Permit • A, 'CITY OF TI GARI? ELECTRICAL PERMIT
PERMIT #: ELC2003 -00260
"61111 DEVELOPMENT SERVICES DATE ISSUED: 5/9/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BA -07700
SITE ADDRESS: 16240 SW WOODCREST AVE
SUBDIVISION: COPPER CREEK STAGE 2 ZONING: R-4.5
BLOCK: LOT : 017 JURISDICTION: TIG
Project Description: Install (2) branch circuits for remodel.
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:
JANINE WALDO ABC ELECTRIC CORPORATION
16240 SW WOODCREST AVE 135 NE 9TH
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503 - 984 -5564 Phone: 233 -7551
Reg #: LIC 288
SUP 1241S
FEES ELE 26 -2C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/9/03 $53.50
[TAX] 8% State Tax 5/9/03 $4 Rough -
Elect'l Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 2 -23
Issued By: 4, Permit Signature: 6)1 & ()A-
OWN 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 / DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
09/28/2001 11:27 FAX 5035981980 CITY OF TIGARD 0 002
ElectricalPermitApp -__ --
1 T .�_} Datereceived:5li - .i ��.= �
j Cl of Tigard �I �' _ Projcet/appl, no.: Expire date:
Ciry ofTigard Address: 13125 5W Hall Blvd. Tigard, OR 97223 Date issued: -fir Receipt no.:
Phone: (503) 639 -4171 MAY (‘ ' 2 g oa
Fax: (503) 598 -1960 Case file Ito.: Payment type.
Land use approval: Li 1 - r II-
-, i y , i�O�G
IMIN 71��14 .' G =�
-- TYPE OF- PERMIT -- — —
l & 2 family dwelling or accessory 0 Commercial/mdustrial 0 Multi- family — O Tenant improvement '
O New construction 0 Addition/alteration/replacement 0 Other: • 0 Partial
- -- - - - - -- JOB SITE .INFOP 1ATlO \'
Job address: , - '• .t / ' a Bldg. no.; Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: '' v 4ffifffill Description and location of work on premises: '
Estimated date of completion/inspection: ,
CONTRACTOR ,APPLICATION - - -
FEL SCHEDIiLE -
Msx
Job no: if — 3 ' _, Qty. no. map
I(tr 1 / New residential- .. or multi-fatally per
oriar 4 / • dwdpr 1ndodm'smelredgantge. mb
��'lv r.a al ii pit &flieeindv
r s 4
Phone: _ �`ilnEr� +%siwt . h iimul woo
finch ft.
300 W R or portion thereof ���
CCB n0, — ,/_ Elec. bus. lie. no- . , — — Limited energy, residential MI M___ 2
City/metro lie. no.: A:_ o) 0 _
Limited me ; ,non - residential 2
A ` ' Each manufactured home or modular dwelling ■■-
Date Service aidror feeder 2
12111j in •
S sure oCstroervisin: electrician (required ` Services orfeeders— installation, 11111 2
� -- alteration er relocation:
I
ROPER OWNER 200 amps or less
Name (print): i 3/r S r ' ,�� 201 e w 400 amps M�1 2
.? , it, _ a, 2 0 1smpsl a 4 00. �_ 2 •
Mailing address: 601 amps to 1000 turps 2
City. State: ZIP: Over 1000 amps or vote ___ 2
M • M , , Fax: grail: Reconnectod I=rNM I
Owner installation: Th installation is being made on property 1 own Temporary t vicevicms e eedas •
which is not intended for sale. lease, rent. or exchange according to 200 snaps or tart 11111111
Indarladonsat 2
ORS 447, 455. 479, 670, 701. 201 amps to 400 amps MI M I= 2
Owner's signature: - Date: 401 to • II arum MME 2
- }.NG L\Lt:R Branch circuits -new, alteration,
or extension per pinch
Name A . Fee for branch circuits with purchase of •
Address: ' service or feeder fee, each branch circuit 11111 2
City: State: ZIP: B. Fee for branc circuits without purchase IIII f • . g.
of service or feeder fee, first brunch circuit:
Phone: Fax: E-mail: Each additional bnmxh circuit li'PM FAFill aill
- - - PLAN RE%'IEW (Please check all thai.apply) _ _. Misc .(Serviceor feeder not Included): NEM 2
0 Service over 225ampt•commcrd 0 Health -care facility Each pump or irrigation circle ___
i o
O Service over 320 amps -rating of 1&2 O Hazardous location Each Ovmaids) or s o ra li f a limited ited energy panel. III Mill
family w Signal
dwellings 0 Building over 10.000 square feet four sign or B
O System over 600 volts nominal more residential units in one tincture alteration. or extension 2
O Building over three stories 0 Feeder+. 400 amps or more •Demcri • turn:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
O EgreasI1ightingplan O Other Per inspection 1♦—N
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other �.7
. to mars iefarmrom.� Notice: This t application Permit fcc • $ 53 ' a7`
14a an parr CI MasterCard � redo please i"' " permit Plan review (at _ %) $
• O vier M a expires if a permit is not obtained
Grecism maw number I withi 180 days after it has been State surcharge (8%) .... S
_ 1. r7Te
eip
accepted as complete. TO S
Horsed cardholder as mare oa Credit end $
Cardholder signawrc Amount i 440.4615 (6r00R:OM)
•
1.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested '—' / AM PM BUP
Location / ' \ L/y �� ite MEC
Contact Person Ph ( ) PLM
Contractor Pi6Cfr/c Ph ( ) Z 3 3 - 7S3/ SWR
BUILDING Tenant/Owner ELC 3 d 6 ' 21-4
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 G
Drywall Nailing • re� im
4 �r v;
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
•
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
:,1;?' PART FAIL
SI Please call for reinspection RE: D Unable to inspect – no access
Fire Supply Line
Ap proach/Sidewalk Date - / t 4 i / Inspector 4 d Grro Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL •
•