Permit A CITY OF T I G�►R ® ELECTRICAL PERMIT
PERMIT #: ELC2001 -00168
:Y�l DEVELOPMENT SERVICES DATE ISSUED: 3/27/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD
SUBDIVISION: blASEONGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: INSTALLATION OF ONE BRANCH CIRCUIT FOR POWER TO PICTURE.
JOB #5030
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 48 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: 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:
PPR WASHINGTON SQUARE LLC NEW TECH ELECTRIC
P.O.BOX 21545 1400 NE 48TH AVE
SEATTLE, WA 98111 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 -1900 ,
Reg #: LIC 41868
SUP 2113s
ELE 26 -418c
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 3/27/01 $46.85 2720010000( Wall Cover
5PCT CTR 3/27/01 $3.75 2720010000( Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty 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 oft se rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE k , ` ISSUED B • � IAA �,� .
..300 O 0 J r , .∎ , o 0 OL '•42 i
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. E EEC'N: , sUjJJ • C,} -(' 76- DATE:
LICENSE NO: l S
Call 639 -4175 by 7 :00pm for an inspection the next business day
03/23/01 FRI 16:03 FAX 503 648 3131 NEW TECH ELEC 44-> TIGARD a 001
Electrical Permit Application
4 v 4 Date received: °vs,i,. Ci of Tigard .3x1 d/ Pet,tritno.: 1 Gt7 /(p
PtojatVappl. no.;
Ciry ofTigerd Address: 13125 SW Hall Blvd, Tigard. Old 972 Airedale:
Phone: (503) 639 -4171 / Date issued: 4y: Receipt no.:
Fax: (503) 598 -1960
✓I , r9 Cate file no.: i Payment type:
Land use approval:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory Commo:rcial/industrial
0 New construction O Multifamily 0 Tenant improvement
lTAddid O Other 0
Partial
�
Job address. p JOB SITE INFORPIATION
/ ' k '4l 40e /Q/' Bldg. no.: Suite no.: T / tax lot/account no.:
Lot: I Subdivision: map
/tax
name �,/ �/ .. �( jo �Desorirdon and location of work on premises: gel / rlaa �
Estimated date of completion/inspection:
CONTRACTOR APPLICATIO
Job no: FEE SCHEDULE
` .r
Business name: New Tech Electric
Destriprim .
Address: 140(j NE 48 Avenue Ne'n'�de�l dogleurmuld- famky,
City: Hillsboro StateOR 2.IP; 97124 S "wa B bd,j tsLttadtedgQm
dot
Phoff43 -648 -1900 Fa>648 -3131 E-mail: 1000 sq. ft. or lets
CCB no.: 41868 Elec. bas, lic, no: 26 -418C Each a don:LI SOO sq. ft of portion thereof
City/ eta 1' no.: Limited energy, residential
S isiog elocaieian (required) p� III III
Sup. elect ammo (print): A' • N , eeo . Li.criSe u 2
• akeratioti or relocation:
PROPERTY OWNER
Name (print): 201 maps to 400 amps 2
Mailing address: , amps 2
•
City: State: ''ap: over 1000 amps or volts
Phone: I Fax: I E -mail:
Owner installation: The installation is being made on property I own
which is not intended for sale. Lease, rear. or exchange a according to 11111 `
ORS 447, 455, 4n, 670, 701.
Owners sine: _ Due: , 2
Branebeitetdts - new, alteration,
or extension per panel:
Post-iN Fax Note 776771 Date3 t-�j /,�,�� or 1 2
A. Fee for branch circuits with purchase of
B. Eke for branch circuits without purchase
T I �'v ill `�T From '� / / a � 9es • /
- service or feeder fee, web branch eirenit , Co /Debt. �`�^ Co.
Phone 11 •P/7 / /' )37-41?-047 Each additional branch circuit
/ coe ,
Phone 0 � r0Y ,, ,6 ,., .
r �� circle 2
FeYq
Fax a� _ O � /�� Each al
�� /� I gn or outline lighting 2
t/ / `r ! % Signal cireuil(s) or a limited energy panel.
0 Building over wen sto „a u reedera,aw sax more
st teratt °n,arettaaasron• ` 2
Occupant load over 99 �P 'Dosed . don: •
❑ o
P persons O ManufarnuedsantennesorRV
Each inspection over the allowable any of the above: [Swats/lighting plan 0 °after
Submit sets o(plans with any of th •Invade above. nv o n
gaden •
'Ibe above are not applicable to temporary coast uction service. Other
Nos as jutitfictiooc accept Cora cdr, pleas call jariadclon for mere inn. "maim,, P
l
o vase O MssrnCara Nona: Thi permit application $�S
dean cam names
expires if a pctmil is not obtained Pia ermit (rc
review (at _ %) $
I_ .1._... within-lea-eta . , : 't has been State surcharge (8 %) .... $
I p t accepted as complete. ' 1 AL . Name or caadhol� as .boo
Cardholder aignarure n on credit card �
s
Ammer . rTzust Account # 41868 - • ado-4615 (MACON)
-CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST _
BUP
Date Requested lU AM PM BLD
Location g D sa) (,JJA Suite MEC
Contact Person /' Ph PLM
- awry Contractor Ph SWR
BUILDING Tenant/Owner `I , _ _ , L, „ , LC ®0
Retaining Wall E R
Footing Access: /
Foundation C9 2-0 - o s--s —� F S
Ftg Drain SGN
Crawl Drain Inspection Notes.
Slab � � LJ1.J �X' SIT
Post & Beam
Ext Sheath /Shear Pt L-7
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler /r/f2Ci�
Fire Alarm
Susp'd Ceiling
Roof
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 •
PA F_ T FAIL
l e . T vicAe
Rough In
UG /Slab
Low Voltage
Fi larm •
'AS • PART FAIL
Sn
• Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for einspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk o D Q
Other / Inspector /L,�F�� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.