Permit ,CITY OF TIGARD -.r =' ELECTRICAL PERMIT
rf PERMIT #: ELC2003 -00005
AJJ, DEVELOPMENT SERVICES DATE ISSUED: 1/9/03
I
•
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 102 C B -02 300
SITE ADDRESS: 13200 SW PACIFIC HWY
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING. C -G
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Install 2 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:
PACIFIC PROPERTIES GARNER ELECTRIC
BY MARTIN JOHNSON 2920 SW 247TH AVE #A
13200 SW PACIFIC HWY HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Phone: 503 - 648 - 4552
Reg #: LIC 121159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/9/03 $53.50
[TAX] 8% State Tax 1/9/03 $4.28 Rough -in
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 - 2344
Issued By: .. Permit Signature: 6`2 -e-pel -/4e
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: , 1 / 4 4 DATE:
LICENSE NO: .. ?X'7 • S
Call 639 -4175 by 7:00pm for an inspection the next business day
02/19/2001 00:57 397 -9022 DOUG MOBERLY PAGE 01
- ' tea.
Electrical Permit Application
44th Date received: t y —a-3 Permit no. Lf .X,i Oq (
-• ii 'i 11 CitY of = Y ar E C E I V E D pro ed/appl. no.: Expire date:
Ciry ofFlgarf Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: r/) I Receipt no.:
Phone: (503) 639.4171
Fax: (503) 598-1960 I JAN 06 2003 Case file no.: Payment type:
Land use approval: CITY OF TIGARD -
- 11 , I ti
111'1: OF 1'12AlI I
O 1 & 2 family dwelling or accessory XCommerciaVrndustrial ❑ Multi - family 0 Tenant improvement
CI New construction 0 Addition /alteration/replacement CI Other Cl Partial
Job address: I 2_0O ,51.%) Pa Cw r llt.Q • Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: Description and location of work on premises: 120 -✓ 20F1 Grp; •f-
Estimated date of completion/inspection: 4 e r Li gent rt Ci r c w -1-• t,,,r
Job no: Fee 1
Business name: � 1 VE I �I L C i /--• f � rlr-��yy / C r Newtesid�ial- ehtgloor p imp- tntt� . (ea.) Total no. bap Address: g20 (V 4..4.17Ham• ✓e.# = dwelling unt . Includes attached garage.
City: as /r State•i 0 ZIP: 7 . ' Servlcehtdluded: •
Phone•/' >- ' 562 Fax:, _- W..4, - Wait 1000 sq. & or less 4
CCB no.: /21/ 5 Elec. bus. lit. no:34 -30
Each additional or portion thereof 2 ,
Ci m • • lie. no.: v y Limited energy, non-residential 2 '
17�J J / 6. Each manufactured home or modular dwelling
r,.�rr} .� %r ! _required) T)atb services. and/or fouler 2
Sup. elect. name (print): A J . Cjf/ Li tm:3767 -s altsratiaa la6°14
PROPER 11' t)\%'Nl•.It 200 amps or less 2
Name (print): Al u 1. I i K 1 n Al e d I C 0,1 Ce►1 - 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: W - • 601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone: (Fax: (E -mail: Reconnect only 1
Oster installation: The installation is being made on property I own Temporary ae^'l°eaor bade= -
which is not intended for sale, lease, rent, or exchange according to irerbttlatlon ,alteraelon,orrelocatlont
ORS 447, 455, 479, 670, 701. 201 amps or lass 2
201 amps to 400 amps 2
Owner's si Date: 401 to 600 2
Brandt dreults • new, alteration,
Name: or extension per pant:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each brunch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: • - of service or feeder fee, Rust branch circuit: yf 2
Each additional branch circuit: ' (o.
PLAN It1- : VII' :'1' (l'It•a.e c all that apply) Misc. (Servlce feeder not leeladed):
O Service over 225 amps- wmmeacial 0 Health-care facility Each pump or irrigation circle 2
O Service over 320 turps - rating of 18t2 O Hazardous location Each signor outline lighting t 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(a) or a limited energy panel.
Cl System over 600 volts nominal more residential units in one structure alteration, or extension' _ 2
O Building over three atones 0 Feeders, 400 amps or more *Description:
D Occupant load over 99 persons 0 Manufactured structures err RV pelt Each additional Minn over the allowable to any of the above:
Cl Egressflightiogplan ❑ Other. Per Inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Nor en J,uted ettoos accept ctodit carts, please call judo:Ocuou fix men mfm®nuo. Notice: This permit application Permit fee $ t3. cs
visa 0 MasterCard expires if a permit is not obtained Plan review (at %) $
Ceedrt awl [amber: ' f i 9OBO 2911 owl O F 103 within 180 days after It has been State aucehtuge (8%) $
&/f1Qlt) E e L..s 6: rig /G =puts accepted as complete. TOTAL $
NCI=EZZ gillf oa c
$ .
Cardholder signature Aec®t • 4404615 (64o/COM)
CITY OF TIGAR[a 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171
MST
�/ BUP
Received Date Requested 2 d AM PM BUP
Location /3 Z D O P Suite MEC
Contact Person. 61 _ Ph ( ) PLM
Contractor Ph ( ) la q F- Y CSa SWR
BUILDING Tenant/Owner ELC 02003 -°°°4-5---
QOO 5
Footing
Foundation ELC
AcceSS:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation Q-1K)
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
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
E EI Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA D � 6.3 Inspector 6(.---6---(7
A Ext Approach/Sidewalk P j
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL