Permit C ITY O FMT I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00317
DEVELOPMENT SERVICES DATE ISSUED: 7/15/02
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: Electrical tenant improvement of (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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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 #: 60
SUP 3707S
ELE 34 -305C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 7/15/02 $53.50 2720020000( Elect'I Final
5PCT CTR 7/15/02 $4.28 2720020000(
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 t egos t7titity lotfication Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these les or direct questions to OUNC at (503) 246 -6699 or
1 -800- 332 -2344.
Permit Signature: yam �1 // / Is ed By: k
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 • NLY
.
SIGNATURE OF SUPR. ELEC'N: G: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
08/25/2000 02:30 397 -9022 DOUG MOBERLY PAGE 01
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Electrical Permit Application
Date received: 7 /. 4 9 — Permit no.:a. Azto.2 -eto3/7
1 1 ' 1 '1 1 1; City of Tigard ; . Project/appl.no.: x ' date:
Ci,, ofTigord Address: 13125 SW Hall Blvd.'lilg d O 977223 batcissued: By Receipt no.:
Phone: (503) 639 -4171
. Fax: (503) 598 -1960 Case file no,: payment type:
Land use approval: . JUL 1 ?r�?
F;. ,q . .__ . ..
.11'PE OF PERMIT
U I & 2 family dwelling of accessory Commercial /industrial 0 Multi - family 0 Tenant improvement
Ll New construction ❑ Addition/alteration/replacement U Other: U Partial
Jon SITE INFORMATION
Joh address: 5200 W li ! , V ..... Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Prvlect name: Description and location of work on premises: i. , _.
Estimated date of com lction/inspcctinn: _ r.
CONTRA( APPLICATION FEE. !+('IIEDULI
Job no: Max
i Deatri . lion — Qty. Total no.lnsp
Business name: New residentiat -single ornadd -fan lyper
Address : etCq o2 41■ al..1111=1 dwelltngunfL Includes attested garage.
City: agirrEMIN1111.111.11EMEN ZIP: 4 - 7/ 13 • Semite included:
PnonC r arriAM111741 1000 sq.11. or less 4
Each additional 5005 • ft. or portion thereof _�
CC13 no.: 9 Elec, bus. taco no:3 Limited energy. residential Ml• 2
Cil t11 a lie. il0•: r Umited energy, non•residential 2
�AV _ 7 1 .2 -/ ,, Each manufactured home or modular dwelling ■�
1� ; f1
ar- uircd Date and/or feeder 2
� sine)�� ! Services or feeders- Installation,
Sup. elect. name (print): J ff /r License no:3 707 S alteration or relocation: ll
1'ltO11• :R1'Y OWNER 200awpsorless 2
Name (print): £ F s y O / NM m g . • 201 amps to 400 amps IIM _ 2
401 amps to 600 amps l•Ml•
Mailing address: 601 amps to 1000 amps _MI= 2
City: _ State: ZIP: Over 1000 amps or volts _� 2
Phone: • , Fax: E -mail: Reconnect only I
Owner installation: lire installation is being made on property I own Tempornt or feeders - . .
which is not intended for sale, lease, rent, or exchange according to inalallatlon ,alteration,orrelocslion:
200 amps or less 2
ORS 447. 455, 479, 670, 701 201 amps to 400 am . s =OM l♦ 2
Owner's signature: Date: 401 to 600 am.. M1M _ 2
ENG IN 1:1: it Branch circuits - new, alteration,
or extension per pastel:
Name: : ;-A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
City State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: � "jai 2
Phone: Fax: E-mail: additional branch circuit: r-1,ArAn'
PLAN It1;VIEWV (I'It':1se check all that tlpplh) Mist . (Service or feeder not included): will
0 Service over 225 amps- commercial 0 Health-we facility Each pump or irrigation circle 2
Q Service over 320 amps-gating of I &2 0 Hazardous location Each sign or outline lighting IIIIIMIll z
family dwellings U Building over 10.000 square feet four or Signal circuit (s)orali`rited energy panel. 111111 2
iJ System over 600 volts nominal more residential units in one structure alteration, ore)ttension
0 Building over three stories 0 Feeders. 400 amps or mote • Descri . lion:
U Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
ci F.gress/lightingplan U Other: Per inspection Mill
5ubrelt sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service, Other
Not all jurisdictions mom credit cords, please call jurisdiction for more Inrormaiaa. Notice: This permit application Permit fee $ 0116 '
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ _
credit cord oamWr _ _ I J within 180 days after it has been State surcharge (8%) .... $ 4. 2 R
Esplres accepted as complete. TOTAL S . 7. - 78
Now of cardholder as shows on credit card
S
e.idholder signature - Amount .1404615 (NatyCOM)
TR t/s 4-ccoteu I , 5 2-
CITY OF TIGARD_ , i � 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business Line: (503) 639 -4171 MST
BUP
Received Date Requested e- 7// ( AM PM BUP
Location 3 a o o bite MEC
Contact Person Ph ( ) PLM
Contractor q°t l Sao 3 --a 2 PPh ( ) SWR
BUILDING Tenant/Owner ELC c2 - 00 3 / 7
Footing ELC
Foundation Access:
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 b ())� •
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
.40124 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Z PART FAIL
SI ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA D ate'' /' Q Inspector 41 / / �' Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the b site.
PASS PART FAIL