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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00417 � ,�w�lij" DEVE ) 639 -4171 DATE ISSUED: 08/14/2001 PARCEL: 2 S 102 C B -01500 SITE ADDRESS: 10425 SW PARK ST SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R-4.5 BLOCK: LOT : 032 JURISDICTION: TIG Project Description: Change out service in garage (200 amp). 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: 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: DURDEL, CHRISTOPHER C + MARGO A + J ELECTRIC 10425 SW PARK ST PO BOX 330 TIGARD, OR 97223 FOREST GROVE, OR 97116 Phone: Phone: 359 -5891 Reg #: LIC 959 SUP 489S ELE 34-1C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 08/14/2001 $80.30 2720010000( Elect'I Service Elect'I Final 5PCT CTR 08/14/2001 $6.42 2720010000( Total $86,72 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. V Permit Signature: Issued By: 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: /1 DATE: LICENSE NO: -4R9-S Call 639 -4175 by 7:00pm for an inspection the next business day 08/09/01 THU 08:28 FAX 503 598 1980 CITY OF TIGARD J I 11002 ■ El ectrical Permit A►pp _ A ion Daterecelved: t �� '" t no.: �� d Project/appl.no.: Bxplredate: _. �: i'i City of. Tigard - - • Address: 13125 SW Hall Blvd, Ti g a� • • ■ � ' D ate issued: �� Receipt no.: CirynfTtgard Phone: (503) 639 -4171 - - - - - - -- Fax: (503) 598=1960 -' — - — 1, �' ZOCi Case file no.:_ Payment type: AUG • Land use approval: a sirr ovifteRAPII— • )l .1 & 2 family dwelling or accessory O Commercial/industrial Cl Multi- family O Tenant improvement - - , O• Nets construction. ________ .__ Addtdon/alteration/repiacement_ 0 Other: 0 Partial JOB SITE INFORMATION Job'address:10425 -_SW P. - r.. - ' .. . Bldg. no.: • Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: Des and location of work on premises: _ . ,', _ N. - . ; _ • a . _ _ . - Estimated date of corn letion/ins ton: - - - - - - Fee Max Job no: - - . - Description Qty. (ea.) Total no, lnsp _ - Business name: A & J Electric, Inc -_ - __ •N _sInglaor amuy -- Address: PO Box 330 dwellinguntt .mdudesattachedgarage. State R I ZIP: 97116 Serficelnduded: Cone :.35 -5YP� 1000 sq. fl or less • 4 P - 3 f191 F ax: 1 • Each additione1500 sq. ft. or portion thereof CCB no.: 959 - - -- Elec. us. c 34 -1C -- - _ � l b It Limited energy, reaidendal 2 City, etro lic. do.: -- - - Litnited energy, tion- residential 2 wall" MAT Each manufactured home or modular dwelling . / Allr• d, $erViceaadlorfcedef 2 ��` '�" a Lilted) - •. T;. Si , l �' - Services or feeders- Installation, • S • elect. name (print): J.11- • ,o a Li' Anse no: 489S alteration orrelocatlon: PROPERTY OWNER 200' amps orless \ k 0,3 2 201 amps to 400 amps _ 2 Name (print): Margo Thlrr1P11 401 amps to 600 amps ' _ 2 Mailing address: 10425 SW P 601 amps to 1000 amps 2 City: Tigard 1 State: OR I. r 1 P: 97271 Over 1000 amps or volts 2 Phone: 624 [Fax: LE -mail: Reconnect only 1 Owner hnstallaUOn he installation is being made on property I own Temporary services or feeders - "' htstalladon ,alteration,orrelocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 • Owner's signature: _ Du rte:. 401 to 600 amps ( 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A Fee for branch circuits with purchase of _ Address: service or feeder fee, each branch circuit 2 � B. Fes for branch circuits without purchase _ City: State: '�' of service or feeder fee, first branch circuit 2 Phone: Fax: E-mail Each additional branch circuit i ' PLAN ItEVIENV (Please check all lira' Misc. (Senlceor feeder not lncluded): 2 Each pump or irrigation circle - O Service over 225amps- cotttmeteial Cl Health-care tl u i Each sgnoroinelighdng 2 Signal gnor 0 Service over 320 amps - rating of 1 &2 0 Hazardous location Ei t in a energy panel, family dwellings 0 Building over 10 000 square feet four or g 2 O System over 600 volts nominal more residential I inits in one structure alteration, or extension , 0 Building over three stories 0 Feeders, 400 an s or more *Description: • 0 Occupant load over 99 persons 0 Manufactured an uctures or RV park Each additional Inspection over the allowable In any of the above: 0 Egress/lightingplan 0 Other: • - Per inspection I I I I Submit sets of plans with any of th1: above. • Investigation fee The above are not applicable to temporary construction service. Other Permit fee ' $ 1 all Jw1ac5cdons'coept credit cards. please call Jmisdtction for more in Ormadoa Notice: This permit application Plan review (at _ %) $ . • 0 Visa 0 MasterCard expires if a permit is not obtained h a $ 6.42 Credit card number: I / within 180 days after it has been S surcharge ( 84a ) "" $6.72 ex tiros accepted as complete. TOTAL $ • Name of cardholder as shown on c edit card $ Cardholder signature An ount d 4444615 (6/0O/COM) CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location 0 Lt 7- S 1- c� Suite MEC Contact Person Ph Jy/ J 7 PLM Contractor 14" Ph 3. ma/— S g9 I SWR BUILDING Tenant/Owner ELC ?-a)/ — 4 2 7 Retaining Wall ELR Footing Access: Foundation _ J FPS 171 Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing S E �- vl C 4 h c {� d 6 4 m p Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING v c „ _ i • k � Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL 27(-tv MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final FAIL C4 . Rough In UG /Slab Low Voltage PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA 6"1 J / Approach /Sidewalk a Other Date ' — 6 ( )/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.