Permit '1y
CITY OF TIGARD ELECTRICAL PERMIT -
Agli RESTRICTED ENERGY
�'�4i DEVELOPMENT H BMENT Tigard, SERVICES (503) 639 -4171 DATE ISSUED: ED: 6/28/2004
SITE ADDRESS: 10865 SW WALNUT ST PARCEL: 2S103AA -00101
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: JOB NO 944038
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHOOL DISTRICT NO 23 J CHERRY CITY ELECTRIC
13137 SW PACIFIC HWY 8100 NE ST JOHNS ROAD D -104
TIGARD, OR 97223 VANCOUVER, WA 98665
Phone: Phone: 360 - 571 - 4411
Reg #: ELE 37 -620C
LIC 91668
SUP 3486S
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 6/28/2004 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surchart 6/28/2004 $6.00
Total $81.00
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.
Issued by Permittee 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 7:00 P.M. for an inspection needed the next business day
CC _ SERV I` LEM 50354081 04/20 '01 12:00 NO.214 03/03
-1 __ ___ .,., yvyvVY,„, Litt or 11g ra f?inn?
E lie !.@- i erm u��ly pp 1 p i ; b L 7 1 1 *1 r r .,:. ;, r .
Ju
. � ° � f l z 20 Date received I Palnicne �pef -0A EsEs
.......,,,. nt Es-
.......,,,. �i- ::. City ®f 'Tigard �y �aoo 6
. te L oa.: -� l 8
c fryteT o' d Address: 13125 SW Hall Blvd, 1 �. (ax T D g I $ I Receiptno.: I
Phone: (503) 639-4171 BUILDING DIVISION
Fax: (503) 59g -1960 � tile no.: Payment gyp`
Land use approval:
'> Y -^ i _ ye p .�Y .0 1... . \ � 1 { f : i
t ry � : . ... . �� - _
' O 1 & 2 fondly dwelling or accessory 0 Commext=aUindustral 0 Multi-family 0 Tenant improvement
0 New corlstruetian 0 Addition/aleeratiaufrcpiaeement U Other 0 Partial
�r'� 1t ,11I" tiI:i)1L�11310� r ,
ti <: - . , ,. �. �., w ., .. . _
Job address: li) 1 (A / ' (J I rt,'Vc, ci ' Bldg. no.: ) Suit no. TsX map lot/account account no.:
Lon Block Subdivision: i •
Project name: ZJ V ( .e'' 1 l � . (r(d,4{_� De`scrip'tion and location of work on prrmi s
Estimated dare of co ..lotiton/Lispecdou:
Job no: l 0 t rct I Max,
Business name: Q-rry City Electric f aiytlar Qty. (at) 2prat no. imsp
Newt artisdG- Eao3EF Fo..r
Addres: 81C0 N St Johns Ram aaite D-lgt tisrtiatg mit. &3olicssa
Ci Vancouver Sone: WA ZIP: 98655 SorrcaadnaasE
Phone: 11 iL !l6:��a�j� E -mail: . l000 -•. P.or1. 4
�' Erich addition/XI fi sg- tt or portion thmtof
CL:13 no.: _21668 Elm bus. lie. no: 37-6 Limited energy. miaeatial ■ 2
ln no.: ' Limited energy. ncti- midcxiol 2
U /11.4r---- Hoch raaattfnaurad hone or rnxluler dam- -Bing
Sigsr urc or supervisin5 a aidan (required) Bran Scita andiorf=ia • 2
(pnntk Jo Orton Lis cena 5 Ses�c.torfrrdets— itsulheioc,
Sop ele:t name �� 7 altcraEeoaactt3�sdaor
- 11,9*Witi. 3si F3 , . ` 240 • or less 2
Name (print):
.- f 201 amps b 4WD prop! ) I Z
401 turps ro 600 amps a
Mailing address: 601 • •• -- m 1CCO amps 2
art- S ZIP: O Ce 1072 amps or wire 2
Pflanz: I Fax: 1 E-mnil• R ecockrrcr a 1 y 1
Owner installation: The inoallauon is being made an ,pea - ^ty 1 o+•ril Teln er -
dlocosi
Which is not intended for sale, le c, rent. or exchange a z ng to ��°�* = ' °r' ore
z
2e0 •••• . orias 2
OILS 447., 455. 479, 670, 701. 201 traps up 400 amps 2
Ownces signature: , Dalt: 401 co 600 • • I 2
7- � G*Itri } r J i' f elt 6zmits - Ql71, a11,�•ra1r1°
. r,.
or estessiost per puma:
Name: + A F= forbrxoch cisme; with partirase of
Address: sxim or feeder fed =eh brmdi eir3rir 2
QCr j State: - IZIP: B. Fee for brunch circuits widtoutpotch c
of=vireorf=fr^s Ire. first branch aired t: 2
P1QnC: Fax: (E-mail: F��h add•;axolbraaen ^^^^r
13.irN ]23TIElvIlJc x1 r1i n 1r1.i.)T , r _ Kis.(s.g.1,. rftQ,dcrnot6e404ed
0 5csvico over275 arnpt•ermor,caelal 0 Hashfr•ceszfsd1t7 ' Eaeh pe.-zq ariaigsion efroie 2
0 Semi = over 320 amps-rating of 1 &2 0 Hn r loesuon ', Es"1t signor outline lighting 2.
1trrtilydwclti�r< 0 gem c ovcro •pxtsgtrmo Signal oaccids )a ■limicedccngypo:rl,
0 Sys,noverMO volts norairo1 more rd sve T' a 1t
desrtialbollsInoneu.r:Lion, `
(J g 2
�
0 Building oY4 three Rona 0 F. 4m amps or ring wrcyccirricer -
0 O upsot lord o 99 pam r,s 0 NS.-inuroctunsi fer=eicit or tt.Y pork Ems+aaditiousl remotion ow= tl,cailv.rahirInany of me *Care
0 Egr�s/Tightingplarr 0 U.tr.S. - PoeL — p . I 1 1
Sabath ,__ sots of plans with any of tile alt f rvcripyri on fee
The afaroe are net appItsbte to testrporsc y eonstriolicrn sic Other
rscc sea jttrisaietimis 02241C aed3t e� pis, -s Cell Jtai26.Litn ra =OM ilE � Noti= This p✓Crit application Permit Fea 5 — 15 • OD
0 Nil= 0 Maya -Cord expires if a pstali is not obntinod Flan =vim' (at _ Co) S
air r . in 1 / • r. 160 days after it has 1or.cri State wrcharee (8%) - ._. S i .
_ aozepced complete. TOTAL s ! 11.rl11
Kann tzi eiretotatr iV Gvawn oa =Real bard
S
s- ar4ntsaQ o}p.ese 6.61146I5 (602KOSO
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 9 z Z AM PM BUP
Location / &e S L- c) C ,' .L t Suite MEC
Contact Person A --2i Ph ( ) 6o7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: _
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 1 SIT
Post & Beam
Shear Sheath/Shear S
E Ed
Int Sheath/Shear
Framing
Insulation P‘ -5 /4
� �� , R ^
Drywall Nailing ss �� /
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof et
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
S i • ke Dampers
•
P S PART FAIL
ELECTRICAL
Service -
Rough -In
UG /Slab
Low Voltage .
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI 0 Please call for reinspection RE: Unable to inspect — no access IA Aire Supply Line ({ ./ / /frt nn� D C ,
ADA Approach/Sidewalk Date Inspector E x t
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL