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Permit 411/I- CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00002 - NT , II I � �� DE SEWOP M SERVICES DATE ISSUED: 1/2/04 9ES (503) 639 -4171 PARCEL: 2S103DD -01201 SITE ADDRESS: 13900 SW PACIFIC HWY SUBDIVISION: ZONING. C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Install (4) branch circuits for exercise machines. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 1.00 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: 3 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: MILLER, PRUDENCE M ORIENT ELECTRIC INC. 4220 SW GREENLEAF DRIVE • 30532 SE BLUFF RD. PORTLAND, OR 97221 GRESHAM, OR 97080 Phone: Phone: 503 - 663 -5881 Reg #: ELE 26 -237C LIC 14261 FEES SUP 1925S Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/2/04 $66.80 [TAX] 8% State Surcharge 1/2/04 $5.34 Rough - Elect'l Final Total $72.14 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By: Permit Signature: Aor 'CA OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Jan 02 04 09 :534 ��•d6� 5036633197 p. 2 ,L 6 a: /Ja /LUUJ 1.u..,...) s'm .+Fig Vi l i v[ •asnw �1v V1 f• #11.......64WCill Pernhit-ADD MW 2004 10k or i.1( 1. ►'Si: 0\t.ti City ►131255 a ( a OR 97R14TY OF TIGARD A, "'B iia . , a Bi g :CJ- E-a•00 - 000(7: n inspection s 50363Fi 75 DING DIVISIO .•i'�, Other Fannie 1 ;�+ r ,fi ,� wwwei.d ard ] liaothd^,fhttrhod: ��r y��.,t'�} '� � 7� 'k: i : -TiigFg• + .T - , k,•errti .T . ? .` - `.Slit -'Y . ? r -. ,7'.�` - :" •4;f: • • Kew ctoiz etioo 0 Additiao%ltc ationh asn at aplaoot Plcasa check m apply: - © Demolition . 'Older: DSerwieS over 22$ acme,. oomm'l OHwrdous location s - is Yp - : J -z� l ;, n.,p�,� °Service over 320 amps ung over 10 000 IR.,•7 {��Jq�` ,ii' .r._] 'y . , n tl �. .41, ?'. q + lq' . ^, � � y } i v yi ; ,•- rr } ' --y'T��� '�" 1 `r-.r �t.. u.,-'N:.Cferz L. 1 ic 1 : ?.S"i7Lu v f:��!I!) -•• iT. : :-.." F= oft - and 2.f y&ma.nes 4or more new residential ■ 1- mod 2- faintly dwelling ..�Commmefa2mduaaial ❑ Accessary building 1=1Systern over 600 volts seminal unite in one structure D Multi- • • • • ' [) Master builder ❑ Other: DB.ilaiets over three atones DFsodcie. 400 arr or mere �a'ry } L° -z •c:• ea�v •: � . a•� ;!TC??T -� t3 • r (]Occupant load over 99 persons O1Kannfact ad au nt ni or `6'^4 ,e ": ':^ti {;+1 'Q . 1. ^. •�1 1, i• f , �. .,71 cam. -: a • R DEVeasil 6 S Plan RV P : w•, i': e��': t'. I. r. n! x�t.. �, r+ v-' i.-77. - ?',inrSt��.,a..v�. � �. a i T f hLA park Job no: J !, 2 00. Job site addre: t 139 0 b S v j PAC. C 41 i A s . 2 . s eu of pion with any of the above. CrtycState/ZIP: - t q A y 0 K The starve teem applicable to temporary construction service. SuitsiblddJapt, too.: ' 1 Project name.: � :�y'� ��'. i! :: t� ' _ ` si .'•i 0: . : -w� tooted.* OW . run • owl Qocc street/directions to job site: New residential singe- sr multi- family towelling melt. Include. attached prage. • NE! _ . . 4 1 -∎ • 1.000 sq. 8 or less 145.15 4 Subdivision: Lot no.: Ea. WI S00 sq. R or portion 33.40 1 Tax map/parcel no.: - l�mdted uttetteY, residential . 71.00 2 r r r limited mercy, non- residential 75.00 2 _., ^, .-� '': = Y�°4' t ., `` � %!i?r�r Qr �_' _ ;1 ; 1�� Each manufactured or modular • 5-6 dwalla , service and/or feeder 90.90 i 2., l ` (1 ' \ b'i 4- t.�`S - �K 2.-r 0 .0 S C - Service or feeders Installation, alteratloq =dim. relocation 2 Wl P. Q.11 1 200 amps or boa 80. 2 �s n 1 n = f? r� y �+C,r.,r�!'l y m r L�' yi +,t� q �� s 201 to moo s 106 113r!`s��',l,_ .!�` :- �StiL : :YF4:y�Ji.+..:iii� �3sh��. :.�2��4- 'M1� d _ n . a?,Sdis: f.. 401 amps to 600 emu 160.60 2 A l_ . Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1.000 maps or volts 454.55 2 Romancer only 66.85 2 City/State/ZIP: Temporary semen err feeders lnuallatien, altered**, aadlar FlUGiam ( ) [ Fax: ( rderltion Chester baatallarlinn: Ibis latimllwioo is bean evade m 200 or 00 0 30 I Ow i Prey Want I own which is not 7A1 aregs to 400 amps � 10030 [ 2 intended for sale, lesse rev, or vschaagc, 'acceding to ORS 447, 449, 670, and 701. 401 m 600 amps saps 133.73 2 Owner aiapattlsm Date: /Breach circuits- new, a turation, or extension, per panel ` �• . � ice. Z.I. :v ti 0C�:w 3:r " s o. •, ., � .., .. �,..,. :.,�. :_ i 7t1 J .. .�a,d k service or feeder tee, matt • Husinots ammo: n1r■ e,.� C je N► C_. j L . branch circuit 6.67 2 1 J,\ / A B. Pus for branch circuits Contact name: ki t J l k widow iervioc or feeder fee. 46, 2 A . _ _ i Cal* /canna circuit 1 4 , gS • Each add'I brunch circuit 6 .65 q . 2 CifyiSt : e - v (� ` b. 1. W 11" hilsedhams (eerriee er leader net iededsd) • Pilooc (<D3) Vol - S kk 1 Fart:: (Sa3) '149V 3 -- 3 t Pump orimiaadert circle 53.40 • 2 E-mail: Sips or outline Militias j 53.40 2 I +, y yy.� Signal cirwir(a) or limited- t s A " ": �,. , '�>: ��.,., �% , �^ �:�Y� "'� y �' r#� l�ia, eae+4Y tune7 slseratl or • examines. Describe: Page 2 2 I, ` ' Each addielsnal Inspection over allowable Ina of me obey. ,J C'rly/$t8001� , _ a i�a�. ■ p Par impaction 62.50 1� -V 1 \ I �y Investigation per hour (t bricks) 6250 i , Phan= (Sa 3) (pkp 3 S e e I Fax: (s�3) �p \p 3 ^ 3i d i brdueniat • Inn per hart _ 73.75 U ccs Lit._ lE 'taeorial • :2 • . -!• 4 = ;;?U t '? _ - :77 T' I q 2 ` . Lie. Z ' '�,._- _ r• i � . . Submit! Supty. Electrician signature, required: i ` � ��i /� / lG 0 /I /, l�ir��" �a - ( - d y Plan .tvi.wc231Latpmmlt pt, Print var. , ' „iv eif ■ .� Date. I - eV _. .4 Stale surcharge (age award' fee) S. • 3 . : TOTAL rzardrr rim q Print Lance: •• , w i ., - I _ _ 0 Tile pwrew da ys mmaml tree te�W n eaem /Moor Print w � 'CC7�� A Data • Pee method:Mu sett by Irt•Covery lei Wintry Service Board .. warmer aretweffowi po' Permit albwd in ernarerrwfsela.C.egfea,epAis..130U / - ) / sroAstsrmiencomwna A CITY OF TIGARD 24 -Hour BUILDING Inspection'! Line 1-(503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested 20 AM PM BUP Location „ /3V Suite MEC Contact Person Ph ( ) 4'43 ' Ff P'/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner — ELC L( — 04O Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing r. 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 ELECTRICAL Service �IJG Low Voltage r✓O L r larm *ASS 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 Approach/Sidewalk Date / 0 Inspecto M - _ -1 Ext Other: Final DO NOT REMOVE this inspection record f om the j site. PASS PART FAIL