Permit CITY O F TIGARD . ELECTRICAL PERMIT
PERMIT #: ELC2000 -00679
tili, DEVELOPMENT SERVICES DATE ISSUED: 12/8/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104CA 03400
SITE ADDRESS: 13648 SW LAUREN LN
SUBDIVISION: HILLSHIRE ZONING: R -7
BLOCK: LOT : 034 JURISDICTION: TIG
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Project Description: Installation of (3) branch circuits
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: 2 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:
AVIS, RICHARD G + JULIAN NE OREGON ELECTRIC CONST /GROUP
13648 SW LAUREN LANE 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone: 234 -9900
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Rough - in
PRMT CTR 12/8/00 $60.15 2720000000( Elect'I Final
5PCT CTR 12/8/00 $4.81 2720000000(
Total $64.96
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This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY: / ✓ /rAV_�Zy
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
T0'd 1101
Electrical Permit 4ication
. 0= 0® Date received: Permitno.: etc „„ — opw
;11. i City ofTigard l� �A Project/appl,no.: Expire date:
City ofTi� st d Address: 13125 SW Hall Blvd, T1 �;H;,OR 9724 h` Date issued: ' By: Receipt no.:
Phone: (503) 639 -4171 'e
Fax: (503) 598-1960 �0 Case file no.: Payment type:
G p @S
Land use approval:
ME TYPE OF PERMIT
x so 1 & 2 family dwelling or accessory Q Commercial/industrial ❑ Multi - family i] Tenant improvement
CD New : onstruction ID Addition /alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address:1 3 48 SW La iron Lane _ Bldg. no.: Suite no.: Tax map /tax lot/accountno.:
Lot: Block: Subdivision: .
Project nlme:. , - it •_,; ,.n 4 �..1.1. ation of work on premises: add 3 ckts in Listening .
Estimate.d date of completion/inspection: S Room
CONTRACTOR APPLICATION FEE SCIIEDI11.
.lob no: Fee Max
.31957 Description Qty. (ea.) Total no- lnsp
Bus name: nr - pty)n F1 PrF ri r Grnt"p New m$debal -single ormufti-family per
Address: 1 al .. $F 1 1 tb As: - dw cUingenit- Includesatmchedeu'age.
Cityp0:r -1 a State: O$ .9 72 1 4 Service included: 4
Phonc :5 )3_234_99 (ft : I E -mail: l000 sq, ft, or less _
Each additional 500 sq. ft. or portion thereof
CCB no.: 2 n 1~lcc. bus. lie. no: Z 6 - 9 5C Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
_
12 -c -nn Each manufactured home or modular dwelling
Signature .4' supervising electrician (reouired) Data Service and/or feeder 2
Services or feeders — installation,
Sup. elect. name (print): n . . ,
• - License no e . alteration or relocation:
I'It OPER I'Y OW'N l ill 200 amps er less 2
201 amps to 400 amps 2 ,
Name (print); R i c� rd 8V i s • 401 amps to 600 amps 2
Mailing address: 401 amps to 1 000 amps 2
1 City: . [ State: I ZIP: Over !ono amps or volts 2
Phone: _ I Fax: I E -mail: Reconnect only 1
Owner u istallation: The installation is being made on property 1 own Temporary services or feeders
installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less. 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps '-
Owner's signature: Date: 401 to 600 amps 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
—
Address: service or feeder fee, each branch circuit 2
City: 'State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 1 4 6 - 85 2
Phone: Fax: E -mail: Each additional branch circuit: -
PLAN RINIEWI' (Please check all that apply) Mist. (Service or feeder not included);
O Service over 225 amps•commercial 0 Health -care facility Each pump or irrigation circle w 2
O Service over 320 amps - rating of 18t2 Cl Hazardous location Each signor outline lighting 2
family lwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O Systerr over 600 volts nominal more residential units in one structure alteration, or extension" 2
O Buildit.g over three stories O Fccdcrt, 400 amps or more *Description:
O Occup: Mt load over 99 persons 0 Manufactured structures or RV park Each add inspection over the allowable in any of the above:
O Egress lighting plan 0 Other: Per inspection I l 1
Submit sets of plans with any of the above. investigation fee
The above are not applicable to temporary construction service. Other -
Permit fee $ 60 . 1 5
Not all ju /dictioept credit cards, please call Jurisdiction for more information.‘ This permit application
n k
O 'Visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $ -
Credit card Dumber: / / within 180 days after it has been State surcharge (8%) .... $ 4 - $
Expires accepted as complete. TOTAL $ 6
N,. a of cardholder as shown on credit card
S
Cardholder signature Amount _, 3 oao-A615 (6100 /COM)
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TO /T0'd S0 :0T 000E S0 –J31
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested �' `'�° AM PM BLD
Location / 3 G q y Set/ La aYLY% "'"‘ Suite MEC
Contact Person 1-apt r4 h, Ph 535= 2 4 7 r PLM
Contractor tiraj Ph 7,3 S7f/ • SWR
BUILDING g � � �. r • Tenant/Owner
ELC '00 G 7 ?
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:
Final
PASS PART FAIL ` /0
PLUMBING •.. . _
Post & Beam
Under Slab
TO Out
Water Service
Sanitary Sewer -
Rain Drains
Final
PASS PART FAIL G� / )1
NIECHANLCAt= ,,; . >,' /
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
F Alarm
PASS P RT FAIL
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 /
Other D -2 6 / Inspector .. I . 1 ■ V � E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.