Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00080
I r* DEVELOPMENT SERVICES DATE ISSUED: 02/06/2001
r - I 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S134CD-10000
SITE ADDRESS: 11530 SW TIGARD DR
SUBDIVISION: BURLWOOD NO.4 ZONING: R -4.5
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Installation of 2 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: 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:
BAKER, ERIC A + JOELLE L PHOENIX ELECTRIC CO
11530 SW TIGARD DR DBA/ENCOMPASS ELECTRICAL TECH
TIGARD, OR 97223 7379 SW TECH CENTER DRIVE
TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Rough in
PRMT CTR 02/06/2001 $53.50 2720010000( Elect'l Final
5PCT CTR 02/06/2001 $4.28 2720010000(
Total $57,78
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE 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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
FEB -05 -2001 MON 09:27 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02
• Electrical Permit Application
Datereceived: ,2 S ,, Permit no.: Za,, j DDO „i
e� ls'ii)'•• City of T Proect/appl.no.: Expire date:
CiryojTiga Address: 13125 SW Hall Blvd, Tigard, OR 9722 Dale issued: By: , - Receipt no.:
Phone: (503) 639- 4171 ,. ice
Pax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
I & 2 family dwelling or accessory Q Commercial/industrial 0 Multi- family 0 Tenant improvement
- New construction l:] Addition /alteration/replacement ❑ Other. 0 Partial
- JOB SITE INFORMATION
Job address : ' ,, ,`61-"I> t Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: B lock: Subdivision: •
Project name: F ,,i \C, ., `( f I Description and location of work on p raises: - 4 dr1rt -e P-Ck. Q b1 • -
Estimated date of completion/inspection: •
CON'RA(TOR APPLICATION [FE S(.'IIEDIALL
Job no: c r .) (fY' - \f)() /°fi &---/ /x E-C�7ga 6 b./303 b./303 Igoe . _
Business nametcv \C'Q,.M � c, , ,ti 6-LE-erg
(p fl 19elerlplioal Qty. (a) Total no.lnsp
�� ll
New residretial -s geormuiti- family per
Address:
•_.1� li L) \' C? n� C R V ��L �✓ &soilingmut includes attached garage.
City: ,acct )` . I Statem. I ZIP: ; Erni= hicluded:
Phone: I'ax: Le ( '' rr ``,,'' E -mail: 1000 sq. ft or less
CC El no.: 2 ,4- I Elec. bus. lie. no• •� � � Each odditienad 500 sq• ft. or portion thereof
limited energy, residential 2
City/metro no.' /��23 D Limited 2
Yi ! N.e ` -uel - f� Each manofectured home or modular dwelling • '
Signature of5upervising •
electrician (required) Dare Service and/orfeeder - • 2
S up. elect. name (prin &1 cit a P trc•-rtra.A. License no73 g' 6 j s Services or feeders-installation, alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): f 1(1,N., ,ra \t, f 201 amps to 400 raps 2
�• 401 amps to 600 turps 2
Mailing address :(\, \� C) ° ,r a t e \! 601 amps to 1000 amps 2
City: \ .� •r p,,,,\•,) I State ;•L I ZIP: f1'7 ,” j over I000amps or volts 2
Phone:, j n- .; -') I Fax: I E -mail:
Owner installation: The installation is being made on property I own Temporary services or feeders - ...
installation, alteration, Or relocalion:
which is not intended for sale, lease, rent, or exchange according to
ORS 447, 455, 479, 670, 701. ' 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 . 2
Branch circuits - new, alrerattan,
or extension per panel:
Name: A. Fee for branch circuits with purchase of �
Address: acrvice or feeder fee, each branch circuit I /�P 2
City: State: ZIP: B. Fee for branch circuits without purchase ( � � �'
2
of service or fm-A-.1. r f cc , first branch circuit:
Phone: Fax: E -mail: Each additional branch circuit:
Misc. (Service or feeder not Included):
Cl Service over 225 amps- communal •0 Health-care facility Each pump or irrip.ttion 2
O Service over 320 amps - rating of 1&2 0 hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 squaw feet four or Signal circuit(g) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension• 2
1) Building over uucc si riet 0 Feeders, 400 amps or nwrc *Description;
O Occupant load over 99 persons CI Manufactured structures or RV park Each additional inspection over the allowable In any of the above•.
O Egress/lightingplan 0 Otter, Per inspection I I I I •
• • • Submit ` sets of plans with any of the above. Investigation fee
-- The above are not applicable to temporary construction service. Other • - • • • • -
Not all Julitdictiuna aclLp/t crtdii caul.• plcase call iurirdctian for more information. Notice: This permit application Permit fee , $ 53 (St)
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at %) $
C.retlit card ',limb / / within 180 days after it has been State surcharge (8%) $ •
Expires
-. accepted as complete. TOTAL $
N o f c,nmoIder as shown on credit crud
Carrtholder signature .....��� Amount � . � A 440.615 (6,„(vcom)
• •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2- 13 AM PM BLD
Location //130 / / rL /7y Suite MEC
Contact Person Ph 6 /C7 3 , ' PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 2 zi/- -UuokU
Retaining Wall ELR -
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear •
Int Sheath /Shear
Framing •
Insulation , C £ "
Drywall Nailing -/
Firewall
. Fire Sprinkler
Fire Alarm 4�� ^ �� D
Susp'd Ceiling
Roof
Final Final
PASS PART - FAIL
Oa
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer -
Rain Drains _
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
• Final
j(
PASS PART FAIL
CELESTRiCAO
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
6)ART FAIL
Sri t
Backfill /Grading
Sanitary Sewer -
Storm Drain [ ] Reinspection fee of $ required before ne • sp:ction. P. at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply'Line [ ] Please call for reinspection RE: AF,, Unable to inspect - no access
ADA
Approach /Sidewalk / / fit
Other Date — ! 3 ��/ Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.