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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00441 DEVELOPMENT SERVICES DATE ISSUED: 7/19/2004 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1 S125DC 02900 SITE ADDRESS: 07160 SW VENTURA DR SUBDIVISION: WASHINGTON SQUARE ESTATES ZONING: R-4.5 . BLOCK: LOT : 022 JURISDICTION: TIG Project Description: Bathroom remodel, floor mat heat. 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: JOHNSTON, MICHAEL R + MARY ELLEN KELSO ELECTRIC INC 7160 SW VENTURA DR 545 SE 3RD TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: Phone: 503 - 648 - 6360 Reg #: LIC 116254 SUP 4270s FEES ELE 34 -433c Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/19/2004 $53.50 [TAX] 8% State Surcharge 7/19/2004 $4.28 Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By: , Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day PROM KELSO ELECTRIC INC � FA FAX NO. : 0000000000 Jul. 16 2004 08 : 58AM P2 �� • RECEOVED ED JUL 16 2004 CITY OF TIGARD BOIL ®INS DIV FOIL OFTIi T, I Si'. Oi\1, Y • E • lectrical Permit Applici. Received : ..-7_,, L._ .:6 L c -_Z_Oa - od 4/Y/ Ci of Tigard MY g T est Form D at APDro u Sy�itN• -: 13125 SW Hall Blvd. flan Review • thcr Tigard, Oregon 97223 Dauffiy PsrmnNo•: Uto Phone: 503- 639.4l71 Fax 503 - 598.1960 Pea t-Itsview Lan U Intern w et: ww,c Ltiga d.or.ua ■ A corium - i s: 0 Sae Page 2 for 24-hour Request: 503-639-4175 hour -K• ` y NrmdM • • \ • . • • • cmostul IalOrrn Lion_ • "t C. i4 \r ° •$ OF..W_•(IRIO :.1 1 .+t: ail� �_, � :. —r ..�. 1 l ( :: • .�I "� , ;.: ,. iH • „t�l• �. :•,IpT.;�i!t'dREiVdE33 :! jlal ~ �ICiill�tkaka• ;,�1� ; . [ New construction - � • Demolition ■ Sarvta over 325 errus- • Health-cm facility t .. aotnatertiol ■ Haz rdaus location A Addition/andratio:l/Te laeaalellt Othe ...`, :...:., � p 1 �, , ❑ 3avioc over 320 aWflpa -r�rig or • Building over 10,000 quart tact, . . , ° . n ' , e e) t�0I4 .r °1+.t a i g`b ita e' 1 1 Qr 1 t60tllY dvreib5Se rout at ((care residential units in ►;:, 1 & 2 -Fami] dwellin _ ' • Commercial/Industrial CJ system OW 600 volts nen+lnal one suuenue 8uildisc aver three stories Feeders, 400 aim cr more Aecasso Building • Multi Family B Occupant load our 99 ptraOnl S Man ufanrured sovotu or RV psi e • Master Builder • • Other: • ❑ ElpvU/li &Mina plan ❑ Over: • .: -JOB S I T I M I O R M A T I O M i r i d ' i : O C A ' IOlsf•.`_` 4 !il :, Submit sets of O m .ay of tba "Savo, ^ 5 , � ,7 ,'� The above Are (tot applicable w�em�owry w ;:;,.. :: a acr.ic. T ' y�• t `r :r� }'•ix •µ ..,1•.. h:1 ob site add V ;_�;;'� � � ., : : :...tr,:7��'�s �� :3tEL, «��b�JL•E'- �1 :,•,•. ., .,.. ;,. :. :a�' :'r° • Suite 7 Ij /5 Bldg./Apt.#: Number of inspection; per permit allowed Project Name: ijD,t,/, 1STrz) Desert neon - Q% _ he (r.> To Cross saeet/1�ITt:Ction. to job Site: Now tosIdondal4infte or melt!- larrt0y per i w • dwaluagside Inaludw rtutbodgaraae- Suvlcs included: 1000 ace. ft Or l as L45.11 4 •, ,; 1•..' 1. :.1. y1,,ti. I 4 • . 1 1 ' ror t / 7 1 z Subdivision: F Lot g: L;miLtQ".+smv. tyln rgiaRKi� Tax ry •e 1 0: Each nunubcsured hung or modular dwelling • • Ts.S ..PE r "= • o OW .1 Y40 • ,= 7' h?. , :. .•? ...._.:•r a"d serriee /or four sarviscs se faedsrs - installation. • D� • ,r te I. S `,, -•---47 aiuradooerreioatto a; • . wa,.. aJ gif-,4, a.0ir.g. z00 un�r of lag 00.36 f z 40 ant • m -00 an Mill 160.60 11111111111111© •1111-FROPERTY!OEWt38it74. ' ;?1 7rs uA NTJN : „ r?7>[�,.I!TLKr .11,•: oliNCt • -'1N.. ■© Over 1030 warn oromits II 454,4s 2 Name: . �•nn . 66.35 2 ! Address: Temporary iol aerviaos or fcaltu•s • Inatallatioa, ' anaemic c or relocation: City /State/Zip: r • • ., orl.- 1 n krP Phonc: Pax: 201 amru tQf04vont - I00.S0 1 7 •LTCAlYV. _ r' I: 4111 to 600 am • 133,75 2 i�r. �' S�- ��:rte[�if;U.'.�'1ral''�T11rDN? ?!:;;tire. -.:i Bradc4 earwig - naw, altantter, er ` Name: es hash's per p"a"ir Address: A . Fco iarbunco*tollswtthpurchase of • series or feeder fcr oirfuir 6.64 2 i C i ty!Statc!Zip: H. no for branch e>taors v'ithout purelws of ' • gamin g isolsr fa, first tench gang;! 46,E • 4 ' phone: _ l Pax: p eict . brush circuit 6.63 1 - E-mail: Mise(Sw V I/1131 r t cir c l e . N® • -.... ,�. :�+:;' :.�,. �;: ; COPl•1'RJ►C3'O),t "1 <,. `r;:° ;;:�. u� 2 :;r_ 1 � � . � WV" p or t�taaagn circle . Esc l ei - °tottlive b' ht' S3 ! Job No: • ...110 orer..•et+d slimly post, r busizlcss 'LSo c?P� - •� i Address: sS $5',F..2''' sr I • City/State/Zip: %,/1t L 50a 0. Ofj 7 7/2 ?, r t$4-11 add•Jdonal hineelion ever the stbNable i le a1r of ehc 6250 sbovo: t i • • - t •ur Phone: 6y, -6 Fax dq� kzi° Inv- •OD our -min. ` CCB Lic. #: JG2 Lic. #: may– e o _ � -��,�,� ti, ' - . i Supervising electrician :11!b.: _ �_ iii:ii :g' ;i :. ".if ".%; ac; — r p (ttVk ,r F 'R;4. ., ,... 1 • n> is required: /may I r Subtotsl it- signor q • Plan Review (2S% of Penult Feel , j/_ Print Name: , Lesfv /,:et -e• c.;.> I Liv. #: S%Z '7"$ State Sureha�e ($% of Pct Fee) 5 TOTAL PERMIT FEE I S L Y r76 1 f utioriaad J Welke This permit slpplintlas expire. u • weak 1" not obtained within 5igninze: Daze: I W' drys attar It has been taowpted u camping. *Ns usetiodology sot by Tr .CQunty Building Industry Service Board (Pismo print asrae) CITY OF TIGARD 24 -Hour BUILDING Inspection. Line: (503) 639 -4175 INSPECTION DIVISION l Business i e: (503) 639 -4171 MST BUP ( • p. o — Received Date Requested AM PM BUP Location 7/ ( 0 JL- Suite MEC Contact Person 1 Ph ( ) 3/0 - S/ (of) PLM '60 3 as Contractor Ph SW - BUILDING Tenant/Owner ELC UI _ Footing Foundation ELC Access: , Ftg Drain ELR i - Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors OWP Ext Sheath/Shear Int Sheath/Shear Framing (� 1 ' Insulation p 1 &. j� K & is brn`. rJ Drywall Nailing Firewall v/� Fire Sprinkler Fire Alarm �1CALytirl 3L 2oQ1`_ 0 0334 - Susp'd Ceiling Roof C Other: Final / PASS PART FAIL - WEAG Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan _ Other: - SS PART 40 MECHANICAL Post.& Beam Rough -In Gas Line , Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage tr F F F F i r e A l a r m PART FAIL 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 ^ ` Ext Approach/Sidewalk Date � � Inspector N Other: Final DO NOT REMOVE this Inspection r rd from the job. site. PASS PART FAIL