Permit •
4 - (s CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00548
DEVELOPMENT SERVICES DATE ISSUED: 8/26/2004
` 1 t 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2S 1126C -LP001
SITE ADDRESS: 08092 SW LEISER LN
SUBDIVISION: LEISER PARK ZONING: R -4.5
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Temporary 200amp service.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI 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: 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:
LEGEND HOMES GARNER ELECTRIC
12755 SW 69TH 2920 SW 247TH AVE #A
SUITE 100 HILLSBORO, OR 97123
PORTLAND, OR 97223
Phone: 503 - 620 -8080 Phone: 503 - 648 -4552
Reg #: LIC 121159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/26/2004 $66.85
[TAX] 8% State Surcharge 8/26/2004 $5.34 Rough -in
Elect'l Final
Total $72.19
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 -000-3 ,, 344. //
Issued By: 4. I -ALI /KIP Permit Signatu .:
Nor
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
I
10/10/2002 04:32 6427925
• r PAGE 01
v,I'T =iii• '. art %• f - ,W.•:1, . r - ..
El P A li EIVED . • FOR OFFICE USE ONL V ,,/
•
City of Ti gird �' • • - '' PennkMCI; •
^ Of) • • D 4a ?l
131 SW Nall Blvd., Tigard. OR 97223 1- I ' 4 Phan Revie , Other Permit:
Phone: 503. 639.4171 FaX 503.598.19 - •,...,-, . `4F * l
- inspection Line: 503.639.4175 CI' Ready/By: ��;C� ® Sir Pace 2 for
g 4 , • - .. it See tor
Notsfed/Metbe
Internet: www et tlgatd BUILDING . -,t';':''' �, ►
. r rP 14 7 , f 7 I ] I I /1 I I r1 tu rAd. d ' i a'i� F,� c '', �!^ ' I 1 ,1,'.. -'01'7 � 4t a4.r. 1,(ia
4 l i 11 t c, I ' r , e <u 7T .,w
'''''''''''/'' ' c � z f 1 i F ,. c. l , , �,a . 4 t.>!..,.;. it �� �S�r..,i ^ : � ,.: �t,� s �� �. ,.t.�.tuit �
'� �'. '.,a..,dz
. Please check all that apply:
PI New construction ■ Addition/alteration/replacelnent .. ❑Service over 225 amps, Gomel ['Hazardous location
■ Demolition Q Othtr ❑ Savice over 320•antps - rating ❑Buildng over 10,000 sq. ft..
,' � i3 ,:' H I '',1',"('-'.1.1 '' v I { "k ; of 1-and 2-family dwelltn 4 or more new residential
Y •' I r
ir °It.''' : ,v . S..i11i1I H
(J, S � '‘,4;';‘,",;.:';'!';.,-;.'
L 4 1 11 _
. � ?.._ 1 "..Le. i....:. •i( i_
, vu,..i,lr
C ommercial/industrial . ❑ Access building ❑ System o 600 volts rtontinal touts in one stricture
Q 1 - and 2 family dwelling ❑ �' g OBuildinB over ver tb ec scoriae
['Feeders, 400 amps or more
❑ Multi - family • 0 Master builder ❑ Other: • ❑Occupant load over 99 persons )]Manufactured structures or
, .2,/,:,: 0 gte � g P RV park
,.:; � t ` .. + ... I Z �y 1, "� • [ I ' �� t l rv : � � �l � i. r „ t l S ICI L .:;;,1:':',', ';'! i 1��I + : � { 11.1: l' IV . � .li }b tm Plan ['Other
.._ .. ❑rltffilth�:are facility
Job no,: Job site address: 7001 Z ,s 1 - ` _ r LP" - Subndt sets of plans with any of the above.
City/State/ZIP: r ,
The above am not applicable to temporary construction service. .
/ D - 4T._,.uf �. ': ti�:e� :!J SIB 1 119 h .!i p y1
.Suite/bldg. /apt tto.: Project name: • De ecipden Qty. Raw Tool Nil
Cross etreet/directlons to job. site: New residential single- or multi- family dwelling unit • Includes attached garage.
' 1,000 sq, ft or Zees 145.15 4
Subdivision: Lot n0.: I Ea add'l 500 sq. ft. or portion 33.40 1
• l hrrited eu residential 75.00 .- 2
Tax map /parcel no Limited energy, non - residential • 75.00 2
• ,,,,. ' I + ••,'i, } 1 'K l r IT ( 1 II v 1
j t [ i !�.■11 , j I tii r', �I ' I T F r 1IiMi `r, 1 ■ : . ' :, Each ffc
manu ttired et modular
. _ _ ,, . . 90.90 • 2
dwellin s ervice and/or fet:der
- - ∎ or - . `, , Services or feeders installation, alteration, and/or relocation
200 antes or less 80.30 • 2
,I r r , 2 T" , 2U a l trip tos 400 amps
. .
106.85
':. ,\rl lI , 1 71 e r ilE tr ' l'••:;.'",'1:!,1,,:: t ! t' -'J' , �f I �1 - =''' ,k}, t 411 y ':': f)''' . , E SIi: i7 2. . .!�, ' '
n. • ,, w .. . Jr 1 401. amen to 600 antes 160.60 Ell
Name: - -_,ad ti f o '~ 601 amps to 1,000 antes 240.60 2
Over 1,000 amps or volts 454.65 2
Address:
Reconnect on 66.85 2 • ' City /State/ZIP: ' Temporary services or feeders Installation, alteration, and/or
• relocation
Phone: ( - ) Gr 20 - 0 g0 • Fax: ( ) 200 amps or less '' 66.85 1. ja ' 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: Date: • . Branch circuits - new, alteration, or extension, per panel
.ii J ( jit \1.•S�, t ' ' 1 I F IItitS ,. , 1 j � S . ,. I ' } .l �., I ,, It + . 1 1 ' I:i? 1 • ._ , I , P• r 1` 1; -1 ( ` l r S + I� ' ir,4 J A. Fee Fea for branch Circuit° wills
.u. , , it..) ._.
! 2.11- .. . . ■ .
,. C 1 r.,._Z service or feeder fee, each
•
Business name: branch circuit 6.65 2
an
B. Fee for circuits
Contact name: • wtLhovt service or feeder fee, 4615 2
• Addreae: - each branc circuit •
Each add'l branch circuit 6.65 2
City/Stet /ZIP: Miscellaneous (servtceor feeder not Included)
Pump ar irrigation circle 53.40
Phone: ( ) $ax:: ( )
Sign Or outline lighting • 53.40 . H
E • Signal circuit(s) or limited -
+ , I + f I ^ 1ji / 1 . .. t S ti ' r. r v i I,J.t' i ii l i il '': l ik . i t . ; 1u1? 'tUr i I . =mei panel, altcrab0n4 Or
extension. Describe: Page 2
Address: • GI . 7U s J y • ' ' '+ A r • 4 4 Each additional Inspection over allowable In any of the above
JR Per inspecti 62.50
• City /State/ZIP: - t 1 tr 0,-0 C' }� e'- -' "7 I c am,,,. Investigation per hour (1 hr min) 62.50
Phonc: ( 5. ( vi S k . EVIVrAINEIMIEffill Industrial plantper hour 73.75
IMEEnEnal Electrical Lic.:? 4 Subtotal i b. 7
Suprv. Electrician sfgnatdlre, required: .7� /%` Plait review (25% of permit fee)
Print flame: ., • . - Date: / _ State sttreh�ge_(8% of perntit_f ee)_ • - - t5 ^-4 `"1"
' ?t1t �� G C _ . l �1 �O TOTAL PERMIT FEE ---2 , C e3
Authorized signature: Thu permit application expire, if e permit le eat obtained within 180
• Print nams: D ate: Fee met bod doll attar It bag bean accepted ar complete
oloey sat byTti -COLmry Building Industry Setvico Board
'• Number of inspections per permit allowed. •
c18Yi1dwalAanhgzELC44maeA5pdoe 12103 • 4`0-K15't(I M1WE9
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 1503) b39 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date quested ' -? AM PM BUP
Location 9 • U 1 Suite MEC
Contact Person /. Ph ( ) o' — 3376 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner
WOW. 4 0 ■ ELC X00
t _.
Footing `- 4 ELC
Foundation Access:
Ftg Crawl r D Drain
p N IT �) ` ELR
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
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 4.1
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
'ICAO
e ,
-In Z
Rough f
UG /Slab � U
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
- Fire Supply Line
ADA 07A Approach/Sidewalk Date y Inspector Nia. Ext
Other:
Final DO NOT REMOVE this Inspection record fr m the job Ito.
PASS PART FAIL