Permit a l oy 6 114 E�p� T / 19 / � LICL 6GARD
•
PERMIT #: ELC2004 -00798
- DEVELOPMENT SERVICES DATE ISSUED: 12/14/2004
- r �' I I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 42 PERFECT
SUBDIVISION: LOOK ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (5) 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: 4 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:
13500 PACIFIC CORP HORIZON ELEC (JMC ELECTRIC)
BY CAP ADVISORS 58916 EVERGREEN LOOP
38345 W TEN MILE RD, STE 170 ST. HELENS, OR 97051
FARMINGTON HILLS, MI 48335
Phone: Phone: 503 - 247 - 3525
Reg #: LIC 159763
ELE 34 -182C
FEES SUP 986S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/14/200 $74.45
[TAX] 8% State Surcharge 12/14/200, $5.88 Rough -
Elect'l Final
Total $80.33
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: l2-t- J24-1.-- 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
i. U.S. :t1U4 lr',• /b t...t JUJJJOLtruU t.iii ur iLU.-S `e: u , . 1 .
V Ep ' r r • e,;
Electrical Permit r ° " , '1 u R OF Ic E C ONG1 'r Fe , t .N
1 Rccovad / 9 O
City of Tigard I r -w'Bv: • H 0 P ermit l Cam �SI
1 3425 SA! Hall i31vd., 1 ;Bird OR 97223 2004 Plan Review
P ptiter Permit. ir. I
• hore 501.039.4171 x: 503.598,193EC �. 4 ; ef ;" ' ^ Date/73 -'-
i •' � - • Date ReadyiSic : I ni Pi Set rage 1 for
.rzer t. Lm . • 523.6'39.475 aro Oe T G - ` �- Supptem°ncnl !Mums i nn
:r.ter ct. uvw.n.tigard.ot . r CITY ` 1 Vt .�t;t;�M��ad: T/ _ -
.rAdditiorJJLerationire lacemenl P leue :beck all that apply:
Nev.' Cunstrucncn p ❑Senicc over 225 amps, comm'1 ❑hazarlous'ociriDn
I (_ � Dcnolition CI Other; ❑Scnice over 320 amps - raring ❑Puildng o' r I U,OJu yti ft.. • r CATEGORY OF' CONSTRIiCTi01V of 1• and 2- family dwellings 4 Cr mere :ev res:denoal
OSystem over 600 volts nominal units in Ur, srrv:ru c
; k L 1- and :-family dwelling �i.omryereialii�dustrial ❑Accessory building Feeder;, 4 . 0 Dent s or more
Master builder ❑Huildirg ovc three stories ❑ Y
ti(ual- ftsnii� ❑ : ❑Other ❑Occupant load over 99 persons ❑Manufcccerec suucoares or
"' E`ressl' htin
JOB SITE I NFORMATION AND LOCATION ❑ 6 lg F plan Rt' park
❑Flcalthwarc facility [Others _
r Job :so.: / 3100,i jite address: elk t e.,, r `f
Submit 2 sus of plans with any of th, above.. ,
� t-) Ok % _s y1' The abve arc not applicable to temporary construe ,or service •
FEE* 'SCHEDULE 4
I Sutte.bldg.laµ. ryas Project name: i Qry Pe.. I "Ivy. I '' '
_ _ _ _ .-- _
I Cr066 streeG`dir:ctionS to job site, New reaideotia) single` or multi -family dwelling unit.
- -_ ^ - Includes attached garage, __,
i 1,000 sq. ft or less l45.I 5 3
Subd:vl5ton;
Lot no Ea. 'dell 500 sq, ft. or pcnion 33.40` _
_- _ -- __ Limited ettttg /, residential 75 I 2 I
I , Tax. ,:lap /parcel no.: Limited energy, non- rosidential 1 i 2
1
DESCRIPTION OF WORK each manufecttued or modular
L - • I
dwelling, service and/or feeder _ I 90.91 1 1 2
—_ —_ _ Services or feeders installation, alteration, aodor relocation
. j 200 amps or less P0.3 I
t . 201 =pa to 400 amps 106.8) : — 71
ER • ... ❑ TENANT 2
❑ P -- -- 401 amps to 600 atrna 160.o:
-- Nome - I 001 amps to 1.000 amps 240.(.0 ___
- - -- Over 1,000 amps or volts 454.x,: 2 ,
P.ccire$S • _
• -1
- -_ 1 Reconnect only I 66.,, 5 1 I
i CI 7y/State!ZIP: Temporary cervices or feeders installation, alteration. and,or
-- - --- ; relocation _
Phone: ( Fax: ( ) 200 &raps or less 66.:5 1
Owner Installation: This installation is being m2de or. property that I own which is not 2.01 amps to 400 amps I 100.0 2
• inteod:d for sale, lease, react, or exchange, according to ORS 4z7, 449, 670, and 701. 401 amps to 600 amps I 133. '5 1 2
Ott'rer signature Date; _ Branch clrcuite - new, alteration, or extussle:t_ per p anel
— • CI APPLICANT • A _ •• I • O CONTACT. PERSON. A. Pee for branch circuses with {
_ service or feeder fee, each I � 6.x +5 2. '
Dame: eme: branch circuit
_ B. Fee for blanch circuits
• Contact name: without service or feeder tic, J I 46.6 t OS :
each branch circuit l J
' Ad____ Barb ad b ranch circuit 6.65 3(p toO 2 I
CiryIStatelLtP: Miscellaneous (service or feeder not included) 1
-- P nIr +D or irrigation circle 53 4( _
Phone: ( ) - ! Fax:: ( Siprt or ou0ine lighting 53.41 rt 2
• E -mail• Signal eircuit(s) or limited -
!
7- --w— CONTRACTOR energy panel, alteration, or
_ _ • _ r r _ (7 extension. Describe: Page =
. Business name: T \/ l ZS (J X0 0 .5IIJ� (1\e„ _
!
Address 1O
1 t to' LL �7�.1t � W ' ' 5 ` V' Each aQd)tio3al Ins. etion ever allowable in an; of lh. & -- h
Pet inspection MT 62.50 r - I --
� C ■ty,Stzte /Z1 ?; L2+�� , q� US I I nveeti anon per how (I h r inert) 52.50 -_-
-- S l ^ t �.- -�— r Oa I /+ � I plmt per hour 73.75
I Piwtre: (C l ���j� I Fax: (SZD5) ?. tic? C{ a. 7' • • . ELECTRICAL • PERMIT . ; J
1 C.'C9 Lie.: 191(p ' Electrical Lic.3y ... Suprv Sub:otal . L )
t " P lan review (:5 °.e o: permit (eel
rv. El signature, required: , I, - -,- ,. I
i
I-- ` t - Stow ana &rte (8% of permit fee,'. S � � ___1
Prim 1t r.prtte: P. �- I, ?ate: �� i TOTAL PERMIT FEljg Y s ii,
Atl : Ionzed signature: AkW/�. lit ' ' ` , 1 This permit application captres d a permit is uo1 ebnh wtthrn I R
days after It Sao Deco accepted as eei.
l.C.C_. �
Pant slue: — O Dale: �2_- • Foe methodology set by Tn- County 81.i Wing incot;•, . rvice bows,
i l_ ._ •• Number of insp.etwns per perm): allowed
:• du.1,.crpermiu`et•eentitt)t.dot : :nt 440451t•T ;latJVCON(N'EB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: .(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / Z - ZP AM PM BUP
Location / 3 s0 ‘) Suite MEC
Contact Person Ph ( ) g g F' PLM
Contractor 614--C, Po , � h ( n ) 4 7 "3 5 SWR
BUILDING (t/Owner �X— T ELC p? De 4-0 Q 7 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
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service C
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
FAIL
ELECTRIC
Service
Rough -In
UG/Slab
Low Voltage
Jra- parm
SASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA _ /
Approach/Sidewalk Date" / Inspector / JA /A Ext
Other:
Final DO NOT REMOVE this inspection recor from t Job site.
PASS PART FAIL