Permit A 'CITY OF TIGARD ELECTRICAL PERMIT
P ERMIT #: ELC2002 -00534
. L liti DEVELOPMENT SERVICES DATE ISSUED: 10/11/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101DC -01100
SITE ADDRESS: 07298 SW TECH CENTER DR
SUBDIVISION: ZONING: I -H
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (2) branch circuits. Job No. ST51517.
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:
CIRCLE A W PRODUCTS COMPANY ENCOMPASS ELECTRICAL TECH
ATTN: PHIL PINGSTERHAUS 5711 SW HOOD
BY B-LINE SYSTEMS, INC PORTLAND, OR 97201
HIGHLAND, IL 62249
Phone: Phone: 503 - 963 -6806
Reg #: ELE 34 -247C
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/11/02 $53.50
[TAX] 8% State Tax 10 /I 1/02 $4 Rough -
Elect'I 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- 3 -23
Issued By: I j' , . ' Permit Signature: Prt/ /97°/4 e 6
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
OCT -08 -2002 TUE 02:09 PM FAX NO. P. 02/02
: A LUEI V Lt.:
. A Electrical Pe 'cation
01 - aI 1 fig'" • Dater ceivec: /Op'ifa 2-- Permit DD.: tiL 2,002-69 53L
,,i ;� :J'i!' City o f Tigard U: r kit.. l��11 -1e'A Project/appl.no.: // Expire date:
City of Tigard Address: 13125 SW Hall �I g �Q 0Z2 3 Date ` 1 O D i D issucd; ay; -Receipt no
Phone: (503) 639-4171 � ��, il,Jt '.I
Fax: (503) 598 -1960 rw �4 Case file no:. payment type:
Land use approval: _
O 1 & 2 family dwelling or accessory Comm
ommercial/industrial ❑ Multi- family ❑ Tenant improvement
0 New construction .. . . 0 Addition /alteration/rreplacOdra: ement , ❑ Oa: ❑ Partial
JOB SITE INFORMATION 1 .
Job address: rl i Sb 11 es Bldg. no.: . Suite no.: Tax map /tax lot/account no.: -
Lot: Block: . Subdivision: • • � -
_I+I,i
project name: ✓�.. Description and location of Work on premises 0,00 )L?6.
. Estimated date of c • • pletion/inspection: , • •
CONTRACTOR APPLICATION FCC SCIII
Job no: 1 al 'O0. - v - - Fee '. Max •
Business name: _ - , - ' : D cription Qty. (ea.) Total no. 'asp
J ..1! 11 /11/ • 1 ► New maid - dreta or audit per
' Address: J A I 0 *A dwelling mitInclanes attached garage. •
City: Iniar�I � ZIP: i. , m Servieeladuded:
Phone: drMiliallOrja co, 401 E -mail: 1000 a ._ tt or less • 4
CCB rno.: i� l� Elec. bus. lie. no: . _ Each additional SOO,y. ft or portion thereof
i i I Limited map, realdenial 2
Ci /metro C. no.: /o a/ 63 Limited energy, nor- residential - 2
0 r / • Each manufactured home or modular dwelling .... -.
_Signature of supervising electrician (required) D Service and/or feeder
Services or feeders- Installation,
Sup. elect. name (Print): r License no. s • alteration or telooatloa: . •
!' PROPEIt`I')' OWNLR 200am 2
Name (print): 5. t _ & 201 amps to 400 amps 2
neaps to 600 amps
Mailing address: ' 601
amps to 1000 saps 2
City: !State: . I ZIP: Over 1000 amp o r volts 2
Phone: • (Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Tempomry secricet or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, alte'°t Ion, arrelocation:
200 amps or less
ORS 447, 455, 479, in 701. 2
201 amps to 400 amps
Owner's signature: Date: 401 to 600 am 2 •
Branch circuits - new, alteration, -
ormambo per panel: • •
Name: A. Fee for branch c ircuits with purchase of AA i� 85
Address: service or feede: fee, each branch circuit I 'in 2
•
City: I State: J ZIP: B. Fee for branchh circuits without purchase I. / Is
Phone: Fax: • E : of service or feeder fee, first branch circuit: 2
Each additional branch circuit
I'I.AN liE_vlENV (I'Ica:e check all that apply) Mine .(Serviceorfeeder not Included):
O Service over 225 amps-commercial • 0 Healthy facility dump or vriamion circle 2
❑ Service over 320 amps.rating of I dt2 C) Hazardous location Each sign or outlinejhting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
❑ System over 600 volts nominal more residential units in one structure . alteration. or extens ion* 2
0 Building over three stories 0 Feeders. 400 amps or more ' ,
Cl occupant load over 99 persons Q Manufactureed structures or RV park Each additional bn:pection over the allowable to any of the above:
O Egr:s/lightingplan . 0 Other: . . Ferinspection •
- -• , ••- Submit �_ sets of plans with any of the above. • . ;. • Investigation fce •
•
_. e above are not applicable to temporary cousirnetton service Other •
et Aljurledieliom accept credit __,:_ OM jurisdiction tor auto infarmmion. Notice: This permit application Permit fee $ 55 -
OVisa • C] .. expires if a permit is not obtained Plan review (at — %) $
cravat and mire - - ' within 180 days after it has been State surcharge (8%) .... $ 4 • • Z
l Of►t /: :T /E. jtA " . ' accepted as complete. TOTAL $ Ti' Z S
r?% hill i%'%�r�.�� s5t7. ,
. *'
- __ Amami 440.4615 Malcom/
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested it Z' AM PM BUP
Location 72 -9 sw Tea c-4-4 ply Suite MEC
Contact Person Ph ( ) j r�3 r �G 6 PLM
Contractor L `pl — f" S E �ftinn/ Ph ( 5 ,33 ) • ELE 3S/ 2
BUILDING Tenant/Owner ELC &(/2-^G c
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
Firewall
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
fggEOD
Service
Rough -In
UG/Slab
Low Voltage
Alarm
Fin Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date - 1 a 1 0 a, Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record -from the Job site.
PASS PART FAIL