Permit ` CITY OF TIGARD ELECTRICAL PERMIT
P ERMIT #: ELC2001 -00409
- 4 * " DEVELOPMENT SERVICES' DATE ISSUED: 08/07/2001
II 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S1 13AB -00600
SITE ADDRESS: 16160 SW UPPER BOONES FERRYRD
SUBDIVISION: B,b,N!W CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (2) branch circuits for replacing lights.
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:
PACIFIC REALTY ASSOCIATES BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 44569
SUP 2808S
ELE 26-451C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 08/07/2001 $53.50 2720010000( Wall Cover
Elect'I Final
5PCT CTR 08/07/2001 $4.28 2720010000(
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 - 6699 or 1 - 800 - 332 - 2344. Permit 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: Y1 alaitil 1 Ott Ill✓ DATE:
LICENSE NO: 5
Call 639 -4175 by 7:00pm for an inspection the next business day
i. ' -06 ,.
✓ Electrical P . ; i l tA,pplic
10111111 Permit no. i - ) Legi r
, ,,t . I I City of Tigard RECEIVED A Expire date:
Ciry ofrigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued:
EMI Receipt no.:
•
Phone: (503) 639 -4171 AUG 0 e 200
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: CETV Clf 11 D
3 -1 I'L OF PI :10111
O 1 & 2 family dwelling or accessory Of Cottunercialfindustrial O Multi - family 0 Tenant improvement
❑ New construction 0 Addition/alteration/replacement ❑ Other. _ ❑ Partial
Job address: 16160 SW UPPER HINES FY.I4). • Bldg. no.: C Suite no.: Tax map/tax lot/account no.:
Lot IBlock: (Subdivision:
Project name:MUMS pute sEROj I Description and location of work on premises:TEEPEE L1IMIE
Estimated date of completion/inspection:
• (O \112.1(: I'OR'11'1'I.1(`. ION alai St ill I)1:LI. .
Job no: 9426 Fee Max
Business name: Bachofner Electric, Inc. iDes° O° Qty. (ea.) Total no. InsP
New residential - dngle or nadli-family per
Address: 55 SE Main St. dwelling wit Iodides atiari edgaage.
City: Portland I State: OR I UP: 97214 Seraicehic alms
Phone: 503- 233 -2006 I Fax: 233 -2963 11E-mail: 1000 sq. fc or less 4
CCB no.: 44569 I Elec• bus. tic. no: 26-451C Each additional 50o sq. ft or portion thereof
Limited energy, residential 2
City /metro lic. no.: 536 Limited energy. non- residential 2
,' ,e ,e4___,_. /31 o f Each manufactured home or modular dwell ing
Signature of supervising electrician ( d) Date Service and/or feeder 2
sup. ele t.name(pint): W. Bachofner License no: 2808S Services or feeders - imtalhdtoo
alteration or relocation:
200 amps or less 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 601 amps to loon amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary strikes or(tains - installation,
which is not intended for sale, lease, rent, or exchange according to
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
-Owner's si Date: 401 to 600 amps 2
Branch deaths - new, alteration,
or extension per pan&
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each brands circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase ` first ` , (92-...5-
of service or feeder fee, st branch circuit I "1
Phone: Fax: E -mail: Each additional branch circuit - I (9 '(P $-
P1.:1.\ RL1I1:11 (1'1c1,c check all that appl■) Misc. (Service or feeder not l ):
O Savice ova 225ampsaommaeial O Healthcasefaality Each pump or irrigation circle 2
O Service over 320 amps - rating of 1612 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy Panel,
Cl System over 600 volts nominal more residential units in one suvcoue alteration. or extension' 2
O Build'mg over three stories 0 Feeders, 400 amps or more *Description:
Cl Occupant load over 99 persons 0 Manufactured structures or RV park Each addition Inspection over the allowable In any of the abova
Cl EtighangPtaa 0 Other: Per inspection ( ( ( I
Sobadt _ sets of plans with any oldie above. Investigation fee
'Ile above are not applicable to temporary construction service. Other T
Wet *ladled= incept rem: cards, please can }at dre ire for more tworm ion. Notice: This permit application Permit fee $ 3• S` ,
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Cirdir cad mmba / / within ISO days after it has been Stale surcharge (8%) .... $ 4 , 9-5
n"pi`a accepte as comp TO T AL $ °i . 'i
Name of mdlolder as shows on aeon card
$
Cardholder die Amount 440-4615 (61001COIM)
`ITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Bus_ines$ Line: 639 -4171
BUP
Date Requested 9 � Y AM PM BLD
Location 16' / G G Sw ,& # #) 41 ✓ y / Suite MEC
Contact Person Ph Y f fiar5 Y PLM
Contractor &c h D p h t0 Y EYe CI T/ C Ph Z3 3- ZGG C SWR
BUILDING Tenant/Owner ELC 2e00/ -G ' 4" f
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
Drywall Nailing ICJ r4 'etc- N ( / Yom' (J S— � l9 It A/
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _
Roof
Misc:
Final
- PASS PART FAIL
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
PASS PART FAIL
ELECT 1�
Service
Rough In
UG /Slab
Low Voltage
F' larm
AS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before ne inspection. y at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: , ] Unable to inspect - no access
ADA 91/) Approach /Sidewalk /,,/ / Date " < � D� Inspector ' ,, _ / //� Ext
Other —
' Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.