Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00058
1 r I 1 DEVELOPMENT SERVICES DATE ISSUED: 2/6/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 102 CC -00600
SITE ADDRESS: 13545 SW PACIFIC HWY
ZONING: C -G
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Temporary service for new construction, (2) temp services & (3) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 3 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:
DDHK VENTURES, LLC CURRENT ELECTRIC
12604 SW 60TH CT PO BOX 19652
PORTLAND, OR 97219 PORTLAND, OR 97280
Phone: 503 - 977 -0578 Phone: 245 -5997
Reg #: SUP 3689S
LIC 46994
FEES ELE 26 -47IC
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/6/04 $153.05
[TAX] 8% State Surcharge 2/6/04 $12.24 Elect'l Service
Rough -in
Total $165.29 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 18. = -ys o • uance, or if work is suspended
for more - . 180 • . ' ATTENTION: Oregon law requires you to follow rules adopted by the Oregon U ' ity •tif on Center. Those rules are set
forth i r *AR 952 - 001 -00 ! through 0A; . i i -!100. You may obtain copies of these rules or direct . uesti.� - • 0 UNC at (503) 246-6699 or
1 -80•- 332 - 2344.
Issu : • By: % v Permit Signature: `_ L
OWNER INSTALLATION ONLY /
The installation is being made on property I own which is not intended for sale, lea e, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTO - INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: 3 • 3
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application (►ill ( F. l NI._ (IN 1.1
Date received: A ff Q ,' I,, Permit no.: f , , 50
; ,, r - .1'i City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
I I'L OF I'Elt'II I
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi -family ❑ Tenant improvement
❑ New construction O Addition/alteration /replacement ❑ Other: ❑ Partial
Job address: t p lcic Lo (2 ThAQ_ Bldg o.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: I Subdivision: i � Bldg
� 4(/ AG )J)tj
Project name: Q t 71 CAC (U12-c I Description and location of work on premises:
Estimated date of completion/inspection:
CON RAC! OR •1P1'li(11 ION FEE SCIILDl LL
Job no: Fee Max
Business name: ( 17 2 i ' ,Jr rl e 2 lc ek. L Qty. (en.) Total no. 'lisp
Address: 4 , / � /3 - / ‘f. Newra tmit.I Includes attached chedgtge.
a�eper
dwud�®lt.lorludeasttacbedgum
City: 0 ,e' � I State)/ I ZIP: 977' p p sa teeincladed:
Phone: .ZqS 5 97 Fax: -Zy5 / E -mail: 1000 sq. ft or less 4
no.: , yc Elec. bus. lic. no: , — C
Each additional 500 R or portion thereof
Limited energy, residential 2
City/in, o lic. no.: r / Limited energy, non-residential 2
c�i manufactured Each mamctured home or modular dwelling
Signs' supervising el- '.'ciao (required) Date Service and/or feeder 2
Sup. elect name (print): License no: 9 Services or feeders— installation,
alteration orrelucaif on:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Tpozaryen51�s or feeders.
• which is not intended for sale, lease, rent, or exchange according to installation, alteration, °tiD°:
ORS 447, 455, 479, 670, 701. 200 amps or less A 1?" i.1(7 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
f \ (. I\ L E R Branch c rcuits- new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of �, l /
Address: service or feeder fee, each branch circuit 3 1 5. 2
City: I State: 1 ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit it 2
Phone: Fax: E -mail: Each additional branch circuit
.. i'IA\ RE% 1E1% (('lease check All tliii apply) Misc. (Service or feeder not included):
D Service over 225 amps - commercial 0 Health-care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 182 0 Hazanio sc location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration. or extension* 2
O Build over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above
O Egress/lighting plan 0 Other. Per inspection I I 1 l
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary constructoon service. Other
Not all jurisdictions accept f e e $ /4713 . D 5
accept credit cards, please call jurisdiction for more inf ormat ion. Not ice: This permit application
O 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 %) $ IZ. IN
Expires
a comp TOTAL $ h 5 . 2 y
/ � y r
r Name of cardholder as shown on credit card lens.
SS
Cardholder signature Amount 440 .4615 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lpe: .(503)•639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 22,1q 3 l -3 Date Reques d , -7/0/04/ AM PM BUP
Location l �� 1'� r Suite MEC
Contact Person 2W' ( Ph (�v 33) 45 S ?7PLM
Contractor C.1 ,1.)\ Ph ( ) SWR
BUILDING Tenant/Owner ? 0C)OScP
Footing
Foundation Access: ELC
Ftg Drain • ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing •
Insulation
Drywall Nailing or
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
EL CTRICAL
1
ough -In
UG /Slab
Low Voltage
Fire Alarm
Fi .I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
. PART FAIL
SITE Please call for reinspection RE: El Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date sa. L AP 0 Z-/ Inspector - 4 / Ext
Other:
Final DO NOT REMOVE this Inspection record from t e Job site.
PASS PART FAIL