Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: CAL ELC2001-00070
DEVELOPMENT SERVICES DATE ISSUED: 02/01/2001
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 1156C -17800
SITE ADDRESS: 16682 SW QUEEN ANNE AVE
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Heat pump & air handler. One floor receptacle
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: 2 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:
WINDECKER, ROBERT.D AND WEST SIDE ELECTRIC CO INC
REEVES, MAE 1834 SE 8TH AVE
16682 SW QUEEN ANNE AVENUE PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone:
231 -1548
Reg #: LIC 13306
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Final
PRMT CTR 02/01/2001 $60.15 2720010000(
5PCT CTR 02/01/2001 $4.81 2720010000(
Total $64.96
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 -1987.
PERMITTEE'S SIGNATURE 0 7 J O y ?n Q 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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
goi 000
Electrical PermitApplicatiion ` :
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['hone: [303) 639.4171
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01/04/2001 14:20 5036393771 CITY OF KING CITY PAGE 03
liair :KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
mmEMMEMMUr Phone: (508) 639 -4082 • FAX (508) 689 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639-4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: / , tnzp liL Ut.t
located at: (419 mac.) 6. 2Q 471-4e..-
4 Ri fliz.itt-
King City Representative /- O/
I 'OSTSWCriST HOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 07 - /C AM PM BLD
Location /4t / ''t z 5 (...) Q 44" a✓1 ✓ / Suite MEC
Contact Person e 6'"/<'t Ph Doze S ' 7 PLM
Contractor /A. 1 c D C S' �-e- -- cc Ph SWR
BUILDING Tenant/Owner
ELC Z',ri l —vt>v 7
Retaining Wall ELR
Footing Access:
Foundation' FPS
Ftg Drain '¢ ( 7 <4.r SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam hi a D �!� �� / - b/!'2 rQG�7
Ext Sheath /Shear �'"'f L
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof P
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
d ERI
FAI L
CAL—
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
-ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: - ble to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk - 2 / o 7 Ins Inspector Ext
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.