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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00629 DEVELOPMENT SERVICES DATE ISSUED: 10/13/03 I r � l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133AD-02200 SITE ADDRESS: 12930 SW SCHOLLS FERRY RD ZONING: R -7 SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Install 1 branch circuit for pathway light. 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: 0 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: WESTGATE BAPTIST CHURCH KELSO ELECTRIC INC 12930 SW SCHOLLS FERRY RD 545 SE 3RD TIGARD, OR 97223 HILLSBORO, OR 97123 • Phone: Phone: 503 - 648 - 6360 Reg #: LIC 116254 SUP 4270s FEES ELE 34 -433c Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/13/03 $46.85 [TAX] 8% State Tax 10/13/03 $3.75 Rough - Elect'l Final Total $50.60 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 or direct questions to OUNC at (503) 246 -6699 or 1 -800-33 -2344. ) ,{ Issued By: 1 .0.0__ . _ �I . _ % Permit Signature: (f Y) ce _ 1 ` • 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 • • FF4v : KEL*SO ELECTRIC I NC FAX N0. 0000000000 Oct. 06 2003 02: 29PM P1 . • . RECEIVED Electrical. Per I ca .OL FOR at Flc r. i SL a Nl) ' City 0.f Tigard B CITYOF FT TIIG � A , RD I' ' t . i - 'a3 X1.3 9 13125 SW Ball Blvd TZSZ �vlt . Wenn : �. Tigard, Oregon 973 Plus Review • r Aotaav Permit No.: Phone: 503 - 639 -4171 Fax: 503. 598 - 1960 Peat•Review Land Um Internet; wwvr.ci.tigard.ar.us � j D.rd� �+'a Are.: 74-hour lrspection Request; S03- 639 -4175 '`- � ' . ` - e/ ' Mus 1ur+r. ❑See Pate 2 far °{ �� 0thod ' ma laformatlaa. .. _ • . -.'�1 •• OF.W17RIt �:.. VC i,1,• r A.F:'I A {�•.i17i:. construction : `: •; VIE7rV' 1�f1 eh t7t11 i1fa �p(y) -g ', ' $ New C D Demolition - • sernw over 2 5 a k Y Adcitiou/al mme I r ❑ H a mi tr-eats f action t a o11 • Iacemer1t I Other: oo DO B Building location .. w.:s• . > • , N Thal o 1 &2 f a dwellings srngs tattngof ❑ ororaw et 10A00sgwre in ��``� family four of awe reshleptial urlts in I 1 & 2- Family dwelling ' ■ Commenialandust ial ❑ l7 System over 600 volts nominal one eaumare : L A . - - .. Buildin _ • Multi Fatttil a Balding aver three merles Feeders. 400 amps ar MOM ' oocvoaru ❑ load over 99 persons cnued =maw oe RV pork I 0 Maste Builder $ Other: • ❑ 0 Other: Egmm/ll;DtieY plan Other: • %J.OB$ITE #T O Fi►TION T OCATit71v : ' %:= -i . ;; i4 Submit sets afplaaa with any of the above. ■ Job sire address: Zj i �T� * T he o bovo ars not a • • leoble to nm 1 t11�L J ..i..i.•' •:•f ;•• •e:a. �10 1er' Y Cenitt4eaon ee �rfe� Suite #: E);, � 3�bI 7 J L i'• . ,��.....- ::�: ;:: ;: =::N � ;'�° .�. ff Numbar of ins • setions cr . erinit allowe Prof ectName: i11Wr , _e Dsrsrs don [?'11 'Mill 1 : Cross sweet/Dire to if•b site: r Cn, I -y . Nov �athaUtereornruttt- iymtPat - [r/i� d+vd111m u nit rnslvdoi atachod Sorge. Service Winded: 145.15 4 I / i 1000 -. ft or - p j AU,� Limited . a � 1�1!•n ubdrvisinn: Lot #: ��.00 Tax caa. =eel >;: ies ts.00 IIIIIW Each esutulkcAVed modular be Mmodular d„ eU . - - "' . ':` • C8'IP•. USE o F 4 DRKs a: :•re>. feeder • • 90 2 Meerietier . / / f u Setr e Me cs or do lonis i gla[iou- �� • "e � • altcritt000rra i ioraaoa • ,i C..,.: ID amps or less I 30.30 -© r . a .i . ' . ...... 10635 2 • 401 am•. to •00aro•■ •'f In PitOPEit1YtI R?: • _ 1 ' _ 11111 160,66 �� T ISTSMC: •:.,T .,ly von 411445 • Ci ress; 'J�i. ; Temporary services or feeders • Imtallatloo, d alumina or rely s uroe: 200 are... Flat Phone: Fax: 731 sew too:1 amot 100.30 ;e ars lrc ., :4 a ,' : ix_. . ®:c o?�TA �" ?n ri .::; 1 :4: 41 6 : 7. 1t * in_ . 333.75 �® Name: rl tterv, alter attea, er I extension per panel: I I I Address: A. service or feeder e Fee Cor lunch choke or erh purchase ,r of 6.65 2 City. State/Zi B. Fie for branch citwis without W rcltrue of Phone: p ax; 'aura or f e e d e r s * . first brand, circuit 46,55 �j•. 2 E•tr ail: - -• addidond hunch errant 6.65 a': (3414'r1t•1.1r.3'f)Jlti' (S • .. . o r Off ... n air d) - _© : :2`:: ..... i:; 'i:: ..; ='u i "!: nub of 5+.40 Job No: Fad ai ororsl;ra lieleri5r S3..0 s at armors(,Mr lmase are,r,.ad, IIIMINI BUSi11C5$ Nacre: . / ��. sae •,L_- - .. ,,... • 7S .. *Damps= — - i Cif / S tate/Zl • : = , ds m i Each a • plena! ias • alien ever the elle • ere , of the shove: i Phone: _ • t� I i ' • �: hour - in. l hour : so �- . CCB Lie. ii: y / „_1, Li !#: _ 5q tf 33C ! ` M aher 1.1111M11 I Supervising electric::812 - : i ;,: Y - : ;F? :1 ;:7::a' :rthtt:: • � ; a. k; l,• � signature re • aired: 4Alt 0-•-.....-- I ` �� S1rb ) + _ . I Print Name: ` Jp • Plan Review OS sti of Permit Pee) $ �� � &� � Stec Sur hoarm /sY. ad: Perusit Fee) s .7 , -- 7S A„rt,n.;eed TOTAL PERMTI FEE S <'O . 6,r) 5igaanse: - � OTIO� ! D d a �! Notice: This psntalt application expires if a permit is net ebtatsed withitl _l - — - I In dun attar It has boa mm as wmplaa. (Please print taros) — *Fee methodology sat by tri•Gwam dlc r BvUg Industry Service Board. •0012 MIN'S I1 .-f0 x.T.Trs noavoteenn vUr i.T.LT __ FROi ! : KE;�SO ELECTRIC I NC FAX N0. 0000000000 Oct. 13 2003 12: 53PM P2 . • 4 RECEIVED 17---,/, _ Eleetri 11 14 3 A II a volt O CFI i is L'Sk: ONLY CI of n OF TICARD two.: 13125 S�{ . D ate/8 u : Mp�v+l Plan Review . Tigard, Oregon 97223 DawB : • Ptsone: 503 - 639 -4171 Fax: 503- 598 -1960 Post•Awiew Internet R/wW.cl,Cl$itdAr.t19 ' !�� ' Dot. _ . �allo 'aour Inspection Request: 503 -639 -4175 - - Came/ lutis•: ■ Sae toga 2 for Name/Method: Sa • • crustal Information. ' 1 - : ; • •,. ' i'''f ".!. 'P.l OF.:WDRiCe. 4:.1.- l'l ;.r.' - - ;T•,., P4 eri ry . i s III New construction : " ` a � '.1aaeR Chjck'al! tB$ a • M1;1;�J <: t % Addition/alteratiotl/re • lacement �• • Other: lititatl • Service over 22$ tows- Flealdt dare 604 commercial ■ li Other: uardoua loader: • :. .... .. ( Lit : a •'CON " e • e Ms-rating of • four mote residential � t> et- ■ 1 & Fattlil dwellin yncm o t l ydw e vhnts four ornwtetestdeggalurisin ' co.. CO'• "11tlst� is1. ❑ sy avrr 600 vans nominal one saucGUe II Accesso Buildm- • Multi -Famil Building oree sioriei [] Fendero, a00 tamps er room Master Builder U. Other ❑ saRi 'ver a oad o vtr rim ❑ Manufactured structures or RV pa:k ::'JOB' SITE: I OZtMiIT ,; :. 8btiag plan ❑ Other: IOi�'.itbd'LOCA OIL . fit Submit - - cab of plage with am of the above. ' Job sit address: . 3C) . V V Tae above . t . not s Citable to ter re �` Bid / l —J +l.'1 ';, !� • : .. F: : r w , o l +: V cont,, alruaia r Suite r s Pro act Nagle r.� ri:� ytr Number Of in, • onion¢ cr ' . emit :Vowed t Pro scree` t ~ +' .`a.� De.'" lien i3�f ✓Directions to .t b site: New ressdeatlal`siap o or muiwram07 per dwalhop o alt. Inc labs attecbad sense t Service lecktde0: /ad - - i000 •.R 5 III 4 Sub CIS • on: / Lot r : Witted ' 4 ' . y Or :�t1en 300 T �� I i . _ c.... Each many5edred bore or nodular dwelling • 1:1 CRIMOM a�'. W _� utviee and/or finder 90 etlin5 ' � � . : P I lilt A'.I, ,� �� I � - ao90 •OCa» MN ! PI2f3PE r!'!!'O'S?�`�y� [/� L^ _ - 2 Ell - " - -• "• . ®L 401:11 r. t -•.. ..CI ~1 .:* . 1 lar JII•:. IW.W Name: t�vcrl000ne•. or volts l Address: � 7ctrtaosuY unites or feeders • tnstaltatloa, /StaIEI/Zl • : 20o aeration, .. o rlas or relorelocation: Phone: Pax: us o idPPLI n• -; - maw _d CA1�7" : -:i 5f d'.r�:•s:'IL@I,CO- `EAOriP3, • 1:Mi;i;*s; '•: i01m600. 2 Name: Bnaett : its - now, tlteratloa, or t Address: e per panel: Dora r.4aria with purchase e( j tit '!$'tdfe /Z1p awtee ar (coder aid branch e;rcoit 6.65 2 j Phone: P• Fee 60 :conchcircuis I :. '1 ., n] ., t , E-mail: Si rake tu Bradt 6.6$ r t :�Ol:l :: _ .l•:...f„.• .`•COI�FI'RACB'OA /`•..-.. : :ti >.. ..'`;4::v`.'fr• .`:;%. © A: 39.40 Business Name: • b. i , n Address: ��� -. 11 t SE r Q / Cl i $tAiC/Zj •_ �� I Each ad - osss! las • -- ' • • over the sC • wade in • of the above: 1 ¢`Rhone: fair.; % :, Ftot: r ., a1 Per i ltaer•min a ho 1 aso �- CCB Liu. ;_: / _1421 Liu. #: 3 C •onta � � Supervising electrician 4,------' �_� ^`f= t - 0.A.:t: _:.s: zlec iical.te'tz'7t3f. • im 4.4..,...K.1-7.k, . ." � • signature re. ed: ' ..— Subtotal 5 I i/it Print Name: rte' a a ; ltavle �(2S'/. of P eel S a State surd.,„ f8% of Permit Fee) S S • "74 ed10R"� MIT FEE S " TOTAL PER Signature: _,� � � �� ! Data_ 1D ,/ Notiar This Dubf t applkatioa -spires If s permit is net obtained within w 180 days star It hat beau accepted to complete. . (Pltise print Horne) 'See methodology set by Tri-Couosty Building Industry Service Ilea rd. TOOK ars'9IZ .d0 ALI° noaroo,,,. .-.• • . _ . _ _ earda Results Page 1 of 1 • __ 6u) g coties tDivisio \\ W 1 t tar i tR ■ min fless Results of your search Your query for: 34 -433c Name: KELSO ELECTRIC INC License No: 34 -433C CCB Registration HILLSBORO , OR 97123 License Status: ACTIVE No: 116254 County: WASHINGTON Expiration Date: 10/01/2003 View License Category: ELECTRICAL construction Signing Suprv. Info: 4270S License Type: C contractor details KELSO JOHN M Total Records Found: 1 Note: It may be necessary to run your search in both categories if you are unsure if the person is licensed as a contractor or an individual. The data file was last updated Mon Oct 6 09:14:27 2003 • Go Back to Query /0/1/0 3 - � .+� 710 4f.x) http: / /www.cbs. state. or .us/ cgi- bin/bcd/licensing/licensing.pl 10/7/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Res ested g —i ( AM PM BUP Location _ % Suite MEC Contact Person 64.4.244 Ph ( 7 — 73 9 — PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 3- 6 0 6 --`P Footing Foundation ELC Access: 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 J PASS PART FAIL PLUMBING /41 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 PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm � Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date 7 l � 6: Inspecto Ext Other: Final DO NOT REMOVE this inspection record from the job Ito. PASS PART FAIL