Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00360
1 DEVELOPMENT o
SERVICES (503) 639-4171
DATE ISSUED: 8/1/02
- 13125 SW Hall Blvd..
PARCEL: 2S 104AD -04800
SITE ADDRESS: 12923 SW WALNUT ST
SUBDIVISION: PP1997 -070 ZONING: R -4.5
BLOCK: LOT : 002 JURISDICTION: TIG
Proiect Description: (2) branch circuits to replace gas furnace and install new a /c. Job No. R02207.
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:
EASLEY, JOHN H + MARGARET M SHARPE ELECTRIC INC
12923 SW WALNUT ST 22605 SW RIGGS
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 642 -7937
Reg #: LIC 81518
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 8/1/02 $53.50 2720020000( Elect'I Final
5PCT CTR 8/1/02 $4.28 2720020000(
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 -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 B
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 INST LLATION ONLY
• •
SIGNATURE OF SUPR. ELEC'N: ' ,,,,c012_ /101 "((' f t �` DATE:
LICENSE NO: 334` /3
Call 639 -4175 by 7:00pm for an inspection the next business day
.Plug i 02 08:46a Specialty Heating 503 598 0718 p.2
•
i I
..., .
40 Electrical Permit Application
I (late received• 1 09- Permit no.: fte;�
tt ► j l �; City of Tig E C E U E
b d� Projcct/appl. no.: cdate:
Ciry ofTrgord Address: 13125 SW Hall Blvd, Tigard, OR 972 Date issued: 1011.21 Receipt no .
Phonc: (503) 639 -4171 AI,h 1 2f Q2 _
Fax: (503) 593 -1960 Case file no.. Payment type:
Land use approval:
(1.; � x Ua g � 7
rain
TYPE OF PERMIT
N It & 2 funily dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Ter :tnt improvemnent
0 New construction • - Addition /altenuion/replacement 0 Other: . 0 Partial
• JOB SITE INFORMATION I
Job address :LAei •7 3 sw tdeR._ri l,(r .,1 Bldg. no.: Suite no.: Tax map/tax lot /account no,.
Lot: Block. Subdivision:
Project name: 674 s f.e/ Description and location of work on prcmtses:_ Macy ,d a CM/14 (I'C.Q g
Estimated date of complet.ton/inspecuon_ Ar1or e , i_ Dl- -i
CONTRACTOR APPLICATION FEE SCHEDULE MEM
Job no: 0 .-. 62 tee Max
Business name: she i ne &- G_x_. / /4 � Description Qty. (ea.) ` total no insp
Address ,.. � �/_ )
5 � C.L r 5 New residential -single or multi- fantily per
dwelling unit- Includes mulched garage.
City: 4/4-4./2,r tervt-- 1 gtate:OK i ZIP: Q xs 07 Service included:
Phone: 3 W qi 29'/ I Fax: ' 1E-mail: 1000 sq, ft. or less 4
Each additional 500 sq It or portion thereof
CCI3 no.: -/ S -i'' Elec. bus. lie. no: 3-/ • a / T Limited energy, residenii al 2
City/metro tic. o.: 0l.5/
Unifier, energy,non•restdenttal _ 2
:( 2 ''++r/�t' / C y • Each manufactured home ormodulardwelling
Signature of supervisi g electrician (required) Date Service and/or feeder 2
_
Sup. elect. name (prim): , it P Licu ne
1so:3 %-/s Services L V
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 ,UnNa to 600 aeijb 2
601 amps to 1000 amps 2
City: [State_ I ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E-mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders - -
which is not intended for sale, lease, rent, or exchange according to tatian ,attcration,orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 tulips 2
Owner's signature: Date: 401 to 600 amps 2 '
ENGINEER Branch circuits • haw, alteration,
or extension per panel:
Name: ��-, c c s aa,. A Hero for branch circuits with purchase of
Address: lt ,�
!`JQj 3 _sic) _sic) (',() l�/bG�(if .Sr service or feeder fee, each branch circuit _ / 2
City: 7 yew, I State: d ZIP: q' 0 3 13. Fee for brunch circuits without purchase
Phone: j,, ._/ .2,0 • Fax: E -mail: of service feeder fee. first branch circuit: 1 - 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) misc. (Service or feeder not included):
U Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
r] service over sit) amps•rau Ong of l ek 2 U liaaanlous location Fach sign or outline lighting
tamilydwellings 0 Budding over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
J System over 600 volts nominal morg lesidential units in one structure alteration, or extension* 2
Y
0 Building over three. stones 0 Feeders. 400 amps or more • Ireseripuun: _
LI Occupant load over ' over qg persom 0 Manufactured structures or RV park Each additional inspection over the allowable is any of the tube re:
• 0 Egress/ lighung plan Cl Other.—_ Per inspection I I I Y
Submit _ acts of plans with any of the above. tnvestigauon fee
Tne above are not applicable to ttUmpurary construction service. Other -
Pcrmit fee $ - 53.50
( Nut an twisdicvious accept cuedli cm,ic, plc.use call lunsdiction for more intamauo~ Notice. This perrnit application -- LI visa U SlastclCard expires if a permit is not obtained Plan review (at _ %) $ _
t :rcdit cant number • . / / - within ISO days alicr it has been State surcharge (8%) ..• $ 4 • "g ,
l:spires accepted es complete TOTAL $ 5 '''7.78'
. 7 '
Name of cardholder as shown on credit card M S [ t :.fr,ll,vlde, aiy�wiwe nmOUne 4. U. (6/00/C:OM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION, DIVISION Business Line: (503) 639 -4171 MST
C. ' BUP
Received Date Requested / � ( AM PM BUP
Location / ? 3 �i()O.1�/Yl ut/t Suite MEC A Z7 8
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner "n01 U ELC
Footing S ! — LP— U ELC
Foundation ccess:
Ftg Drain ' ` �j ELR
Crawl Drain
Slab Inspection Note . (_ SIT
Post & Beam ''f
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
S T FAIL •
CH L
ost & Beam G
Rough -In �(
Gas Line
Smoke Dampers
Fi
RT FAIL
L
' e
Rou• � C •
UG/Slab 1 `
Low Voltage
Fire Alarm
� `1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
i' PART FAIL
Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA / J /
D C/ ,Z Inspector Ins
'J � Est
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL