Permit ELECTRICAL PERMIT
, ;ITY O F TI GARD PERMIT #: ELC2002 -00666
• 77 DEVELOPMENT SERVICES DATE ISSUED: 12/31/02
" 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 102 C 6 -00302
SITE ADDRESS: 13185 SW PACIFIC HWY 8-1 ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION
BLOCK: LOT : 033 JURISDICTION: TIG
Project Description: 1 branch circuit for oven.
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: 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:
ALADDIN MOTOR INNS OREGON ELECTRIC CONST /GROUP
BY BENZENISTE, IRVING 1010 SE 11TH AVE
10155 SW CAPITOL HWY PORTLAND, OR 97214
PORTLAND, OR 97219
Phone: Phone:
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/31/02 $46.85
[TAX] 8% State Tax 12/31/02 $3.75 Elect'I Final
Total $50.60
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 -800-3 -2344. .
Issued By: /ili Permit Signature: 671 (PO. • yer--4
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: telQ DATE:
LICENSE NO: ` ! Z 5 •
Call 639 -4175 by 7:00pm for an inspection the next business day
4 •
or
Electrical Permit A llcatlon OFFICE USE ONLY
r I : • � ED D bate received: _ 'r j / —p tir t , .
City of Tigard �"` -��''
- J I I� g Project/opal. no.: Expire dart:
City of Tigard Address: 13125 SW Hall B1vcI, T 06 fl
Phone: (503) 639.4171 DDE�, 1�U( Date issued:
Elan R ece i pt no.
Pax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval: BUILDIN nIVISION
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory I /Commercial /industrial 0 Multi- family g7 Tenant improvement
0 New construction 0 Addition /alteration /replacement 0 Othcr. CI Partial
JOB SITE INFORMATION
• Job address: 13185 SW Pacific Hw Bldg. no.: Suite no.: Tax map/tax lot/account no.;
Lot: Block: Subdivision;
—
Project name: Salvadores BAk:• ' ption and location of work on premises: 1 ckt for oven
Estimated date of completion /inspection:
CONTRACTOR APPLICATION fEE SCHEDULE
Job no: 7 3 6 69 Fee Max
Business name: • _ . • s _ • • Description Qty. (en.) Total no.lnsp
Address; 1010 SE 11 th Ave
New residential -single ormuhi- famllyper
Cit Portland S udesaCmchodgarag�
State:
OR � ZIP: 9 7 214 Ser.icetacl
Phone: 234- 9 900IFax :234 - 10011E -mail: 1000 sq. ft. orlete _ 4
CCB no.: , 0 I Elec. bus. lit. no: Each additional 500 sq. A d
A. or portion xrcof
76 - Limited energy. residential 2
Cctro li no,: Limited ens
tbY. non-residential 2
12-10-02 Each manufactured home or modular dwelling
-t e o ' um. i r' a sT"1!r-/'.. r red) Date Service and/or feeder 2
Sup. elect c (p . i ., e e License nn: , • Services or feeders- installation,
PROPt RTY OWNER a llcrai ion nrrelocs6on:
200 Amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: rState: I ZIP: Over 1000 amps or volts 2
Phone: JFax: I E -mail; Reconne only t
Owner installation: The installation is being made on property I own Temporary service,: or feeders.
which is not intended for sale, lease, rent, or exchange according to Inslaation,alttuatioa , orrelocation:
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
ENGINEER Branch circuits - new, alteration,
Name; or extension per panel:
A. Fee for blanch circuit,. with purchase of
Address: service or feeder fee. each branch circuit 2
City: I State: ` ZIP: B. Fee for branch circuits without purchase
Phone: fax: E -mail: of service or feeder fee, f rst branch Circuit 1 46.85 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Mire- ($erviccor feeder not included):
O Service over 225 amps- commercial 0 Health-aim facility Each pump or irritation circle 2
—
0 Service over 320 amps-rating of ldt2 ❑ Hmerdous location Each sign or outline lighting 2
family dwellings Cl Building over 10.000 square feet four or Sigma' circuit(s) or a limited energy panel.
❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2
O Building over duce stories ❑ Feeders, 400 amps or mote
O Occupant load over 99 persons Cl Manufactured structure,. or RV park Each additional _
0 Egress/lighting plan 0 Other: E iiomlitutpecti000ver the allowable ioarryof the aLore:
Per inspection I I 1 J
Submit _ sets of plans with any of the above. Investigation fete — L
The above are not applicable to temporary construction service. Other
Not all junsdictiuns accept =Or cants, please cull jurisdiction for more information. Notice: This permit application Permit fee $ 46.85
O 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 %) S
Oxptfej accepted as com TOTAL $ S
Nana of cardhnldcr as shown on credit card Q _ 60 -
S
Cardholder signatUh Amount 440 4615 (ms/CON)
819 -J 600/ZOO'd 099-1 -AM Y9 Zl ZO- 08 -�30
CITY OF TIGiARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reqv AM ' PM BUP
Location / 3/ 3S Suite MEC
Contact Person CiL(/17 Ph ( ) ' 3 `� " 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC '" v 6 (o
Footing -606
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
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 , / J j
Service
Rough -In 1 ��tl
UG/Slab
Low Voltage
Fire. Alarm
PART FAIL
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE I=1 Please call for reinspection RE: LI Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date aN m ) na Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL