Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00153
DEVELOPMENT SERVICES DATE ISSUED: 3/24/03
jlll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 112 DA -01200
SITE ADDRESS: 15060 SW SEQUOIA PKWY
SUBDIVISION: PP1995 -098 ZONING. I -P
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Install 2 branch circuits for counter display.
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:
PACIFIC REALTY ASSOCIATES BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 - 2006
Reg #: LIC 44569
SUP 1769S
FEES ELE 26 -451C
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 3/21/03 $53.50
[TAX] 8% State Tax 3/21/03 $4.28 Rough -
Elect'l Final
Total $57.78
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 - 332 -2344.
Issued By: / Permit Signature: 0 , 71 , ,9-,0
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: £ V- i/ 77.0" DATE:
LICENSE NO:
Call 639 - 4175 by 7:00pm for an inspection the next business day
03/3 3/2003 15:40 5032332963 BACHOFNER ELECTRIC PAGE 02
•
Ai, Electrical Permit Application
3 972
7ppl. ived� /_�� Ptrmit no. ��/
_ . li' •1 il kty of T1g�rd REC E no.: Expire date:
City of Tigard Address: 13125 SW14a11 Blvd, Tigard, OR ed: BO I Receipt no.:
Phone: (503) 639 -4171 QQ3 Fax: (503) 598 - 1960 M AR 18 2 no.: Payment type:
Land use approval: C T '( OF TIGARD
01 & 2 family dwelling or accessory O Commercialfnndustrial O Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
Job address: 1 fip sw spill/CITA PhRtitipur Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: OFFT('R n prww I Description and location of work on premises: T ic I T COUNTER DISPLAY I
Estimated date of compledon/ins ' --;on:
( ON It %t OIt .\I'l'I.I( AI ION 11- SC III 111 I:I
Job no: 0672 Fee Msac
Description
Business name: �, T -mst� Qty. (ea.) Total oo.lmap_
Nev. roadside! Address: 55 SE /SIN dw+ea ngle& Medea ouedied prose.
City: POWITANII I Stater 1 97214 service
- Phone: 3-23 Fax: e 733-2963 J E -mail: 1000 sq. fl or leas 4
Each additional 500 sq. R or portion thereof
CCB no.: r44n4 Elec. bus. lic. no: 26.45 Limited energy, rosiderttial 2
City /metro lic. no.: 2D Limivaenergy. non-residential 2
i .n(�,e4 - 3 -18 -03 Eas ;hmanufactured home or modular dwelling
of supervising electrician ( eed) Date Service and/or feeder 2
. Sup. elect. name (print): 11M121/4 V alCIERER Uceoseao: bersleaorfosdets- ImblLtiaa,
abtexslion er relo:tlom
200 amps or less 2
_ Name (print): 201 amps to 400 amps 2
amps to 1000 atop _ 2
Mailing address: 601
amps to 1000 aelpe 2
City: I State: ' ZIP: Over 1000 amps or vole 2
Phone: 'Fax: I &mail: Reeormect only 1 . ,
Owner installation: The installation is being made on property I own iimerponry services or feeders - . .
which is not intended for sale, lease, rent, or exchange according to ' on, er 'el°°`
200 mope leu ORS 447, 455, 479. 670. 701. tern 1 3
Owners Si Date: ' 401 to 600 s 2
Breech drafts - new, altaatfoa,
orexteodoo per pea*
Name: A. Poe for branch circuits with purchase of
Address: � l � strike or feeder fee, each branch circuit 2
City: I State: ' B. Fee for branch smelts without porcine* ' u .
Phone: Fax: ) mil; of service or feeder fee. fast brand circuit 2
Each additional branch circuit - I to , bS
1'1..\\ It I' 1 I NV (1'Ica.c died, all ili:11 :Tilt %) MLe.(Senleeor feeder act lndaded):
O Service ova 215 amptaommacial ' O Waltham facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1612 O llszardoasloadion Bach sign or outline lighting . 2
family dam O Building over 10.000 agaare feet four or Signal dreui*(a) or a limited energy panel,
O System over 600 volts nominal more residential write in one erects elaratioa. or extension' - .. - 2
O Building over three stories O Feeders. 400 amps or mom *Description:
0 Occupant load over 99 persona O Manufaaurod moues or RV part loch over Impectioa over the allowable berry of the slows
O BgressAighdngptan O OM= Pain:payon i I j - ,
Smolt sets of plain with any of the above. 1m fx
. The above one not applkable to temporary construction smite. Other
Net all JoANNea �
eoa weep t cards, &we all Jai. ictim tQ memo irdamrum. Notice: This permit application Permit fee $ 53 .51:L
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $
Cade cad camber: / / within 180 days after it has been
State surcharge (8%) $
Expj° accepted as complete. TOTAL $
Nome d smolder as down re eredll Ord
Csdbolder dins Amount 4104615 (6ioor:OM)
I
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION business Line: (503) 639 -4171
3 BUP
3
Received Date Requested - .27 AM PM BUP
Location _� to D Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner" v� ELC 3 -06 /313
Footing
Foundation ELC
Ftg Drain Access: 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 'WP 1)
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 PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
►. Please call for reinspection RE: _ U ab a to inspect — no access
Fire Supply Line
ADA :
Approach/Sidewalk Date 3111 03 Inspector ' / «� Ext
Other:
Final D NOT REMOVE this inspection record from the job site.
PASS PART FAIL