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Permit 4 t, CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00767 DEVELOPMENT SERVICES DATE ISSUED: 12/3/2004 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171 • PARCEL: 1S134BC -00800 • SITE ADDRESS: 12398 SW SCHOLLS FERRY RD SUBDIVISION: PP1993 -058 ZONING. C -P BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Repair damage from car accident, (4) branch circuits. 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: 3 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: THOMPSON /DAVIDSON LEASE B & L ELECTRIC DBA CUSTOM ELECTRIC PROPERTY VENTURE, THE 3015 BABER CT SE PO BOX 398 SALEM, OR 97301 PORTLAND, OR 97207 Phone: Phone: 503 - 399 -0907 • Reg #: LIC 75668 ELE 24 -73 FEES Description Date Amount Required Inspections [TAX] 8% State Surcharge 12/3/2004 $5.34 [ELPRMT] ELC Permit 12/3/2004 $66.80 Rough - Elect Final Total $72.14 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules •r direct questi •.ns to OUNC at (503) 246-6699 or 1-800-332-2344. • • Issued By: , r /" Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: • Call 639 -4175 by 7:00pm for an inspection the next business day Dec 02 04 09:11a Frank Graney (503)362 -6890 p.1 NOV -30 -2004 TUE 12:37 PM EOFF ELECT' -:- ^ 5033639397 P. 01 Electrical Pbrmit • ;L_: E -fir I tt: t i t ,t „1 1 CittY M Turd sY�� i �� r Permit Nu.: i4 ?t 1 17125 Sw}rau °Elva. Tigard. OR 9 O 2004 o nen Review Phone: 503.639.4171 Fax! 503.59 72$ noenty: Ocher weer: lrc acljon Line 503.639.4 L75 .., i4• 'IL Da. Read ®S.a Page 2 for Internet w.c ogsrd TIGP 0 - Notified /f Supplemental :�� _ � "rG"; .s �e ;. �^cy,.,:hs'- ..any y-r!'wn•�:�,. r:�: ?,. c �� ::- .a. 1,4x7_ {u -\ �' •I � ` .5il < , h� y;. '''-Mi' ., _ _ a. New construction i,•' '7. r • on/alb:ran . , Please chair all that apply: - ❑ Dernolitiitmtt • Other. ❑Servi00 amps. coos x'l ❑Liarardouslowtim 'A `C• K�F -i.; ' ff =. . yISLi ;:les7 •'� . i. 7 / W 0 o and 2- family dwellings 18 ❑ 4 err mogre aver ew residential ❑ 1 and 2 family dwelling ' i_ Canmercial/'Industrial ❑ s Ato�Ory building ❑ Yetem ova 600 volts severe d units in ebbs structure ❑ Multi- family_ CI MaSter builder ❑ Other: ❑llailding war duce stories ❑Peedcra, 400 amps or more ' •.�.,, N ;�'+• a '7' - `L:. i�'ti"Y°� •v ❑ It load over 99 pests is OR481111facaned structures or > i . ,.s : ... DERMAL: an RN pa Job no.: Job site address: iceltb� are facility t: Jr o • ❑ ty Cloth= _ • • • .• -, •' Submit a sets of plans with an: of the above. City /State/ZIP: -774-47e. t 9 ntponmiy conzOuCfion service. Sirilelbldg /apt. no.: � 6 n 7 � 20 The above are not applicable to o Plo3 l cct name: ! ear) /-/e72/2-1/ =T ".i '• ; - :. s -.7- -?v. - -gr fiEe.f �' Crass street/directions to job ate: 4,2/ t7' New reeldeodnl mingle- or mot 1- family dwelling volt. %clsdes.ttaehed garage. 1,000 sq. ft er lac: . l45.1 5 4 Subdivision: 1 Lot n0.: Ea. add'1500 sq. R or portion • 33.40 t 1 Tax map/parcel no.: Limited energy. residential 75.00 2 ytt .v , 1 , Limited en non-residential 2 N.f .. "w' . , ., 7.-7'77.4•0#10/44k : "7 - :: �:. -1 ; ∎7 :4Vi• VII. 75.00 +� Each factored or modular �p4 / r ,/ /ice-Jae/1f- d� , ? /� * d r dwdling, service and/or feeder 90.90 2 r � ty / r % (� !'� Services or feeder ineeaQatiot , abrratioo, nod/orreload°. 1 200 amps or �e1,v� Ices 8030 2 `�`t }i - F`s+yr!Y ,;,� 91'"C ) ZOl amps l0 400 amps 106.03 - 2 l "•• - " -� 401 amps l0 600 amps 160.60 2 Nlinw: 0,17245 5 ..4A 4.,e� /; � 601 amps to 1.000 emu 240.60 2 Address: Over 1,000 amps or volts 454.61 2 City/5tatdL1F: Reconnect only 66.85 2 Temporary services or feeden Iastsllatoe, alteration, and/or Phone: ( ) l Fax: ( ) Mimetic 200 amps ere toes 66.1I5 1 Owner installation: This installation is being made on peaperty that I awn which is not 201 amps to 400 amps 100.30 2 Wended for sale. lease. rent, or exchange, according to ORS 447. 449, 670, and 701. 401 s to 600 Owm Ownr ssignature: ° ' 133.75 _ 2 e r _ r r ry n� cx y R . Date: Snaebdnuits- sew, alrentd in, orextension. rpeael :"� iii:'.. i::;i; d t .�� >' k. :x- , c ,.,� �, , o ;= tc:.: ;s A Fats for branch evmita with r T -- =Nun or fade fee, each Business naen is C ( N GJ r C T ) Cr we-- - branch Walt 6.65 2 Contact name- FiA - ��-7Q // B. Fee ou t service o branch crews r fad ` without feeder fee. • Address: /7 Jc7rh 5T /`) each Numb assn a6.8 �d.85 2 RR � Each adds hunch circuit 6.65 s t 9.95' 2 � City/State/ZIP: g-(,jv tJ- 4) 7�j 0 / MlseelLaeosss(service or feed r s betoded) Phone: () 3) 40q, I Fax:: (563) 3 ( „ 2 _ - z , 0 9 0 Pane or manta circle 53.40 2 E -mail: xGlt1 0 I?AIST�iuc.T7vlYl�1�� d't_' 7� �gnoroutlinetislltlag 53.40 2 � .., ar _ v ,' ' s - Si c a i s tan or limited- o or '•��::'�=L" � F energy bend, situation. or O Huss mess llamex El Q! r 1 M 1 catrns Describe: Page 2 2 . 1. ZIEc4a•)c tnc. AL'►. W'A L � an-l- er, - N Address. ..31:, l A A b. �� • sE Feb *Whiten,' inspection owl r albwabIr is any of the above Per inspection 62.50 • 0 City/State/ZIP : ,3aJ --.. ©R, , 73oI Investigation pa boar (1tomice) 62.50 Industrial ant per boar - c (503 )•3 . Cr 90-7 i Fax: ( ) P 79.75 Cat Lic.: 7 , r d 6 $ I Electrical Lim : 4 - 73 Fr , 1 Stuprv. Lie.: 2v J 2 ssbwmt (04_ R4 Suprv. Electrici n an sig a n'e, required: 0 f Plan review (25° of permit tee) I Print mani 13.-4--A, 1 M re a.4 Date: H • 2 9 -O State wmJxargr (8B . of permit fee) TOTAL 'ERMfl' FEE Authorized signature: Q Tits permit • d.a [ ", - ppt i bas boo o II • peewit nisei obtained tdado 780 ` days Avail bee bra el:MOW n eoesplete Print name: !• 44.s.. h F r y n. .o >ry m en J Dar= 13 -Z3 -Ok • Fee autlodoloay rat by Td -Coin y Building Industry Service Board i1BUiIthr lP ieA2t.C•vawjt*4,pdoe Il ( •• Number of inspections dlmixt 446I6tsv Iaaiico Wweer CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Reque ted ! AM PM BUP Location • : -� = _ �i Suite MEC Contact Person Ph ( ) `r 9 _ 3 c • 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner C J ELC o = ( 1�d ° 767 Footing Foundation ELC Acce s: 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 FAIL qtEGTRICAL Se Rough -In UG/Slab Low Voltage Fire Alarm 7 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE n Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / / Inspector A Ext Other: Final DO NOT REMOVE this Inspection record from th Job site. PASS PART FAIL