Permit i CITY OF TIGARD ELECTRICAL PERMIT
- PERMIT #: ELC2002 -00064
a1I1j"
— 13125 D EVE PM E N� r SERVICES - (503) 639 -4171 DATE ISSUED: 2/20/02
PARCEL: 2S115BC -10500
SITE ADDRESS: 16555 SW ROYALTY PKWY
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Install 2 branch circuits for new furnace.
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: 1 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:
HAKKINEN, ELISABETH S + FELIX • SHARPE ELECTRIC INC
16555 SW ROYALTY PKWY 22605 SW RIGGS
KING CITY, OR 97224 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 81518
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 2/20/02 $53.50 2720020000( Wall Cover
Elect'I Final
5PCT CTR 2/20/02 $4.28 2720020000(
Total $57,78
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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.
Permit Signature: 0 .17 /2 Issued By: AO / - - ��
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: dh apse DATE:
LICENSE NO: 3 /'/ S
Call 639 -4175 by 7:00pm for an inspection the next business day
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Fib 14 02 02:40p Specialty Heating 503 598 0718 p.1
Electrical Application ,
ical Permit r rm too.: I - ate
Date received: Gf //, Peit
A � l Pro ject/appl• no.: Expire date:
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�' :� City of Tigard CM Receipt nt
Address: 13125 SW Hall Blvd, TiEI " 1/ "� ateissued:
City r)fTignt'd Phone: (503) 639 -4171 Lr. �I
Case tiles no.: Payment type:
Fax: (503) 598 -1960
Land use approval: FEB , 4. 2002
I �
`TZxE :.k 's':�, :(f. I
a a ' " a ` . J Ai tent
�F 2 family dwelling or acc 0 cssery Cotrurercial /indttstritll 0 U Partial
0 New construction �' Addition /alteration/replaceoent I
JOB SITE INFOI� IATION
Job address: /69_65,6 31.0 • 1 _.._ Bldg, no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivisio :
Project name: Description and location of work on premises: - Estimated date of completion/inspection:
FEE SCHEDULE
CONTRACTOR APPLICATION Fee tN:uc
Job no: ( 7 a Des cription Qty (ea.) total no. insp
Business name: 5 (% L ue><C- -/ New midential or multi - family per
Address: t:. 6, C 45 _Du) '' a dwelling unit. Includes attached garage,
City: /.N/Zr tat�/e 9 fL
3 1 ZIP: l 0 7 Service included: 4
Y-�" e:, lOWsq. ft.orless
I Fax: ' E Phone: � y Each s additional . r less sq, ft. or portion thereof 2
CCF3 no.: / .$/ $ I Elec. bus. lic. no: .3.•-/ ' 4� f 7 c:„ Limited energy. residential _ 2
City /meu lic. no.: ,g/...5--1/ 1 imitedenergy, non residential --�/ ^-
/ Each manufactured home or modular dwelling 2
�� • Ate S elvice;altt/or t'eCdcr
Signature of supervisi g electrician (required) D / ' s Services eea d /or f e edS- iaStallalion,
Sup. elect. name (print): + f]- ' Llceust uu. �{ `/ S alteration or relocation:
PROPERTY OWNER 200 Lumps or less 2
- 2
Name '! 2 0l amps m 400 amps 2
Name (pant): C Lfs ,4-he. TA I ne' 401 amps to 60A nmps 2
Mailing a dress: ,S" Sin/ R • Az- ) f10 tun to 1000 amps 2
Cit � �e States® I ZIP: Ql ct . Over 1000 amps or volts 1
y' :`eu -'��L tteeonnectonly
Phone: 6p?�t{ - a yef2 Fax: E -mail:
Owner installation: The installation is being math on property I own Tetttpomty services or [ceders -
intallauon, alteration, orrelocation;
rent, or exchange according n $ to 2
which is not intended for sale, lease, 200 amps or less -- 2
ORS 947, 455. 479, 670, 701. 201 emp:t to 400 amps 2
Owner's signature: _ Date: 401 to 600 amps
Branch circuits - new, alteration,
or extension per panel:
Name: _ A. Fee Par branch cu wits with porchaze of
service or feeder fee, each branch circuit
City Address:
State: ZIP: d. Fee for branch circuits without purchase 2. 2 •
City: — of service or feeder fee, first branch circuit: — _
Phone: Fax: E- mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
•
amps - rating of t Bach pump or irrigation circle - _ _ �
❑
Q ,�,p,,vicavvci 22S arttpc_r.nmttt¢PCial ❑ Hcalth•earctacility E i signot'nutline lighting _ __. I ••
f Service family over :12.0 &2 (] Building over 10.000 square feet four or location Signal clrtvit(s) or a limited Co
family dwellings 0 Buildig oe 2
more residential units in one structure alteration, or extension 2
r System over 600 volts nominal --
ILI winding ovet Uucc,torica r. F,rtlers. amps nrmore ''Description:
I 0 Occupant load over 99 persons 0 Manufactured structures or RV pats: Each additional inspection over the allowable in any of tfC: irnvei
E n:ssilightingplan 0 Other. Per inspection 1 r r—
. Submit — sets of plan with any of the above. _ investigauuo fee
The above are not appl to temporary construction service. Ot he' -
P ermit fee $ ._' g"`
1 P application Plact " ' < < _ ec,1 e �3• SO
� V t jurisdictions accept credit =Is, please Call jtui�ctlon for mom infomtaaon. Notice: Thi omit
vita u MasterCard , 1 expires if a permit is not obtained -
/ within 1E0 days atter it has been State surcharge (8%) . % . ' zv
l'tcdit card number C1 / , Li �, �, J TOTAL $ __ S�
Fc accepted ted as complete.
Sher rf t t_s — P
��rr N amp or shown on taedtt cant s
l.f �n.if r . �a *ham ( d/ — wmount 440-46I5 (6N0/CUM)
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Cardholder s'sni>�
CITY OF TIGARD 24 -Hour
BUILDING' Inspection Line: (503) 639 -4175
INSPECTION DIVISION 6' Business Line: (503).639 -4171 MST
' BUP
Received Date R nested 2— Z l— 0 S AM PM BUP
Locatio t 'k k/ Suite
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner L0 c )-ooe2 - Do46 5
Footing
Foundation
Ftg Drain / ELC
Access: Etc_ —Q to ( y) ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing �
Insulation C
Drywall Nailing •
Firewall -FV\04K
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 P T FAIL
LEC
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
� S 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 - 2 Inspect° • - -! • ' Ext
Other:
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL