_: Tax ma ' /tax lot/account no.: Lot: Block: Subdivision: Project name: Description and location of work on premises: , 4 ,,, 4- °t , ' r Estimated date of completion/ins a - ctiotr �` � ' ( \1' t2%CrOH I'1'1.1(.kI • Fir S(Ill !)1 1.1. Job no: / . Business name: Hi _ s b o r• El e c t r' LLC Aestsi� d oe Qty. f Total F Address: 21185 NW Ever • re en PIN' Ste C� Nowrvatdentrad. roe per : I � _ .. • �� dnenh�lmiY.lnclodesa�bN�arage, rJ+i:�el.;! ZIP: 97124 Seevicelnelodad: Phone:4 39— • • 6 6 Fax6 0]_ 3 6 8 0 1 -mail: 1000 ft or l 4 CCB no 134481 Elec. bus. tic. no 3 4_49 9 C Each additional 500 a._ $ or .. 'on thereof �� — City/ afro tic. alp,; Limited energy, residential _�� ' Limited en- ;r non - residential �_ 2 -- Each manufactured home or modular dwelling �� 3t rviain. electrician .yam) Date Service aecVor fader 2 Sup, elect name (print): JO - V i 0 License no: 4941 S Services or 6Wera- lmptlletion, P[tOM:R 1 011' \1U It . 20.0 Hoaor rooea l4 eat .1 200 amps or less Name (print : 201 am.. to 400 am. MIIIIIIIMIIII 2 Mail'. • address: 401 am• . to 600 ..s M1.1 Got .. to 1000 amps City: State: ZIP: Over 1000 : or voles 1111111 Phone: Fax: E -mail: Reconnect on! 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 insrtallafiae , alteration, orrplocetSou ORS 447, 455, 479, 670, 701. 200 amps or less 401 am ••: to coo em.: Owner's si : : ture. ME__ S Date: _ 401 to 600 am. )a',' :: . v .._. :'I .N(,1NI,I.R.. . ",; i:, ..t , a' ', ., . Breach circuits - new, alteration, Name: or extension par pariah Address: A. Fee for branch circuits whh purchase of service or lbeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase Phone: lax: E -mail. of service or /bade fee fist branch circuit ©� 2 Each additional branch circuit rsr r: ' S'S% i(!''1 11' I1' (florist check' :all thin :apish) Misc. (Senice or feeder uotinMadeo: Ill 0 Service over 225 amps- oommetrelal 0 Health -gate facility Each pump or lard 'on circle 2 0 Service over anrpwating of 1&2 0 Hazstdous location Each sign or outline lighting 2 0 Building over 10,000 square that four or Signal ainuit(s) or a limited energy papal, 0 System OVER 600 voice nominal moat residcnriel units in one atmu state alteration, or ablation* 2 ❑ Building over three stories 0 Feeders, 400 cups or more 0 Occupant bad over 99 persons "Deaari.tiop: _ 9� 0 Manutbctured structures or RV patio . -• —. 0 E ess/lighting plan ' 0 Other Each additional laspectlon over the allovta6le is arty oftlr ah•vet Per inspection Submit sets of plans witb any of the above. Invesu_ : 'on fee The above are not applicable to temporary conafructlost service. Other /49.411 jurisdictions accept credit cards. plasm call jurisdieden For more Information. . Notice: This permit application Permit fee $ j'3. 5 Visa ❑ b tsacetcare expires if a permit is sot obtained Pl review (at ^ %) $ ----„ Credit card aumber. / / _ Within 180 days Mier it he been _ State surcharge (8%) $ e tutees accepted as complete- TOTAL s S ? Name or cardholder as shown on credit oar S Ccrdh r e goetute Amount 4140-4619 (6/0WCOM) CITY OF TIGARD 24 -Hour • BUILDING Inspe;.tior*.Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 7 I AM PM V BUP O q Location � � b / � f Suite MEC C s 3 VQ V �e Contact Person gie Ph ( ) PLM Contractor / Ph ( ) R 7 7 9 SWR BUILDING Tenant/Owner - � 140/-<-, i5 &D E r� 1 ELC , / Footing ELC - 7"S-3 Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam • Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing • Insulation Drywall Nailing. �;�,, �1 fir, A , Firewall Fire Sprinkler �� "� > �/ � �►J` V' �. y N _ �l ►�t/�:11 '' ° " Fire Alarm Susp'd Ceiling Roof Other: • Final PASS PART FAIL PLUMBING _ Post & Beam Under Slab Rough -In , Water Service Sanitary Sew er Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final N T FAIL Post & Beam Rough -In Gas Line Smoke Dampers T FAIL LECTRICAL Rough -In - UG /Slab Low Voltage Fire arm - Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. - PART FAIL SITE ❑ Please call ft reins:ection RE: El Unable to inspect - no access Fire Supply Line ADA ' Approach /Sidewalk Dat4b Inspect'' ;AI _ _ _ AL • '� Ext Other: Final DO NOT REMOVE this inspection record fr m the ob site. PASS PART FAIL