Permit •
•
F ~ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00087
A DEVELOPMENT SERVICES DATE ISSUED: 2/21/03
FBI II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136DB-02502
SITE ADDRESS: 11634 SW PACIFIC HWY ZONING: C -G
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: W
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: 2
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: 0 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 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:
FRED NACHTIGAL TICE ELECTRIC
& JULES E. KESSLER PO BOX 15009
101 SW WASHINGTON ST 2139 SE BELMONT ST
HILLSBORO, OR 97123 PORTLAND, OR 97293 -5009
Phone: Phone: F- 231 -3372
Reg #: 2013-8801 .166
SUP 2586S
FEES ELE 26 -126C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/21/03 $53.50
[TAX] 8% State Tax 2/21/03 $4 Rough -
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 -806- 2 -2344.
Issued By: � , , + , , l Permit Signature:
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: $� C
Call 639 -4175 by 7:00pm for an inspection the next business day
02/19/2003 15:16 503 -872 -8290 TICE ELECT.SERV.DEPT PAGE 02
i0/10, /O(I. TUE 08:00 FAX 509 598 1980 CITY OF TIGARD %Jour. .
•
- . • Electrica 1 r PPUion cat - •
` J t ) Datereceived;7 -. J - 03 Permit no.: X03 •-• 0,1.. �1
.!!,L ..,I I
w ,; {; 1 , Qty 0 • v , ji i ` ProjrsUappL Expire date;
•
City of Tisaed Address: 1 . Hall Blvd, Wtkill. OR 97223 Datelssued: Receipt no.:
Phone: (503) 1 9 Case file no.: Payment type:
Fax: (503) 598-19W 1\G PRD
Land use appr:l Of D � �l \SV DN
1I l'E 01: 1'1:10111' '
1 0 1 & 2 family dwelling or accessory a1 Commereisl/ladustrial 0 Multi- family 0 Tenant improvement
B1 Addition /alteration/replacement CI Other. _. 0 Partial
0 New construction . •
Jolt S1 I12 INI -OIt1IATION •
lab address: 11634 SW. Pacific Hwy Bldg. no.: Suite no.: as map(tax lot/account ro.:
Lot: J 13 loot . I Subdivision:
. • Project name: Subway Sarldwicl'' s I Description and location of work on premises: Wire 2 - circuits to roof ar
Estimated date of compledonii , • -• . • : 2 21 03 - for new si • -
l;()N I ItACIOIt ,11'l'I.l(A1 ION . 1'I•.1% St:111:11U1.1; • .
Job do: ' 99.7271 • • ay ,g
•13usinesrname: - . Ilea .►.n!:!I - eiagioorsaatddatatbPer
.4ddrea Del 1:10., 15009 dwelUneuelt .lndndtsiettebeeptKe.
City: _ State: ; . 00 •. & blue .
ZIP: . .. D seniceindudat
P4onr: • _ • F I - - 1 t : : • t 10
�„ = ' • I' lllllllllllll � �
RP.: ' Eaatial �
ate �ry /• • lip - n..: 204 3 , con tesi
- 'ytr 2/1.9/03 Eaohmaaa - - •hams or •••vlardwtlling
• Se+vice feeder 2
Simi re lain: e lecgtCiam i r. , ulad ° - Mika ccCecina tnstatlatloa,
Sup. elect. rtarPe( dill): O A V - . •u - . • : • alteration orrsle adno:
' 1'Lt0I'1• 11 (11ti NI It :. • 200. • orla® NM 2 . .
Name (.tint)' t;1 ti ito 400atrhps - -
• • • ••••••• 401 amps w600amys
Mailipg address:. _ • 601 amps to 1000 amps • 1111
City: State: ' 12IP: over 1000 Amps or volts -
• Phone: . {Fax: ...IF: - snail: Reeooneetooly MN MEMO 1
Owner lnstallalion The instal is bei made on property I own Temporary ardour or feeders-
4rsbdlatioo, attersaah evreloradare
which is not intended for sale, lease, rent. or exchange according to
200 amps or loss
ORS 44 7, 455, 479, 670, 7 201 amps to 400amp!
Owner's signature: Data: 401 to 600 am • Mil 2 •
ENGI:NEL'lt Brace cults-nett, rat • •M
• • or •era aioa par posh 46 •
Name: A. Fee for branch eiratlu with purchase of
Address: service or feeder foe, each branch drams
City: • _ State: • 21P' t3• pas
oerrl or first branch cirewt: 6. ill'
.
C. . , Fax: . •&snail: Emit ado - caul branch drewc NM
. -FLAN ItLV11:w (I'Ica,c.tuck ;tit ilia c appll). . tribe. (Scribal orfnderabt lath . -•)t •
0 Stri is over 213 amps comaiatsial Cl He.lth ea+e tiding Suit putmp at initatloa crone •
' O Service over 320ampPrutinaof 1&2 • 0 Ilah:ardousMartian Eadhai • or0Ilinal biro. 2 '
famlydwelilnts 08gtldlag ever 10,000 armors feet Wrist Sunder reoit(a)oralt∎ahcdenergyPanel.
O Sunsmover voila nominal more reridemial134118 III taxstructure alteration, or extansion' l
O B•uildingovereater stories G Feeders, 40Daarpeor •Dnceiptie a �..��.
I O A:cuparet loud over 99 perm). 0 Mimi twured itruatuns or &V pork Fitt, OddNsenal Igq•ectloa •..r di. alknable1a any of the abort:
• J hiforsailu$t 0 • 1• eri aapodtoo -
r� J • Submit theta of pleas with any of the above. • hweetliadoa fee
The above are oar applicable to temporary coAStractloasturNee. Otter
ma e.:t )arisdimonh aoaig credo cards, pwe eon jurWdceioo fa mars laramacoe. Notice: This permit application Permit fee .. $ 5.3...50__—
0--.-
ez ass if a it is not obtained Flan ttsvlow (at _ 96) $
t number: `` 4910 0014 6247 / 01'` within 180 days alter Ithas.been
..:1' _ ; :. « State surcharge (8af) ._ .. $ 4.28
a accepted as complete- TOTAL $ 57.78
.
57.78
AtaauMM 444461: tom- mi
CITY OF TIGARD 24 -Hour
BOLDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested O AM PM BUP
Location 1I ta3 izote-zi-e Suite -°� MEC
Contact Person Ph ( ) 3 �{ I - / 3 i PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner l�l� ELC 3 - 006 g l
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
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
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage •
Fire Alarm
ASS PAT FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE I=1 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date , 1 a 3 In s ect � Ext
Approach/Sidewalk P r
Other:
Final DO NOT REMOVE this inspection record from t Job site.
PASS PART FAIL