Permit . 'IRC I TY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -26002
4 zAiiii?' DEVELOPMENT SERVICES DATE ISSUED: 10/1/02 .
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DC 04602
SITE ADDRESS: 07291 SW TECH CENTER DR
SUBDIVISION: ZONING: I -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (6) additional 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: 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: 5 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:
MCCORMACK, WILLIAM L + DARLENE HANDSKILL CORP
7190 SW SANDBURG ST P.O. BOX 33079
TIGARD, OR 97223 PORTLAND, OR 97292
Phone: Phone: 503 - 252 - 6225
Reg #: ELE 26 - 529C
FEES Required Inspections
Description Date Amount Rough -
[ELPRMT] ELC Permit 9/27/02 $80.10 Elect'I Final
[ ELPRMT] ELC Permit 9/30/02 $0.00
[TAX] 8% State Tax 9/27/02 $6.41
(additional fees not listed here)
Total $86.51
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: € 7 / /69 j`7DPl/
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
09/16/2002 10:17 FAX 5035981960 CITY OF TIGARD 10092
./
:
Electrical Permit Application
Date received: 9/24 Q?/i 'Penni' �"/t zoo z -Z . ,
...mo .,k,, (:sty of Tigard C ` T - �.. w -. I
l , . -� ,
A ddress: 13125 SW Hall 21 d, • �' 23J �� ProjecVappl. no.: Expire date:
h
CihnjTigard Date issued: By . Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 SEP 2 il. ?8fl Case no.: Payment type: .
Land use approval: 1 a • u� n,, aft ! 4 I ,6 -.7 „6,u70 670 e 2 — D i 13 %5
I PE OF: PEIi - -- =
0 1 & 2 family dwelling or accessory /4, ComrnerciaL/industrial O Multi- family 0 Tenant improvement
0 New construction 51Addition /alteration/replacement ❑ Other: • 0 Partial
• JOB 'SITE INFORMATION' -
Job address: y e'/ S. to , a ll CEot..jjd). Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: Description and location of work on premises: . ( _ :•,., I'e eel- . it- c c,
Estimated date of completion/inspection: /0-- / -- s9
''COTRACTO APPLICATION: 1 r ; ':
N R' FEE SCHEDULE
Job no: fee Maur
Business name: ` / Deseriptlon Qty (ra•) no- bup
AM d�P ifLk.: f ` e..:'. , tr CS C! eE'' r. New residential • single or niollt- family per
Address: . l? , ?, 30 9 dwelling unit Whisks attaehedPIMP.
City: ef) $i ( State t`Z.[ ZIP : 1 y 7 7_9 Z. Service included
i Fax. mail: 1000 Sq. ft. or less 4
Phone: 2 S� Z Each additional 500 sq. ft. or portion thereof =� �
CCB no.: a. I Elec. - ' v ma • E btu. lie. no: 26, .2.c/ C Limited energy, r
2
- Li
y /me o : n0.: J I 2,. 07' /0 0/ OS Limited energy, non- residential —__ 2
�' . • ' p � Each manufactured home or modular dwelling
Signature of supetviling electrician (required) Date , �D Service and/or feeder feeder 2 tl
_� ,. Sena
teothteders installation,
• - alteration or relocation:
•
"PRO ER 200 amps or less _ 2 •
Name (print): '�fe0 J ce,0 e2 r 7:),4C , =A-) C...- 201 amps to 400 amps ___ 2
401 amps to 600 amps 2
Mailing address: w j S - C,,,,. i 601 amps to 1000 amps 2
City LAW • e . + , , P „ .. f , State :d , . ZIP:`?' 7 3 Ova 1000 amps or volts 1111.11MMI 2
Phone: ' 'de " ,.yfi Fax: r4'$ °®q a - mail: Roconnect MEN_ 1
Owner installation: The installation is being made on property I own Temporary services or feeders •
iastaU anon, alteration, or relocation:
which is not intended for sale. lease. rent, or exchange according to 200 amps or less 2
ORS 447. 455, 479. 670. 70) . 201 amps to 400 amps 2
Owners signature: Date: 401 to 600 amps 2
,. ENGINEER: ' ' _ ' • Branch circuits - new alteration,
or extension per pastel:
Nam A. Fee for branch circuits with purchase of
Address: • service or feeder fee. each branch circuit
City:
Sim.: ZIP: B. oft for circuits , without circuit: �.
of service ce or or feeder er feee, firrst t branch nch circuit:
Phone: Fax: E -mail: Each additional branch circuit:
• -. .PLAIN 1•I Ell (9rlcage:check ail that : appl) ` s) Misc. (Service orfeedor not included):
or irrigation circle 2
Cl Service over 225 amps - commercial a Neath•care facility Each p 2
O Service over 320 amps- rating of I &2 0 Hazardous location Each Sign or outline lighting
family dwellings 0 Building over 10.000 square feet four or Signal circuit(a) or a limited energy panel.
O System over 600 volts nominal
more residential units in OM structure alteration, or extension' 2
O Building over three stories U Feeders. 400 amps or more •Descfipdon: �C172 t CAL . • d
0 Occupant load over 99 persona 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
Cl Egressllightingplan 0 Other: — Per inspection 1 1 1 I
. Submit _ sets of plans with any of the above. - . investigation fee
The above are not applicable to temporary construction service. Other . - .. • •
Permit fee • $ , • • /-=-
N ue..beuoaa accept credit cards. please call jurisdiction for mote information. Notice: This permit application Plan review (at %) $
0 Visa 0 Ma-•terCard • - expires if a permit is not obtained •
• c card nuruout I 1 within 186 days after it has been State surcharge (8%) .... $ ,W
1es accepted as complete.
Name S � . Nae of cardholder as shown on credit card
$ .
Cardholder signature Amount 4404615 (6 X/COM)
■
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
•eceive Date Requested F / 0 /-- AM PM BUP
L• ion Suite MEC
Contact Person Ph ( ) - 3 g0( PLM
Contractor Ph ( ) SWR
\-2/1...e711
BUILDING Tenant/Owner \-2/1...e711 ELC X 00 . 2 —
Footing
ELC
Foundation Access: �t/D
Ftg Drain 7? _ hc Ci4- ELR
Crawl Drain
Slab Inspection Notes: / SIT
Post & Beam JJ71A O
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
0 Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
Susp'd Ceiling
CRoof
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
Fjnal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS) PART FAIL
SI ❑ Please call for reinspection RE: El Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date /0 — 03 -- as Inspector ( q 7 Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL