Permit ELECTRICAL PERMIT
._QI Y OF TIGARD
DATE PERMIT SU C 1 4 / 9
DATE ISSUED: OS/14/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 1 S 136DB- 0`803
SITE ADDRESS...: 11812 SW PACIFIC HWY
SUBDIVISION ZONING:C —G
BLOCK • LOT
Project Description: Installing one 200 amp service and 5 branch circuits
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 — 200 amp 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 1 W /SERVICE OR FEEDER: 5 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 800 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
RICK KINDG TRI MET type amount by date recpt
710 NE HOLLADAY ST PRMT $ 85.00 B 05/14/96 95- 279348
5PCT $ 4.25 B 05/14/96 95- 279348
PORTLAND OR 9732
Phone #: 239 -2100
Contractor:
H & H ELECTRIC $ 89.25 TOTAL
PO BOX 30868
REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Elect' 1 Service
Phone #: 503 -253 -0425 Wall Cover Elect' 1 Final
Reg #..: 50449
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other P - i t t - e 4WD
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started OF
within 180 days of issuance, or if work is suspended for more (91/l ItAki i -
t 180 days. Issued By
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 : CP/L O ( DATE: S V
LICENSE NO:
Call for inspection — 639-4175
05/13/96 08:30 12503 684 7297 CITY OF TIGARD R1001/001
Community Development ELECTRICAL PERMIT APPLICATION
iiii 13125 SW Hall Blvd.
Tigard, OR 97223 PIanCWRec. #
Permit # ESC 1(o -0.52- r "II' ' ,. Phone (503) 639 - 4171
FAX (503) 684 - 7297 Date Issued 5 - 14 — 6 1(0
CITY OF TIGARD TDD No. (503) 684 - 2772 Issued by 1g . �� u Q a l 1--
Inspection (503) 639 -4175
1. Job Address: l44 / S Pez ( n 4W ) 4. Complete Fee Schedule Below:
Name of Development /1 c►h r�l J , rL s /VU� t j Number of Inspections per permit Mowed —
AddressS,t�, PA H t C1IUI ACl£$C Service included: IDims Cost(ea) Sum
^�
City/State/Zip 1 1571.4 ( OR 4a Revidentisl - per unit a
• AA 1000 .q. it or Ni 1110.00
Name (or name of business) /I^ I - Ms,-1— East addalemr 500 op. h' or
pardon 01n.41 coo) 1
Commercial A Residential ❑ Lir^"i0 &lava. 125.00
— Each grad I. or Heide 2
Omar" Bans or Nader moo
2a. Contractor installation only: 4b. or Feeders
Electrical ontractor t �� d�wrwn. man. ar �roon 2
doa
Address O �N[ . 201 t a 400 mega UM � d' 2
City States e , a,ip= WI ants 1a 500 wpm s120,00 2
001 amo. b 00 10 amps stem 2
Phone N. 03-. 5�3 - Oy,,t,S - Omar 1000 ants arvela :mom 2
Contractor's License No. 9- 9 3 C A �`"+a a'4 $50 .00
Contractors Board Reg_ No_ yy 9 Temp Services or Feeders
7 1
Thelon, alrearbn. or ralomien 2
Signature of Supra Elec'n f i t , ( 200 am or l as 1s0.00 2
License No. R / 'ri �J .S / On NO Ti - 0%IS 201 amps ID 40o annoy $7500 2
101 amps 0.500 wipe $100.00
Omar e00 amps to 1000 vets
lb. For owner installations: oao 'I
Print Owners Name 4d. Brands Circuits
No.. styrene or mansion p• porrd
Address a) 7ls tae or wards titans arm
City State Zip purchase
nn%I s�rsrllewyr S5.00 A . S 00 2
Emil Phone No. _ by The we far brwth wiz swim
The installation is being made on property I own which is pertriar a moire or WO. ISO. 2
not intended for sale, lease or rent F"' tram ovum OO 2
Ee■ir.dd.iared br.dr circuit 15.00
Owners Signature d.. Il I.cdlaeteou.
C included)
3. Plan Review section (if required): r P or �o 2
Earth so*, , or warm fglaing �' $40.00
tiynal aircuit00 or a limited snow 2
Please check sppropriste Item and cedar I.s in asclbn 5B. paid. Menzies or amnion $4000
4 or more residential units in One structure ,vivo. Latino (10) 5100.00
Service and leader 225 amps or more
-
System over 600 volts nominal 4f. Each .didonel inepectien over
Classified wee or sb ours containirl0 special acupunoy the a1 olrebte in any o/ the above
as described in N.E.C. Chapter 5 Par i won 535.00
Per Neu 16500
—
In Plant 555.00
Submit 2 eats of plans with application where any of the reeve -
apply. Not required for tempdnry cottednretian aartrioee. 5. Fees:
NOTICE 5a Enter total of above tees $ S . OO
5% Surcharge (.05 X total Teas) $ •
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal s 8691:o
rJ °�
56. Enter 25% d fire A for
AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (See.3) 5
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal 3
COMMENCED. ❑ Trust Account a
:
rte, r
i To: To Y•A V0 J yv +-( .
14 e- H max wr i�G� T .
rAx r:Z3- O_! FNt r: (o5�- � r: 634 -.!44.7.7
■
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /*P- PG C. /44) Vk Suite MEC
Contact Person Ph PLM
Contractor 4+ IA- au_ Ph 2S3'0 a S SWR
BUILDING Tenant/Owner ELC 9(0 -CO 2
Retaining Wall ELR
Footing
F FPS
Foundation NOT REQUESTED
Ftg Drain
Crawl Drain FOUND DURING RESEARCH SGN
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam Me- v iGe- - $ b 14Ylch CA7C .
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING EXPIRED Post & Beam '2'
Under Slab �� D /27
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
+_-46EUDD=
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
• ASS PART FAIL
SITE
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 Date
Other f1 2 I nsp ect or 7 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from t he j site.