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Permit 4' CITY ®F T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2002 -00363 '° DEVELOPMENT SERVICES DATE ISSUED: 8/1/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 • PARCEL: 1S135BD -01200 SITE ADDRESS: 09802 SW SHADY LN SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical tenant improvement, (1) 200 amp service or feeder and (6) 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: 1 W /SERVICE OR FEEDER: 6 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: • FORBES, DONALD CAROLYN JC ELECTRIC INC BURDICK, DONALD LINDA 118 NW 184TH STREET 434 RIDGEWAY RD RIDGEFIELD, WA 98647 LAKE OSWEGO, OR 97034 Phone: Phone: 360- 887 -7889 Reg #: SUP 4289S ELE 37 -724C LIC 118452 FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT CTR 8/1/02 $120.20 2720020000( Rough -in Elect'I Final 5PCT CTR 8/1/02 $9.62 2720020000( Total $129.82 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 OA' 95 101 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to I Permit Signature: if' Issued By: • / / 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: QY\ Q- finfl • DATE: LICENSE NO: S Call 639 -4175 by 7:00pm for an inspection the next business day Jul 29 02 11:35a JC Electric Inc 1 360 887 5584 p.2 - Jul-'29 02 07:25p. Memmingson Construction 5036460129 p.3 PlectricalPermitApplication - Date received: ; ep„2., Pamir no.: _ ,, _tp% . 1,' . City of Tigard Projcct/appl. no.: Address: 13125 SW Hall Blvd, Tigard. OR 97223 City n /Tigard Date Issued: : Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT O I & 2 family dwelling or accessory ® Cammercialfmt nurial O Multi family O Tenant improvement O New construction O Addition/alteration /replacement O Other. O Partial JOB SITE INI OIiMAT1OV Job address: q c iK1g, SF\R4cj LA4I Bldg_ no.: Suite no.: Tax map/tax lotleccount no.: Lot: 1Btuck: [Subdivision: Project name: E(; tl 1 - 1 , 4 CAL 1 Description and location of work on premises: Estimated date of completionfmspection: CONTRACWOt( APPLICATION FFE SC11EDUl.F - Job no: W. RIPIERI residential -elogloamfdd -fene7y per III Address: 1q i�1h1 \14 SS dwe lragindr.lorladreattedwdemega City: RAG Ft t.:) I State: W1 ZIP: Cy4fla • Servleeatdoas& • Phone: , ' 1.- . Ai Fax: : , .c'r E- trail : - r Zt.i..OS 100os' - ft- °tea 4 CCB no.: IF^(•e Flee. btu. lie, no: E a c h additiond SOO sq. f t . .. thereof 11.111111/11/1111 2 l \�4�a. ---- ��C'- Limitcd energy.=dent id 111111111111= City/metro tic_ .: S\Vg /e' Eiudted 1111 � � d _ 1 /a�I:a. . Each manufactured home or modular dwel ling Sign supervising can(requred) — `15ate /s - / Sev'icearnJor up. elect Dame (print): fir` CcutAte•g lZ License no: 4 aBss Seri °Meccas- bniaafion, alteealloo yr velotad B PROPER '1'1' O1P1NER 2 00 amps orlest 111 2 IOl amps to 400 amps 401 ails to 600 amps 601 amps to 1000 an>ps City: Stale: ZIP: Over 1000 en* or volts Phone: Fox: 1 E -mail: Reconnect only Owner installation: The installation is being made on property I own T iiporlu7 services errand= • which is not intended for sale, lease, rent. or exchange according to lahstanatian,alteradoo , orrdoca6oa ORS 447, 455, 479, 670, 701. 200 cape or leis III 201 amps to 400 amps Owner's signature: Date: 401 to 600 amps • ' . - ' • ENGINEER . • , Brancbelreatc- new,aberatlon, or eatcasioo per pant A. Fee forbranch circuits with purchase of iD 2 anvice ar feeder fee. each blanch circuit B. Fee for branch circuits without purchase City: State: ZIP: of service or feeder fee. first branch circuit 2 Phone: Fax: E-mall: Each additional branch circuit PLAN AN REV11 1% (Plcac check all that apply) , Mfse.(Serdie feeder not mclyded) O Service over 225 amps - aonm ercai O Heelt .csre facilit p O° circle 2 0 Service over 320 amps-rating of 1 &2 O Hazardous location Each sign cream= lighting 2 tamilydwellinga 0 Building over 10.000 square feel four or Signal circa It) era limited energy panel. 0 System amain writs nominal mote resies identialunits inane sour alreratioaorattention' 2 _ ' O Building ova duce stories Cl Feeders, 400 Amps or move •, _.. • O Occupant load over 99 persons 0 Manufacuted structures or 1W park Each addtdoa inspection over the allowable In any 'lithe above. 0 Egress/lightingplan O Otter: Per inspediou . I I I ( Submit sets of plans with any ditto above. Investigationfee The above are not applicable to temporary construction service. Other "'" ' Permit fee $ . O AO Not all jurisdiction: mein credit cards, pirate can jurisdiction for more iaformauaa. Notice: This permit application _ ew v 46) E Plan rei (at O v O MauciCard expires if a permit is not obtained Stale Iew at (8%) .... $ f!• C:edr cud norther. —.1.--L— within 180 days after it Ids been R 8 not. accepted as complete.', TOTAL S • / Name of amtbolder as shown on credit card _ s i Cardholder airman Amosan 440•46» f6 CON1) CITY OF TIGARD, 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business 'ne: (503) 639 -4171 MST BUP Received Date Requested /'" PM BUP Location c D S uite MEC Contact Person ibYL} (3(ov) , Rg 7 — 1 ggq PLM Contractor Ph (4.) 1 )) � � � SWR BUILDING Tenant/Owner ELC ' 363 Footing Foundation _„ ELC Ftg Drain Access: D F 6/ ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors M Ext Sheath/Shear • Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler / Fire Alarm /A 2��T -- 1 ' ■Y � L� Susp'd Ceiling 1� V ` 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 PART FAIL ELECTRICAL Service UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date ■ Inspector . � _.4 �/ / / ✓ Ext P Other: Final DO NOT REMOVE this inspection record from the jo site. PASS PART FAIL Y OF TIGARD, 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested �� AM PM BUP Location Suite MEC Contact Person Ph ( ) PLM Contractor C0 Pie C Ph (J gg 7 7 ? SWR BUILDING Tenant/Owner ELC 2 r C o 3(9 Footing ELC Foundation Access: Ftg Drain L a-6 t ELR Crawl Drain 7 Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear r Framing 1 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm / Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam ,.� IrK4., W a - Under Slab A Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Drain Storm Drain (•,/ Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service_ ough- UGTSlab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PAR ,40 SITE j Please call for reinspection RE: Q Unable to inspect – no access Fire Supply Line • ADA Approach/Sidewalk Date 67-E,R6 Inspector — �' Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD. 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 6 AM PM BUP Location 9 � � Z Suite MEC Contact Person /y9/, d Ph ( ) - — _�_ _ PLM Contractor Ph () P — SWR BUILDING Tenant/Owner ELC — 0-7) 34,3 Footing Foundation ELC Access: Ftg Drain — ELR 1 A. Crawl Drain /3-0/( T /: `•�. Slab Inspection Notes: SIT Post & Beam r Shear Anchors Pr Ext Sheath/Shear Int Sheath/Shear Framing Insulation C I �1 � h( A CD v PP)S6 Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof S 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 • gh -In C,, \ ZIrr n a. �f Low Voltage Fire Alarm 4 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE El Please call for einspecti.n RE: ❑ Unable to inspect – no access Fire Supply Line ADA 63 Approach/Sidewalk Dat d 2- Inspect. I Other: Final DO NOT REMOVE this inspection record from the Jo site. PASS PART FAIL