Permit .t, CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -26005
Al,a DEVELOPMENT SERVICES DATE ISSUED: 9/30/02
�= ��' I' 13125 SW Ha Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S133AD-13900
SITE ADDRESS: 12701 SW SORREL DOCK CT
SUBDIVISION: SUMMER LAKE ZONING: R -7
BLOCK: LOT : 020 JURISDICTION: TIG •
Project Description: Installation of (3) branch circuits for utility shed and bathroom.
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:
FERNANDEZ, JUAN + MELANIE DAN CORRELL ELECTRIC INC
12701 SW SORREL DOCK CT 11712 SE RHONE ST
TIGARD, OR 97223 PORTLAND, OR 97266
Phone: 503 - 524 -4368 Phone: 761 -2178
Reg #: ELE 26 -103C
FEES Required Inspections
Description Date Amount Rough -in
Elect'I Final
[ELPRMT] ELC Permit 9/27/02 $60.15
[ELPRMT] ELC Permit 9/30/02 $0.00
[TAX] 8% State Tax 9/27/02 $4.81
(additional fees not listed here)
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 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: e-
Ai Signature: J /97 /C'� /7e".
OWNER INSTALLATION ONLY
The installation is being made on I own which is not intended for sale, lease, or rent.
property
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
SEP 25 2002 3:52PM HP LRSERJET 3200 p.2
09/24/2002 08:49 FAX 5035881980 CITY OF TIGARD \ g)003 .
El ectrical PermitApplicatio
fl
°� .9/2,6/0 v
Date received; Permit no.:f
z -Z4elOg
r_y C ity of Tigard - - � , 1'nnlealappl.no.: 6 :pira datc:
C;O, o)7gerd Addreks: 13 125 SW Hall Blv 3 Dale issued: By: Y �Receipt no.:
Phone: (503) 639 -4171 'LJ� f
Fax: (503) 598-1960 ,-, e f an Case file no.: Payment type:
Land use approval: « , a .cPk
u k. a ► ,
TYPE OF PERI1111
• lei & 2 family dwelling or accessory O Corn'merciai/industrial O Multi- family CI Tenant improvement
O Ncw construction a(dditionfalteration /replacement O Other: CI Partial
• J011 SHE INFORMATION
Job address:/27p/ J . • tree D4ek'c, Bldg, no.: Suite no.; Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: j Description and location of work on premiscs:4 jg r - r'� r.
Estimated date of completion/inspection:
CONTRACTOR ATPLIC.4 FION FEE SCIIFDULL
Job no: 71/.5
Business name: /P ., Drseri or+ • r � n o. tarp
C • `err ..'t -dicker mutd-famiy per
Address: .Q_ • "t( !6 ? 8f5_' doellingunil.Iachnla attached prom
C l ry ; Q I a I5tate f e . I ZIPI9-7 j'7 - Ser.iminehtdcd
Phone:7,6 –.12.91 I Fay ,�.2f' J E-mail: � � " 00ri
I0•. ft. orins 4 , •
CCB no.: 7 3 i
Vvo lac. bus. lio. no: Each additions) eq
500. ft. or portion thereof
I Lim tied en efay,residenlial 2
City /, • lie. no., igz., .. /0 f0 / 03 Limited energy. non- residential 2
/ ' Ili 4. /d o , Each manufactured home or modular dwelling ■ 7. of su. rvisi electrician aired Date i 0 Service and/orfeeder � ■ 2 •
�.m a License no: «I_ekil Servires ceders — installation, ■
alteration of reloeation:
' PROPERTY OWNER 200am•. Or lest 2
Name (print); • I amp' to 400 amps 2 !
401 ampe to 600 amps 2
Mailing address: 601 amps so moo amps 2 •
City: 1 State! I ZIP: Over woo amps or volts 2
Phone: I Fax: [E-Mail: Rgtermectonly I i
Owner installation: The installation is being made oo property I own leahporaty ata.iceaorreedero • . •
which Is not intended for sale, lease, rent, or exchange according to tuitallad oni alteration, orretoaliwt:
•
ORS 447, 455, 479, 6/0, 701. 200 ompa or kis 2 •
201 amps to400amps 2
Owners signature: Date: _ 401 to 600 •. •s 2
ENGINEER ninth circuits - nest', alteration, •
or aat' mkt o per panel:
A. Foe for breach circuits with purchase of
Address: ow or feeder fee, each breech circuit 2
City: State: • ZIP: B. Fee for branch elteuiis without purehme
Phone: 1 Email: ol service er loader fee first branch circuit (�� 1
Each additional branch eireult: ,2„. 3 1g •
PLAN R1 :111;ll (l'le:lse check Al Ihat apply) tae • (Smite or feeder not loci aded);
O Service over 225 amp'- oommerdal • CI Hall th- carrefacility Each pomp oritri &' � on c1rcle 2
O Service over 320 amps -edng of) &2 O Hazardous louden Each sign or outline 2 '
family dwellings 0 Building over 10,000 squat feet four or Signal d mitts) era limited cnergy panel.
O System over600 ' nominal more , e■idmhld uniu in urn aoucrumo Wax atlon, orcatenstOn• 2 '
O Building over throe movie, 0 Feeders, 400 amp Or more •Dcami • : on: _
•
0 Occupant load over 99 person: D Momrface, red mrvauree or RV p •ric Each additional Irspedtos orertbe allowable In any of the above: •
O
•
Ea mu/lighting plan 0 Other;
Per inspection I 1 I I
SuDtnit _ seta of plans with any orate above. tuvc:dgedon fee
The above areaol applicable to temporary construction service. Other �J •
Nm all Justsd nc's
leueoept twat cards, pique call Jod moss adielion for IId I to Ioe. Notice: This permit application Permit Etc aTlt� • ! S
o.vt.a olaaaterCerd expires i f a permit is not obtained Plan review (at — %) $ •
omit owe number: -18.1714— within I RD days after it has been State surcharge (8%) .... $
era accepted as complete. TOTAL $ _ ' •
Nose drmm,•tdsras dawn on credit cud
S
e Cudhol4ev *immune A cat 6.40.4615 (610elCOM)
ha` I 6 C
d
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 741 AM PM BUP
Location / ;— 01 Suite e MEC
Contact Person '' Jr . 4. Ph ( ) 7 (o / — 7c - ' ? PLM
Contractor f't G7y`f / / - - Ph ( ) / 71 SWR
BUILDING Tenant/Owner ELC a
Footing ELC
Foundation s
Ftg Drain Access.�rJ`fNuX" // �� �� y�) �Z — ELR
Crawl Drain O D c < Ht�� LL:'C1t Q}�o
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing 6.tkST: S I / C
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final .� f�
PASS PART FAIL JC
PLUMBING 4/--371, 1.s-1 A / 7 73 vZ - CI
Post & Beam
Under Slab
Rough -In
Water Service ` I t _ �
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
clou•
Low Voltage
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA � Inspector 2 ) Ext
Approach/Sidewalk Date ' 5 —� — P � �� i
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 /0/0/. 7 AM PM BUP
Location / a 7 6 I 6�VLQ f . Suite 0— 7 MEC
Contact Person 04—^% Ph ( ) o`Z D `- 7/3e PLM
Contractor DP,/ Qtr// t 7c per' Ph ( ) SWR
BUILDING Tenant/Owner ELC of — <<Le c;.660S
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
Fi rewal I
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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
Slab
Low �\ n �
Low Voltage \`�
Fire Alarm
�� Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
.10 PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA L
Approach/Sidewalk Date (7c . f ( � Inspector d ' Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL