Permit A,.. CITY OF TI OARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00055
1 DEVELOPMENT SERVICES DATE ISSUED: 2/10/03
,111. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102 BD -02600
SITE ADDRESS: 12925 SW PACIFIC HWY AMERICAN
SUBDIVISION: ITIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT : 037 JURISDICTION: TIG
Project Description: I
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: 1
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 2 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:
KIM, ROBERT + HAE LIM RTB CONTRACTING INC
1360 SW WOODWARD WAY PO BOX 80546
PORTLAND, OR 97225 SEATTLE, WA 98108
Phone: Phone: 206 762 - 4007
Reg #: LIC 148508
ELE 37 -687C
FEES SUP 4899S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/10/03 $168.60
[TAX] 8% State Tax 2/10/03 $13.49 Low Voltage Inspection
Elect'l Service
Total $182.09 Rough -in
Elect'l Final
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 - 332 -2344.
Issued By: _ 1Q 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:
ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: . I - �� �• DATE: 2 - /(>
LICENSE NO: G1
Call 639 -4175 by 7:00pm for an inspection the next business day
02/07/2003 04:35 2067624045 RTB PAGE 02/03
ElectddcalPermit Application n II I I( III I r 1, t ,
Alik _ Ftr—C=-WED
Dan received: , g 2eG.teo 3- 000SS"
t 'I , . City of Tigard ppp cct/appl. ..
of regard Address: 13125 SW Hall Blvdifed,ri sal Date issued: I + I I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598-1960 CITY OF TIGARD Can file no.. i :, type.
Laud use approval: BUILDING DIVISION _
•
I, Pt (li ri•.i ' i I
O t & 2 family dwelling or accessory peCamlmeroialinduettial 0Mu1ti- fstaily I I , t impf0Vement
0 Ncw construction 0 Addition/alteration/replacement 0 Other: n ' • 1
.IUIt 61 1 1: I \I 0R;;I ‘l IU\
Job address: 12925 SW Pacific Hwy Bldg. no.: • Suite no.: :. map/ • r, = mount no.:
Lot: 1 Block i Subdivision: (4'ac artivi b l - • P-'
Project name: I Description and location of work on premises: I net a 11 1 va amp feeder
Estimated date of completion/inapection: 2 branch a •' S
IIII 1)1 I.I
Job oo: 1Ka
Daatptloo I= Total minim
Business »> VY Contracting, Inc. , N - Reada :,
Address: PO Box 80546 dwelmdenIt ladadeaastarhed gnrnge.
City: •'��l'la Seattle li ��;;�� { State: WA ZIP: 98108 :
Phone: a s '(:p e i E -mail: 1000th 8. or lean J 4
Each additional son sq, ft Of P urine It _
CCB no.: 148508, Elec. bus• lie. no: 37-687C - Lmtindy, , I 2
City/metro lie. no.: 7 pl _ /0 /D, \ Limited energy, too resi I 2
Each manufactured home or m dinar doe I
Signature of atpervismg electrician (requited) Date Service and/or feeder 2
-
sup• deer_ name (pint): Dan Hale L ieense not 4899 S 8.1.1em O` erne —lam
altersdenormleentiom 1 Qo,3a gO�P
200 amps ar less 2
Name (print): V e r i Z o n Wireless 201 amps to 400 amps II 2
401 amps to 600 smas I
wiling address: 3350 161st Ave NE , 601 amps to 1000 amps „ I 2
City: Bellevue I State: WA I ZIP: 98008 over moms or volts I 2
Phone: iFax: I E-mail: Reconnect only I I
Owner installation: The installation is being made on property I own Temporary services crr feeders -
which is not intended for sale, lease, rent, or exchange according to 'O"
2
200 =Ps a ka
ORS 447, ass, 479, 67 col. 201 iiTE to 4011 amps I 2
Cnielt&S Date: -" 7rt .5 sot to 600 amp 1 2
Branch cheeks -new, alterative,
or extendoa Bela 3 )
Name: A. Fie for branch circuits with purchase �
Address: service or lbeder fee, etch , ;WO 2
City: I State: , ZIP: B. For hr branch circuits pu:. '
of service Of feeder Om. blanch -. 2
Phone: Fax: E -mail: Each additional branch I I
1'L,\ Rl :\ II \1 Ii'le :wr chrrI\ all that :illph I Moe. (Rorke or feeder lied deitk
0 Swine over 22s emps�m
marial 0 Hen care Sway Each pomp or irrigation cite . I 2
a Service over 320 annwatisa of 1&2 0 Hasp *+a location Each sign or outline lighting I 2
&may dwellimp u Building ova 10.000 mum teen /bur o r Signal cinvit(s) or a limited energy pone B ?�00 2
0 System over 600 volts nominal mote reatdernal units is one structure altemdan, err extension•
0 Building over three tears. 0 Feeder 400 amps or mate •De.cr)ed= , I
0 Occupant load over 99 persons 0 M6nu on
d structures or RV pelt Each addi8al Ioap edon otertbe 1 111 ' • nay of the above:
0 EPcagaiellin8 plan ID Other. Per inspection J I T
Submit _Retie of plain with any of the above. invealgation fee I:
The above are toot applicable to temporary coon service. Other I
Permit I`- • $ /�.
Not an itwIdletto., a audit amda pleat call jmisttk lawmen. don fbr morlawmen. Notice: This permit application � o
0 Vila 0 MasteCetd ragmen if a remit is nor obtained Plan nevi (at /o) S 9
c,edir mad number / / within 180 days antler it hart been State an ' � : , 93) $ ..5•Y
El accepted as complete. 'I OTAIL . $ $A.
Warmo err earenatdQ of shown on ared earn -
t
Cardholder alms + . Amount 4404615 (6/00/COM)
CITY_ QF TIGARD 24 -Hour • •
BUILDING ` Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION e — Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested AM PM BUP
Location /,- 9 a- s Pa--c-A /4<J7 Suite MEC
Contact Person 4 ' V Qdi z e--/ Ph ( co ) 3910 - b 4/ e PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC p2 "6 ■5
Footing _ ELC
Foundation Access:
Ftg Crawl D rain 110‘1 ( � \i , n11 p N9 ) 0.41f ELR
Crl D K IV !� /
Slab Inspection , + _ _�V_j�__ SIT
Post & Beam ¢ i / I — b
Shear Anchors
Ext Sheath/Shear r /I Qi — _�
Int Sheath/Shear
Framing )/11,1-:
�1�
Drywall ( ,A �1 (\.� , \ .1 -8 r T /� Drywall Nailing v\ �/ J
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
ELECTRICA
Service
ug -
UG /Slab
Low Voltage
Fire Alarm
'nab PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
E fl Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date _ .7 " l / Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the j site.
PASS PART FAIL
CITY OF TIGA3D 24 -Hour -
BUILDING r Inspection Line: (503) 639 -4175 — .
INSPECTION DIVISION — Business Line: (503) 639 -4171 MST
2 BUP
Received Date Requested 3 3 AM PM BUP
Location / a gas Suite MEC
Contact Person Ph ( .7010) 3 [ 6 - S I ID PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 6
Footing
Foundation ELC
Access:
Crawl ELR
Dr ain GEL 5 p /�
Crl Dr
Slab Inspection Notes: 0 SIT
Post & Beam
Shear Anchors 1/-0
Ext Sheath/Shear alin/I4AV .Q�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 7
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
*y'PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk DateR -- Q Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL