Permit CITY OF T I GARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00642
DEVELOPMENT SERVICES DATE ISSUED: 10/20/03
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171 PARCEL: 2S102BD - 00701
SITE ADDRESS: 12785 SW PACIFIC HWY
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: C -G
BLOCK: LOT : 008 JURISDICTION: TIG
•
Project Description: Instal 15 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: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
SPADA, FRED TRUSTEE BECK ELECTRIC INC
WIENER, NORMAN J TRUSTEE 9318 SE CHURCH ST
72907 BEL AIR RD CLACKAMAS, OR 97015
PALM DESERT, CA 92260
Phone: Phone: 656 -7396
Reg #: SUP 1326S
LIC 00002629
FEES ELE 3 -5C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/20/03 $139.95
[TAX] 8% State Tax 10/20/03 $11.19 Rough -
Elect'l Final
Total $151.14
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 -800-3 344.
I ,
Issued By: � ��> Permit Signature: 0— N �c
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
•
Oct 20 03 09:12a beck electric 503-658-4397 p.2
,
` Electrical Pe:ranit A 1 1 lication
�,.. rrl^
t. R C ( I v C U Date received: ao 0-3 Permit no.:, , '
Y'x , '1l1t. City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall 131vd,{ (g rdp L1 Date issued: G`1 Receipt no.:
Phone: (503) 639 -4171 1Y4�)MM uu
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval: _ DUILDI NanIVISION • ° `' i. . , . TYl'E 'Oh'l'ERMIT '` Y " ;.,� ":'
❑ 1 & 2 family dwelling or accessory XI Commercial/industrial 0 Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
I n C ORS•'
f � i t , wt N '' ` JOI35 ' CI . .. l, lATlulf .``. •. . il i
Job address: /a."72.5 64.t..) W a C _ LC if C uy Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: !Block: 1Subdivfiion:
Project name: I Description and location of work on premises: /-S CI-TS
Estimated date of com.letion/inspection:
CONTRACTOR APP.ICATION: :., • . FEE SCHEDULE;' a' ,a n ;
J ob n 3.73 Fee Max
Description Qty. (ea.) Total no. rap
G /L r
Business name: 7p c � l
L yi
j /!� New tesldendal - single or multi-family per
Address: 7 a / tJ C Gj1„!_C 1'C.� dwelling unit Includes attached garage.
City: C /QGke. m aS j Slate:(g � ZIP: ► S Serviceutcluded:
Phone: (pa - 7�jL I Fax: (0S(, 39 7I E -mail: 1000 sq. ft. or less 4 ft
Each additional 500 sq. . or portion thereof
CCB no.: °2lot2ct Elec. bus. lic. no: 3 -5C_, _ Limited energy, residential 2
City /metro lic. no.: S ?S S Limited energy, non- residential 2
I 20 8 Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): (:,fk4v US 'Bet 4.1 t1 t License no: 5oaS -5 Se rvices or feeders – installation,
alteration or relocation:
. YROPERTY'O% 200 amps or less 2
201 amps to 400 amps
Name (print): (�iVtD� hl t
S 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: 'State: 1 ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is beitig made on property I own Temporary servlcesor feeders -
which is not intended for sale, lease, rent. or exchange according to Installation, alteration, urrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701 • 201 amps to 400 amps 2 ,
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: I .date: • 'ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: I t bk$ 2
Phone: Fax: E -mail: Each additional branch circuit / 4 c..ma '73 a O
• • PLAN REVIEW (Please eh Misc. (Service or feeder not Included):
0 Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 H:iza douslocation Each sign or outline lighting - 2
family dwellings 0 Building over 10.000 square feet four or Signal circuit(s) or a l i mited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description: -
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan Cl Oher. Per inspection I 1 I I
Submit _ sets of plans with any of the above. Investigation fee
• The above are not applicable to temporary construction service. Other
PermitTee $ i39.9S
' Not all jurisdictions accept credit cards, please call jurisdiizion for more information Notice: This permit application P lan rev (a[ — %) $
O Visa O MasterCard expires if a permit is not obtained
Cre.a: card number: I / within 180 days after it has been State surcharge (8 %) .... $ / / '
expires TOTAL as complete. TOTAL $ / S/ . / t 1 /
Name of cardholder as shown on credit card
4 _ s
Cardholder signature Amount , t 440d615 (6V0(COM)
11/2/2004
Case Activity Listing 1:31:09PM
TIDEMARK Case #: ELC2003 -00642
COMPUTER SYSTEMS. INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
ELCC001 Application received 10/20/2003 None RECD FAX 10/20/2003
BB
ELCC003 Permit created 10/20/2003 None DONE BB 10/20/2003
BB
ELCC775 Rough -in None 10/20/2003
BB
ELCC799 Elect'! Final 11/4/2003 None PASS HFY 10/18/2004
RB
ELCC500 (F)Issue permit 10/20/2003 None DONE BB 10/20/2003
BB
ELCA920 Miscellaneous action 10/30/2003 None DONE HFY 10/30/2003 I stopped by wend'ys to check on
HFY wiring that was done on 10 -19 &
20th of this month, It was done by
Beck Electric, I have an appointment
with Becks supervisor for Nov. 4, to
inspect the wiring.
ELCC800 Case Finaled 10/18/2004 None DONE RB 10/18/2004
RB
Page 1 of 1 CaseActivity..rpt