Permit •
CITY OF T I GARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00655
A l DEVELOPMENT PMENT SERVICES 639 -4171 DATE ISSUED: 12/01/2000
PARCEL: 2S115BC-06800
SITE ADDRESS: 16790 SW ROYALTY PKWY
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Wire for two kilns and one plug for door opener
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: 2 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:
WANDA BARCOMB DELTA ELECTRIC INC
16790 SW ROYALTY PARKWAY 1322 SE HAWTHORNE BLVD
KING CITY, OR 97224 PORTLAND, OR 97214
Phone: 639 -1274 Phone: 234- 4328
Reg #: LIC 00001968 EXPIRED
SUP 744S
'401 - ..� � - ELE 26 -39C
Arm
FEES Required Inspections r
Type By Date Amount Receipt Elect'l Final
PRMT CTR 12/01 /200C $60.15 2720000000(
5PCT CTR 12/01/200C $4.81 2720000000(
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 1
suspended for m ore 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 —rn ISSUED BY: ��itz&a
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
BUP - Building Permit ELC - Electrical Permit
/ Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 11 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG- Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing � Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in
Welding Lab Final
Fire damper •
Concrete Lab Final
Duct work
Bolting Lab Final
Smoke detector
Fireproofing Lab Final
Mechanical fmal
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
J Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP/backflow preventer
_ I Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00655
DEVELOPMENT SERVICES DATE ISSUED: 12/01/2000
' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S115BC -06800
SITE ADDRESS: 16790 SW ROYALTY PKWY
•
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Wire for two kilns and one plug for door opener
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: 2 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:
WANDA BARCOMB DELTA ELECTRIC INC
16790 SW ROYALTY PARKWAY 1322 SE HAWTHORNE BLVD
. KING CITY, OR 97224 PORTLAND, OR 97214
Phone: 639 -1274 Phone: 234 -4328
Reg #: LIC 00001968
SUP 744S
ELE 26 -39C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 12/01/200C $60.15 2720000000(
5PCT CTR 12/01/200C $4.81 2720000000(
Total $64.96
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 ISSUED BY: a
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
11/28/00 TOE 17:15 FAX 503 598 1980 CITY OF TIGARD Z002
�•
Electrical Permit Application
. A _ Date received: Permit no.: Eic,Qtro oii) & SS
_;;;j: City of Tigard RECEIVED
� ProjecVappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: : Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 NOV 3 C
2000 Casefileno.: Payment type: •
Land use approval: COMMUNITY DEVELOPMENT
X1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other. 0 Partial
' JOB sum INFORMATION
Job address: 1 (]q 0 5, Ul • o . ' w Bldg. no.: Suite no.: Tax map /tax lodaccount no.:
Lot: I Block: Su. • vision: k i vie C; t , n i2.
Project name: w b,►not 4, Iba,i Co p 'Description and location of work on premises: of 4,_ tar 6) ii ;in $
Estimated date of corn letion/inspection: • A. a cl C Do r O t-,. -y
Job no: 5??yg Fee Max
Business name: D e 1 +0, E [c ri a Ty t., • Description Qty. (ea.) Total no. hasp
7��y+, New residential - single or mild- tamlly per
Address: 1 3 2 2 5. trc . !4 A w o r su- S v d dwelungunk. Includes attached garage.
City: POT VA d I State: on 1 23P: q 7z / y _ Serrtceiacladed:
Phone: ° 3 2 3 i. • sz s; Fax: 2.32-3061 I E-mail: 1000 sq. ft. or less 4
.C(� - 3 C E additional 500 sq. ft. or portion thereof
CCB no.: ' (, ; Elec. bus. lie. no: 9 Limited enemy, residential 2
City/metro tic. no.: 5 S 0000 1 ° I q > • - • Limited energy, non- residential 2
r :' .. 0 u(nct std h ors or modular dwelling
Signature o supervising electrician required) s./ /L' —)...9.-:.•,-,-,A•
.
r" • , Date t 2
. elect name riot): Li enseao: S `Servicesorfeedas— Iuiotalation,
Sup. (p- D b C r 4 ✓+ h alteration or relocation:
200 amps or less : 2
Name (print): f &v 6, I Al Co it4 ;201 amps to 400 samba 2
A 79(1.4)k 401 amps to 600 amps r---, Mailing address: 1 ( 9 0 ,W . J20 yex 1 ty 601 amps to 1000 amps • 2
City: K i lit e c; ty 'State: 0 k I2;IP: y 72 Z y Over 1000 amps or volts 2
- Phone: 563 63q -I274l Fax; 1B-mail: Reconnectonl 1
Owner installation: The installation is being made on property I own 1- Temporary servi or feed -
which is not intended for sale, lease, rent, or exchange according to aOp ' elmr°H0° ' Dt � dO°`
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's sl e: • Date: 401 to 600 amps 2 ,
Branch clreslta - new, alteration,
or extension per pant
Name: ._ A. Fee for branch circuits with purchase of
•
Address: service or feeder fee, each branch circuit 2
State: e3P: B. Fee for branch circuits without purchase
City: of service or feeder fee, first branch circuit: I '16 `b4 '1616 2
Phone: Fax: E -mail: Bach addidonal branch circuit: '7i 4, ex 1'4 30
PLAN RI:v11;11' (Please check all Ilia apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facWt i Each pump or irrigation circle 2
O Servlx over 320 amps - rating of I &2 0 Hazardous Iocatio1 Bach signor outline lighting 2
family dwellings 0 Building over 10,1100 square feet four or Signal circuit(a) or a limited energy panel,
0 System over 600 vole nominal more residential u its in one structure alteration or extension' — 2
0 Building over three stories ❑ Feeders, 400 amp; or more *Description:
0 Occupant load over 99 persona 0 Manufactured strt ctures or RV park Each additional inspection over the allowable in any of the above•.
0 Egress/lighting plan 0 Other Per inspection I I I I
Submit _ sets of plans with any of the above. • investigation fee
The above are not applicable to temporary coast' ucdon service. Other
Not all Jurisdictions secant credit cards, please call Jurisdletioe for more infctmetl� •iotice: '[his permit• application Permit fee 60 17
a
p review (at _ %) $
• O visa ❑ MasterCard ertphres If a permit i9 not obtatnod ° S $ y $ I
Credit card number; . L- within 180 days after it has been ta surcharge ( 8g'o ) ""
�"p f° ' accepted as complete. TOTAL $ 6 `� 9(
Name of cardholder as shown on credit card
Cardholder signature Amount 440-4615 (6A0/COM)
11/28/2000 16:31 5036393771 CITY OF KING CITY . PAGE 02/02
. N L�
„✓
KING CITY
15800 SW 116th Avenue, King City, Oregon 97224.2693
Phone: (603) 639 -4082 • FAX (508) 639-3771
Notice To Contractors Working In Kin C'
g g b qty
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: GlA,,. ,,,, '3 mac 6 . .
located at: 14:196
g_e_i4.-)
King City Representative /! t-60
1 LSTSI:CIN$T DOC