Permit C ITY OF T I GAR D ELECTRICAL PERMIT
PERMIT #: ELC2004 -00042
416 DEVELOPMENT SERVICES DATE ISSUED: 1/29/04
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 102CC -00600
SITE ADDRESS: 13545 SW PACIFIC HWY
ZONING: C -G
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant Improvement
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: 2
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: 1 W /SERVICE OR FEEDER: 26 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 -471C
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 1/29/04 $360.00
[TAX] 8% State Surcharge 1/29/04 $28.80 Ceiling Cover
Wall Cover
Total $388.80 Elect'l Service
Elect'l Final
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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: T Permit Signature:
OWNER INSTALLATION ON
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
' e
• '
. ElectricalPermitApplication C►l i l(1 I ,I:
Date received: - .- b '-'1 Permit no.: / 2 # -000
: � I ' .1, City of Tigard Projectiappl. 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'F OF I'[R.t1 I
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi -family ❑ Tenant improvement
❑ New construction 3 <- ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB ‘ , I 11- I \I 0101: IO.\
Job address: % Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: IUCt_i)t3 r T( Description and location of work on premises:
Estimated date of completion/inspection:
CON II? 1(.`1012 •1I'I'I.1( 1110N FI-F titIiFDI 1.1. :
Job no: Fee Max
Business name: Co ee � e Cie ICAL 0 r ce Qtr. (ea.) Total no.insp
New r -singeormld- frmiiyper
Address :
, /ql� dwelliog�t.I�desattncLedg .
City: / ,/ZTLA,t_PO I State: at I ZIP: 97413o servieelndrided:
Phone: 3 3 -2 v5. Fax:S'pj,Zys E-mail: 1000 sq. ft. or less 4
CCB no.: 4/6995/' 1 Elec. bus. lic. no: a6 — c{7 /C
Each additional 500 sq. ft. or portion thereof
/me o Limited energy, residential 2
Limited energy, non-residential 2
. `� a- ' Z P7 ' 17 Each manufactured home or modular dwelling
Signature of supervising electrician (required) Da Service and/or feeder 2
Sup. elect name (print): ,� y RSp�' License nn: g Services or feeders— installation,
alteration or relocation:
200 amps or less ( a32 1c 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 Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to OOt O°, orreloeation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
I= \ , I \ 1_ F it Branch c(reults- new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit A b /72 2
. City: I State: I ZIP: B. Fee for branch circuits without purchase
� of service or feeder fee, first branch circuit 2
Phone: Fax: E -mail: Each additional branch circuit
Pi Ill :\ IF \\ ( I'Icasc check all Iha1 apply) Mize. (Service
`, ❑ Service over 225 amps- o°snmercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of Idr2 CO Hazardous l acer ' 7 Each sign or outline lighting A 53 el , 2
family dwellings dialing ding 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 Building over three stades ❑ 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 abort
❑ Egress/lighting plan ❑ Other Per inspection I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cords, please call jurisdiction for more information. Notice: This permit application Permit fee $ 3a) .0C..2 cords,
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ ----- Credit card number: / / within 180 days after it has been State surcharge (8 %) $ A , 9)b
s TOTAL $ 32 , �b
Name of cardholder as shown on credit card a 88 CO bete.
Cardholder signature Amount 440 .4615 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 6 V/ (/AM PM BUP
Location 1 L / ! 14 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner go[G/LWse ELC 20 0 — 000 92..
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ?Witt-- SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear 9kt -09 /4
Int Sheath/Shear
Framing
Insulation �!�
71 � T p � GS w,Di" VeD FDA- F C,TfwG - T 0A/
Drywall Nailing /�
Firewall FOGGObc • 1 0 6 / T W O Rer7 5 5 Mina MODE 7D Q5
Fire Sprinkler (4) � G a,� re.
Fire Alarm �4) IN t P/T �I �wi 1 atE WI BE NO 1 15/R 5 I Ceiling /
Roof Ho$E$ AIM No // s ', - )cu/ OR siV oN6- W al?
Other:
Final wer5A.... •
PASS PART FAIL
PLUMBING
Post & Beam CB) TR Po-- ,y r-
Under Slab / S1 �/ I 1-
Rough-In / G F" - l of EX/1'nQ5T /1-11Z. WH)GK WILCO
Water Service
Sanitary Sewer 1R. e4 tj1Af Do p two- iK L KdU1 $ of IMF
Rain Drains
Catch Basin / Manhole L� V pit7q Gc)
Storm Drain I
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
r ir d o PART FAIL D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE El Please call for reinspection RE: Ej Unable to inspect — no access
Fire Supply Line
ADA Date [ I ` 0 y Inspector EXt
Other: � I M P �.Rgy
Final DO NOT REMOVE this inspection ection from the job site.
PASS PART FAIL