Permit -'-= CITY OF TIGARD ELECTRICAL PERMIT
.v` PERMIT #: ELC2002 -00637
"41 1111 DEVELOPMENT SERVICES DATE ISSUED: 12/12/02
'�" r � I 13125 SW Hall Blvd., Tioard, OR 97223 (503) 639 -4171
PARCEL: 1S134BC-00600
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD
SUBDIVISION: PP1993 -057 ZONING: C -G
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Install 1 200amp service and 3 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: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
SPRINT PCS MONTI ELECTRIC INC
4683 CHABOT DR. PO BOX 30478
PLEASANTON, CA 94588 PORTLAND, OR 97294
Phone: Phone: 503 - 860 - 2682
Reg #: ELE 26- -1018C
LIC 135326
FEES SUP 4591S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/12/02 $100.25
[TAX] 8% State Tax 12/12/02 $8 Elect'I Service
Rough -in
Total $108.27 Elect'l Final
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: .� � ) 277/) Permit Signature: 1fYt r� .pe M,Le X-.
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: (T`Y C Q . DATE:
LICENSE NO: s
Call 639 -4175 by 7:00pm for an inspection the next business day
,12/09/2002 12:37 FAX 5035981960 CITY OF TIGARD el 002
--- 1;•+-k.. ' --- e''''-'"'''' -. - 00193
..s
` -- A Electrical Permit Application ,
- ' ' ', n 4 , 1 , � _ Data received: la. - 17- -0 Permit no.: /x. - (v
1F , j`. - l' " City of rig F?rojecvappl. no.: Expire dune .
CIrya Bard Address: 13125 SW Hall Blvd, Tigerd,,QR 97223
Plicate: (503) 6394171 L- • Date issued By: Receipt
Fax: (503) 598-1960 a 0 LOO One the no.: Payment type:
L i and use approval: r a n � l � , � 1 _< .. ; �
.. ' .4 , gym,_, • • —.(d lases .
:-;1 ]'PL of .ttf.1c f
01 & 2 family dwelling or accessory ore mevt ial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition /alteration/replacement 0 Other, 0 Partial
ao13 Silt IF\ Ioi'l.; litii. "
Job address: jg . :l Bl. no.: S uite no: Tax
_ map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: ,.. ' • 1 Description and location of work on premises: . • q,.,_ • _ , _ , 3 C S ,
Estimated date of o •letionrmspection: - ,. _ '
t.' O\IItA'CTOR.-A f:EF S( ILD1LL
Job no: � .
Business name: , c =, D�+eti .:..• t
..
Address: a a O New eeo�tl f per
' ZIP: ' , dweEngel*.loelYdmattached garage.
��11. Serriminduded:
Phone: ; . - Z,b$z_ Fax: 2. e &mail• 1000 sq. ft- or less 4
e 1 O $C
Each Kb:WGO ft or portion thereof
CCB no.: e ,� Elec. bus. lic. no:
• ...... mew, residential • IIIEMI
City/metro lic. no.: j /0 - / -0;7., Limited mercy, non- residential 2
'-k • �`'�" i z °I I o Z • Each maau1acmrrd home or modular dwelling
Signature of ising eiec ,ciaa (required Due I k2 - O Srnncensdlarfeeder 2
Sup. elect
•'� • •rvteeso rreedera-
sl name (print): u�e no: y5 1 S rD4
alteration or relocation
i''I• (01'1 Itf"t 01%'N1112 . - 200 empsor l ese I BD32. 2
Name (• ' , t): 201 amps to 400 amps 2
„ : address: 4 L ' as 2
601 amps to la amps 2
City: State: ZIP Over 1000 amps or volts 2
Phone: - I Fax: E-mail: Rmaumeeto i - i
Owner installation: The installation is being made on property I own i tlets
which is not intended for sale, lease, rent, or exchange according to
ORS 447, 455, 479, 670, 701. 200 amps or teas 2
201 amps to 2
Owner's signature: Date: 401 to 600 ..... - 2
F \C l r . F,R Branchdralta new. alteration,
or extension per panel:
Nerve. A. Fee for branch cizvwia with purchase or
Address: service or feeder fee, each branch circuit 3 (42 19 2
C' .: State: IIP: B. Fee for branch dtada without purchase
Phone: Fax: 13-Mail: of serviceor reed fee. fast branch circuit 2
Each nddiho®1 branch circuit
171 ;.AN UI:- II 11 (Iii I' ehcfI: 3II :.t1e:lt :tjrlif) - 1'x.(6ernfee antineleded);`
0 knit:c aver22i ampecoremerdal 0 Hsahhruefeenity Each pomp or irrigation elide 2
O Service ovcr320 amps-rating of 1822 0 Hazardous location Each sign or outline lighting - 2
family dwellings 0 Building over 10.000 squats foot four es slam" circuit(,) or a halted energy panel,
Cl System over 600 volts nominal more residential vuesin one grarluto attention, or extension* 2
O amldmg over three atones 0 Feeder's. 400 amps or more *Description
0 Occupant load over 99 persons Cl Manufactured structures or RV park - •
0 EEtasN$tdagDlnm Cl Oth Each O°a1 0° over the allowable In any of the above:
Pa inspection I I i I
Submit _ sets of plans with any curdle above, investigation fee .
The above are hot applicable to temporary ecaistrudion service. Other
Not en )miu,rtioes seep omit carts, plasm, call J for more i�ee Notice: Thi8 permit application Permit fee $ p 5
0visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. 4 within 180 days after it has been Stan: surcharge (8%) $ •
Name or gp,dhai‘r u .hoe r oe coedit wad accepted as comp/eta. TOTAL _... $ d
S
Cmdaatdes.igname Amara= 440.4615 (tie00ACOt4)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: ' (503) 639 -4171
BUP
Received Date Requested / f ! AM PM BUP
Location / ,3 �d��� �� Suite MEC
Contact Person 4.44-) Ph ( ) g(; � �� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC — 40 3 7
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
'ELECTRICAL
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Fi -
1� PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Li Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA —
Approach/Sidewalk Dates i2a7, '�
Inspector /—{ c / Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour •
BUILDING` Inspection (503) 639 -4175
INSPECTION DIVISION Businbne: (503) 639 -4171 MST
st
BUP
Received Date Requested / - AM PM BUP
Location ♦ -=- - / I_ uite MEC
Contact Person Ph'(_ / ) C) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner OZZA__ Ce- -/ ELC 40 2 - e 63 7
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 `� rot_i -S r () �E S
Fire Sprinkler
Fire Alarm
Susp'd Ceiling t �� (62_)›-,,e4
Roof
Other:
Final t S
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
RoJ.gh -In
1•Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 0 Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA 0 3 Inspector Ext
Approach/Sidewalk Date �`
a Qom
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 R uested AM PM BUP
Location / a"3 ! v r4 -eiyi Suite MEC
Contact Person , /�Yt Ph ( ) E&O � EP- PLM
Contractor Ph ( ) /1- SWR
BUILDING Tenant/Owner CO,W ELC 2 -6Z)o3 7
Footing Z-Q/L ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam _ 4'n,14/1
Ext /
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 �' l
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
41 M ill"
RT FAIL El 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 Date Z 2 - OJ
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection recor from the Job site.
PASS PART FAIL