Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00409
Ando1 DEVELOPMENT I i p d 97223 DATE ISSUED: 7/8/2004
13125 (503) 639 - 4171
PARCEL: 2S104CA -06000
SITE ADDRESS: 13585 SW WESTRIDGE TERR
SUBDIVISION: HILLSHIRE ZONING: R -7
BLOCK: LOT : 060 JURISDICTION: TIG
Project Description: 2 branch circuits: AC and serv. plug.
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:
KNAPPENBERGER, JOHN D +SHERYL G BOB'S ACTION ELECTRIC INC
13585 SW WESTRIDGE TERR 2700 NE BURTON ROAD
TIGARD, OR 97224 STE A
VANCOUVER, WA 98662
Phone: 503 - 524 -9113 Phone: 360 - 254 -7200
Reg #: SUP 4322S
L1C 53136
FEES ELE 37 -431C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/8/2004 $60.15
[TAX] 8% State Surcharge 7/8/2004 $4.81 Rough -
Elect'l Final
Total $64.96
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 -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: � 3.2. 5
Call 639 -4175 by 7:00pm for an inspection the next business day
%
Electrical Permi Applicatiop,_„ ' •< , FOR OFFICE USE ONLY
• -_ �_. ,: .
..
City Of Tigard Date/By 7 7 j PemutNo b (�
13125 SW Hall Blvd , Tigard, OR 97223 Plan Revie / /
Phone: 503 639.4171 Fax: 503.598 1960 //ru: /I=.,rt�s'1�' Date/By: Other Permit
Inspection Line: 503 639.4175 v/ • E� D Ready /By ions 0 See Page 2 for
Internet' www ci.tigard or us ., i FLt ' Notified/Method: - Supplemental Information
3 - i':k.,L / ' ,, (. • ` .. ; 's? , ; ',. w; ,.. ° i %,:;, ° . ,, . . T YPE.OF 1W ORIt' .. `,'.'' . � . ~ n.;..' . .,.. , PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply
❑ Demolition ❑ Other' ❑Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq ft ,
' , ,', a ; : t.' ; °CATEGORY, OF' CONSTRUCTION W ,i ,. '4 7L - "x •;s ' _ of 1- and 2- family dwellings 4 or more new residential
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
'h• . k-„— u . . . ' . _ I .r "" RV park
�.: - . �, OB'SITE 'INFO AND. LOCATION ' E ess /li h im plan P
❑Health -care facility ❑Other
Job no.: 04 -581 Job site address: 13585 SW West Ridge Submit 2 sets of plans with any of the above
City/State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name: :t'•. ° : :FEE * - : SCHEDULE: -
Description • I Qty. I Fee Total
Cross street/directions to job site New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq ft or less 145 15 4
Subdivision: Lot no : Ea. add'I 500 sq. ft or portion 33 40 l
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75 00 2
,
,. ;, - i F
,r• ` ''T ` P"' I. '` . -
, )- HOCEiir IW, OF .AY!ORIC -'
"rt - ' iM.� " 3 ; ' ' . 'i '� °� ' rl.i � " � : v Each manufactured or modular
dwelling, service and /or feeder 90.90 2
A/C & service plug Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
'''":" IN PR OWNER ' I ' =
• u :i'' •''-'4:4 r , ,-,, - • " -v ', 201 am to 400 amps 106.85 2
401 amps to 600 amps 160 60 2
Name: Knapenberger 601 amps to 1,000 amps 240 60 2
Address: 13585 SW West Ridge Over 1,000 amps or volts 454 65 2
Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( 503) 524 -9113 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
"'''..'‘;'`-;-''''r Q; , r. �: ` • , '` `' %` ' ' A. Fee for branch circuits with
y ` `•;. 't %�. -, -
® 4 . -, - . i '•., t o ,. - I; ;
''' `( s- , - --^ �CONTACT ' E`K;RSOIY '�
=''' service or feeder fee, each
Business name: branch circuit 6 65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 1 46 85 46.85 2
Address:
Each add'1 branch circuit 1 6 65 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53 40 2
Phone ( ) Fax: : ( )
Sign or outline lighting 53 40 2
E -mail: Signal circuit(s) or limited-
r ..q.!_-;;...1—• . F ' 00 TR OTOR ,''' ° rr, . t` ,,'` energy panel, alteration, or
extension. Describe Page 2 2
Business name: Bob's Action Electric
Address: �t Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 6250
City /State /ZIP: nu
Vancouver. WA 98662 investigation per hour (1 hr mm) 62.50
( 3 60) 254 -7200 ( 360) 254 8219 . Industrial plant 73 75
Phone: Fax. —... ,
; 'r ELECTRICAL; PERMIT' FEES* '
CCB Lic.: 53136 Electrical Lic.: 37 -431C Suprv. Lic.: 4322S Subtotal 60.15
Suprv. Electrician signature, required:
AG� ( ` / !, `¢-/ � �L Plan review (25 %ofpermit fee)
Z 7/6/04
State surcharge (8% of permit fee) 4.81
Print name: Kevin Broselle Date:
TOTAL PERMIT FEE 64.96
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date' • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per pemut allowed
I \Building\Pemtits\ELC- PernutApp doe 12/03 440- 4615T(10 /02 /COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Re uested ri Th d� -'AM PM BUP l J
Location 1 ' SA 1\ ci- Suite MEC Q
Contact Person c \\ - (�-- Ph ) 5 � " 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC b 4 00 ? 0C1
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
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: 0 R)r-Y-3-4-
Final
FAIL I
M _
Post & Beam
Rough -In C (
Gas Line
Smoke Dampers
V S . " PART FAIL
Service
•
Rough -In 1(\\.) C
UG /Slab
Low Voltage (°/---1)
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Date 1 "I l i�3 ]d,\ Inspector \)•/\41
)• \ y
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record fro he J Ext
Job site.
PASS PART FAIL