Permit CITY OF T I G R D ELECTRICAL PERMIT
PERMIT #: ELC2002-00405
andookilhA DEVELOPMENT SER ICES DATE ISSUED: 8/20/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102CB -02300
SITE ADDRESS: 13200 SW PACIFIC HWY
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Install 3 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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 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:
Reg #: -64fit4ffig
SUP 3707S
ELE 34 -305C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 8/20/02 $60.15 2720020000( Elea! Final
5PCT CTR 8/20/02 $4.82 2720020000(
Total $64.97
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 - 6699 or 1 - 800 - 332 - 2344. / Permit Signature: �� Issued By:
G
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
1
SIGNATURE OF SUPR. ELEC'N: TY) 1.2.1) DATE:
LICENSE NO: 7 0
Call 639 -4175 by 7:00pm for an inspection the next business day
10/02/2000 06:54 397 -9022 DOUG MOBERLY PAGE 01
•
4 ...r
Electrical Permit Application � .-2.0-0-2.-- a po 5
Date Permit no.:
,: Pro ect/appl. no.: Expire date:
, " 1 C ity of Tigard , .
Address: 13125 SW Hall Blv Tigard, OR 97223 pale issued: B y .- 466 I
('irk gfTig <rrd Receipt no.:
Phone: (503) 639 -4171 t -4
Fax: (503) 598 Case file nu.: Payment type:
Land use approval: arum 2 a a �1x _i
U I & 2 family dwelling or accessory Commercial /industrial ❑ Multi - family U Tenant improvement
U New construction 0 Addition /altcration/replacement O Other U Partial
Jolt SI l L INFORMATION
Job address: Z r 0 s .. A ,Gt or A Bldg. no.: Suite no.: Tax map /tax lot /account no.:
Lot: Block: Subdivision:
- Project name: _ Description and location of work on premises: 0 - S
Estimated date of conlplctiorl/ins Lion:
Fee Max
Job no:
Description Qty (ea.) Total no Insp
Business name: A l// - ,' / / / G New residential - edngk rnulli- famllyper
Address: a 9a p SGv a-- p i-- / 1 p .r e . dwelling unit. Includes attached garage.
City: mg S As State.* 0 ZIP: 4 - 7 /Z,3 . Service included:
1000 sq. ft. or less 4
Phone , ,.Al Fax :ff - 7% . -mail:
" Each additional 500 $9,.. ft. or portion thcrcuf
CCB no.: 5 9 Elec. bus. lie. rto:,3 Q 7G Limited rc 2
Cit 1 o tic. no.: � l,imited energy, non- reSidciiiial 2
'/,
� home manufactured twe or modular dwelling
and/or feeder 2
;37 r z *� suited) Date
License no: Servlceeorfeeders - installation,
Sup. elect. name (print): A . la_ . 70� alteration or relocation;
... a iiVI ZOO amps or less
Name (print): \/I SCt3 roy15'jYL(.(.tt?),„.-- 201 amps to 400amps 2
, , ,e101 amps to 600 amps
Mailing address: 601 amps to 1000 amps 2
City: !State: I ZIP: Over 1000 amps or volts l _ 2
r a x : E - mail: Reconnectoni I 1
Phone: �� � -
Owner installation: The installation is being made on property 1 own Temporary services or feeders -
installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
Branch circuits - new, alteration, ---
or extension per panel:
Name: - A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
- City State: ZIP: B Fee f or branch circuits without purchase r,
of service or feeder fee, first branch circuit: I 4$QI 2
Phone: Fax: -mail: Each additional branch circuit:
PLAN ItlIVIF11•(Please check all that apple) base. (Servlceor feeder net Included):
❑ Service over 225 amps - commercial U Health -care facility Each pump or irrigation circle 2
— 2
U Service over i20 amps - rating of 111c2 t 1 Hazardous location Each sign or outline lighting -
family dwellings s U Building ver 10,000 square feet four or Signal circuit(s) or a limited energy panel.
8
U System over 600 volts nominal more residential units in one structure alteration, ur extension' 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons U Manufactured structures or RY park Each additional inspection over the allowable In any of the above:
U tigress/lighting/Ann U Other. Per inspection J I 1 I
Submit — sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Oder
Nat au ium,4tctiacs mega credit cards. please cell Jurisdiction
isdiction for mare tefoaatiaa �m
Notice: Thkpetit application Permit fee $
Cl visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
credit card number . / / within 180 days after it has been State surcharge (8%) $ 4 Q P
Exp d res accepted as complete. TOTAL $ • G i - C 7
Name of cardholder as shown on credit card
S
Cardholder alarlattara Anwl
roI 440-4615 (&V0 /CON)
— - TRUST C,CDL•N -
L
CITY OF TIG 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Busines's Line: (503) 639 -4171 MST
BUP
Received Date Requested cj � AM PM BUP
Location 13 o Suite MEC
Contact Person Ph ( ) 6 9,? 4 i$$ 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC , — 07) elD c
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation Drywall Nailing ph,c
Firewall
Fire Sprinkler
Fire Alarm �►' ` r 7��U `. S
Susp'd Ceiling Ll \ = ��N2IT ��a���� ► =_� `� \� •
Roof ! !�:��NN:% `,�
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
' 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 0- Approach/Sidewalk Dat Z InSpectOrii Ext
Other:
Final DO NOT REMOVE this inspection record from the site.
PASS PART FAIL