Permit Ato CITY OF TIGARD ELECTRICAL PERMIT
P ERMIT #: ELC2003 -00587
1'�� D EVELOPMENT SERVICES D ATE ISSUED: 9/19/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S133CD -16400
SITE ADDRESS: 11582 SW TALLWOOD DR
SUBDIVISION: PEBBLECREEK NO. 3 ZONING: R
BLOCK: LOT : 054 JURISDICTION: TIG
Project Description: Installation of (1) branch circuit for hot tub.
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: 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:
JEFF LEAPTROTT OLIVERS PRECISION ELECTRIC CO
11582 SW TALLWOOD DR 17035 SW HIGH HILL LN
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 503 - 579 - 7747
Reg #: LIC 41435
SUP 2539s
FEES ELE 34 -521C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/19/03 $46.85
[TAX] 8% State Tax 9/19/03 $3.75 Rough -in
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 - 332 -2344.
Issued By: 4t d *All Airyj _ .cam- Permit Signature: per/ /9 / C9 y 7o,/
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: 0r /`- / 0r /`- / / 51-7° V --7
/)` / C 40 DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
• '69/18/2003 66:56 2035795907 REVI LO SAINTS PAGE 62
vok `Electrica Permit App lication Received ea. Electrical
Date/By: V / 8� 3 1s. r PcrmitNo.: Ze..Z003 '40527
Planning Approval Sign
City o 'Tigard EC 4 `V Date/Bg: Permit No.:
13125 SW Hall Blvd. Plan Review Other
/By: hermit No,:
Post-Review Tigard, Oregon 97223 land Use
Phone: 503-639-4171 Fax: 503 -598 1 8 1 1 q �� ;{+ p Dat e/D _ Case No.:
Internet: www.ci.tigard.or.us 1 contact wee Page 2 for
24-hour Inspection Request: 503 639- �1 OF DIVISION ~r
Name/Method: .� Supplemental Information.
BUILDIN
TM
Service over 225 amps. I Health -care facility
]r New construction �0 Demolition
• commercial 0 Hazardous location
1 I MINA ❑ S ervice over 320 amps - rating of ❑ Building over 10,000 square feet,
Addition/alteration/re • segment Other: four or more residential nnits in
r y� 1 & 2 fa dwellings
; P a 8' o b � ' ' „�� one structure
Ea➢I _ � .
- & 2-Famil dwellin; id CommerciaUlndusirial ❑ System over 600 volts nominal 0 Building over three stones ❑ Feeders, 400 amps or more
rill Accesso Buildin_ , ., ❑ Occupant t oad over 99 persons 0 Manufactured structures or RV park
.. ... Other:
�� Master Builder Other:
❑ Egress/lighting plan of the above.
aren
' , . • ,' .Q ,t ; -'IT i a a k t _,elf' 0 The above
m t not al sets eabie to tem construction service.
Job site address: I S''NA a.' FEE' 5CR IT' ''. ` :. •
Suite #: Bld . /Apt. #; Number of Ins sections , r ertnit allowed
-
Desert lion Qty Fee tea.) Total Fro'ect Name: t'� New residential - single or multi - family per
Cross street/Directions o job site: dwelling unit. Includes attached garage_
Service Included:
1000 s•. ft, or less 145.15 4
Each additional 500 s.. ft, or t • rtion thereof 33,40 MEM 1
Limited crier:* residential 75.00 2
Subdivision: Lot #- Limited crier !, non residential MI 75 MOM 2
r e Each manufactured home or modular dwelling 90.90 2
„ µ, A serv artdlor feeder
!'�a'19y�F,lat't f V. Services or feeders - installation,
siterattOn or rmlocattan:
200 am s or leas 1111 50.30 IN 2
20I am.. to 400 am.. 111.11 106.85 2
401 ant. • to 600 am.. 11111 160.60 J 2
r o �� �1�I1�y" i 1 , a , , M ! 601 Nit m imam- - 240.60 2
�VrJY!�d >. INS 2
Big �',�.:a�f) t :�!.s�'.�t' �n rGxt� ,?::'°t;HG�i3�+7L .. ,,,lia.�.� Over 1000 am. or volts � 66.85 2 45 4.65
Name: em. • r t Reconnect onl
- Te ' L .7t G W i/� , r• Temporary services or feeders - installation,
Address: ' alteration, or relocation: t
Ca< /Stan: /Zi s : r 1 40.' , 3 66 200 am..: or less �
201 am • a to 400 100,30 2
Phone: I/ y Fax 401 to 600 am. < MI 133.75 2
P PwIix. M1Y. dtli:tW;111�117�S +dw'�t %tifN
_ENIERE� tie hl ".,tom•• i3rapch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 6,65 2
Address: service feeder cu each branch circuit II
B. Fee for branch circuits without purchase of / ,515 2
ISL I SEEZE r serv branch or feeder fee firs branc circuit �� (F
Each additional branch circuit (� 6.65 2
Phone: � + *t .n.l1i Mise. (service or feeder not included): ■ 53 2
E -mail: 1 1 ,, Each .mn. Or iai: •tio>a circle
I t'c 11 A � f /5 51ii lih/ _ 53.40 MEM 2
Job No: — Signal citcuit(a) or a limited energy panel, ■ 2
alteration or extension .
Business Name: Q vas r eg " e. I peacription:
Address: / !•.a ' f Each additional ins 1 ection over the allowable In an of the above:
s : �'_.. r h . -. 62.50 _
F AX: �
• ^ . _ Investi'r. Lion fee:
Phone; 5 other- .
CCB Lic. #: / 5 . Lic. #: -524 q sz IRMI ?A.11: ;: a� a,i��l' 4�`I .t, `g "' )t
Supervising electrician EllW _
Subtotal >�
Si: ature re r uiz : La Plan Review 25% of Permit Fee S _
Print Name: 1l L 0 f Lic. #: _ . 9 - - State Surehttr :e 8% o('Permit Fee S • 7
TOTAL PERMIT FEE. I • ,
Authorized Notice: This permit application expires if a permit is not obtained w 1 in
Pate: 110 days after it. has been accepted as complete.
Signature: =Foe methodology set, by Tri- County Building Industry Service Board.
(Please print name)
i s\0sts\Permtt Forms\ElcPcmdtApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection tine: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
774 BUP
Received Date Requested �% AM PM BUP
Location 1 �Z `�a...RQ LA.) Suite MEC
Contact Person Ph ( ) 70 - 6369' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner a 3- oQ
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 0 r r SIT
Post & Beam . I L WU t \ .�
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling r
Roof
Other: 7 i
Final "Pic-)9'
PASS PART FAIL r _a
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
pat SR ART FAIL
LECT L
Service F(...s
Rough In
UG /Slab
Low Voltage
F' Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for einspe tion RE: Unable to inspect — no access
Fire Supply Line
ADA S') •
Approach /Sidewalk Date .�I I Inspe / — _ ° Ext
Other:
Final ' • NOT REMOVE this inspection record rom t °e job site.
PASS PART FAIL