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9020 SW Burnham Street
i CITCITY OF TIGARD ELECTRICAL PERMIT
Y PERMIT M ELC2001-00605
DEVELOPMENT SERVICES DATE ISSUED: 12/4/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102AD-02800
SITE ADDRESS: 09020 SW BURNHAM ST
SUBDIVISION: BURNHAM TRACTS ZONING: CRD
BLOCK: LOT : 005 JURISDICTION: TIG
Prosect Description: Loc,.,tion of work: CAO/CPAH Lighting retrofit.
RESIDENTIAL UNIT _TEMP SRVC/FEEDERS_ vMISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 anip: SIGNAL/PANEL:
MANF HMI 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 amn: 1st W/O SRVC OR FDR. 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amn: PLAN REVII=r'.'Qg_rTV';d
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
__— Reconnect only_ SVC/FDR?= 225 AMPS: CLASS AREA/SPEC OCC-
Owner: Coritractor:
TIGARD, CITY OF OREGON EL ECTRIC CONST/GROUP
13125 SW HALL BLVD 1010 SE 11TH AVE
TIGARD, OR 91223 PORTLAND, OR 97214
Phone: Phone:
Reg #: LIC 203
SUP 4460S
EL.E 26-95C
FEES Required Ins.,ections
Type By Date Amount Receipt Ceiling Guver
J— — --�-- - Wall Cover
---- -- -------- —
Elect'! Final
Total
This Permil.s issued subject to the regulations contained in the Tigard ,unidpal Code, State r. OR Specialtv Codes and ali other applicable laws.
All work will be done in accordance with approved plans This permit will expire if work is rot 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 oy the Oregun Utility Notification Center Those
rules am set forth in OAR 952.001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions tc OUNC at(503)
24f)-lj6!?9 or 1.800-332-2344. /
Parmit Signature: Issued By: ! �r
_ OWNER INSTALLATION ONLY —The installation is being made on property I own which is net intended for sale, lease, or rent.
OWNER'S SIGNATURE: � _ _. DATE:
CONTRACTOR INSTALLATQN ONLY
SIGNATURE Oi= SLIPR. ELEC'N: .� .�L �,�_ DATE:---___ --_
LICENSE NO: —
Call 639.1175 by 7:00pm for an inspection the next business day
ElectricalPeWEAMPE 'on
- -` '- Date recetvul. ,l ). � Permit tto.:
.�
City of Tigard Ptoject/appl,no.: Expiredata:
C'ityofTigard Address: 13125 SW Halt Blvd,' d,RV pate issued: Hy:, p7i7pt.... .7
Phone: (503) 639.4171 "v,Fax• (303)598.1960 CITY 0 �1'1UARU Case file no.: Payment ty
Land usC approval: BtM.DINNO DIVISION
a
i &2 family dwching o-.accessory O Commerciai/industnal U Multi-family Q Tenant improvement . r
O Ncw construction U Addition/:lteraounArhlarernent Cl Other. _—_- j Partial
IS SITE INFORNIA110N
Job address: 907.0 SW nha� B1dR�uo.. _ Suiteno.: 1';,Amap/taxlol/accountoo.-
].of: dock: Subdivision: _.,
Project name: try Tigard Description and location of work on premises: ICAO/CPAH li h' ting re r0 t
Estimated date of rompletion/incprscdon:
Fee
Job no: ti 1 5 _ - Ma=
Total ma.In:
Business name: pregon Electric Group De+etipuoo vnr• (y)
Nen nr�tkntlal-rinp}e orrmWtamly pri
Address: S 1; 1 1 tin p, _ d"rUinbrnit.tnchides attacird iw act-
City; portlaz:- I State;0 ZIP: 97214 Serrceincluded.
,r
Phone: Fax: toxo aq.ft or leas a
-
Each additional 500 sq.n or portion thereof :r -rrrr.i r
CCB n Elec.bus.lie.no: 2 — 5 C Limited energy residential -1 t,2
tet liC. o.: Urnitedenergy,non-residential
ch manufactured home or modular welling
ignarure oCs rvis' g rlectri an(tvaCu' ) pate Serviceandlorfeeder - 2
Licrnse no: 4 4 6 U S Sere{cm orleeden Instal adon,
Sup,deet.ea (pri ): k nn,_ alteration or relocation:
2W amps or less 2
2amp_jj
s ps to 400 amps 2
afire not 1 amps to 600 amps _ 2
Mailing address• __L0 _.ps _
do l amps to 11x10 amps
City- state: _ Z1P Over 1000 amps at volts
Phone: Fax: E-mail: Rcconnee t0nly
Owner installation:'Che instailtidon is being made on property 1 own howlTemporary ^mai a,urreocrs "
which is not intended for sale,lease,rent,or exchange according to 200all amps
or dlrr,tica,or relocation: ;2':
ORS 447,455,479,670.701. 200 amps or lis 2
201 amps to 400 anapr,
Owner's si ature, hate: 401 m 60o ata '
Yrmt clrettlts-new.alteradon,
orextenaba per panel: ••
Name: _ I!_ Fee for branch r imuits with purchase of
Ad
^ dteSs: service or fender fee,each hunch circuit
�-
City. SL1ic� ZIP: B. Fee for branchdmaitswithoutpr:rchaase
-._ '- -- - of service or feeder fee,finat brunch circuit I "•'Z
Phone: Fax: F ttlail: finch additional brunch circuit —
Mise.(Service or * not Inc.uded)t
Each pump or irrigation circle 2
1]Service over 223 amps-enmme,ri,l U Health-care facility Eachaignoroudine{ighdng - -
U 3erviceover 320atnps-ratingof 1.&2 0 HmArriouslocation --family dwellings U Bailding over 10,000square feet four rr Slgnal circuit(s)or a liml!ed energy panel.
Usystem over 6W-oltsnominal more residential units in one structure alteration,or extension, - t 2
u Butldtngover three stories 0 lrmltas.400ampsormom -I-Description;
U Ocrupait loud Over"persana t]Manufactured stmetuns or RV parkFAch additiorvil inspection aver the atlowahlr:In any of the SIM
m--�-
D E¢:Astlightingplan C3 Other. Perinspecdon ---t---
Submit_-_-sets of plans with any of the strove. lnvabgadon tee ___ --
The above are not appilrable to t aaporstry construction serrice. ►
—, __-- Permit fee.....................E
Nm all)ari-Aednes accept relit wdt,pk-_W call jnuisd etion for mote information, Notice:This permit application Plan review(at _ % Si
Cl visa Q MasterCard expires if a permit is not obtained
Credit curd number within 180 days after it has been State stlrch3rge(8%) ....E _
accepted tug Complete. TOTAL .................. ....$
Nan of car outer u wn as 6RH cud
( --isrd6otder signatae — _s gmeust 401.141%1rrtnK nMl
098-d 900000 d 991-1 10011EEE09 11101113 110g0JO-00di 9080 10-OF-AON
CITY OF TIGAIRD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --
RUP
_ Date Requested _ ! /3 AM-----PM
Lo,,ation I u -A . �r,,�,� J_ Su!ta — MEC --
Contact Person _ Ph — PI-M
Contractor
�(f-C"fi�r Ph SWR
BUILDING Tenant/Owner ELClUY C� c 16 G j
Retaining Wall EL IR
Footing Access: —
Foundation FPS _
Ftg Drain — --- SGN
Crawl Drain Inspection Notes: - —
5!ab ----- - - --- - SIT
Post& Beam -
Ext Sheath/Shens
Int Sheath/Shear
Framing
Insulatior. -
Drywall Nailing —_.--
Fir-Nall
Fire Sprinkler
Fire Alarm i r�
Sust i Ceil g --
Roof 11 ✓
Misc. -- -
Fi;ial -
PASS PART FAIL --
PLUMHING G
Post&Beam -- ---
Under Slab
Top Out -�/ --------- —-
Water Service _ � r•, _ --
Sanitary Sewer
Rain Drains --- �__- •�•c / ' �C,24 t ----
Final --
PASS PART FAIL.
MECHANICAL
Post& Beam - - --- ----
Rough In
Gas Line - - -
Smoke Dampers
Final ----- -- - - --
PASS PART FAIL.
ELECTRICAL_ - v -— --------�—
Service
Rough In ------ -------- --- ----
UGISIab ----_--- -. ---_- - --
I_ow Voltage
F Alarm -- -- _ - --- -
PART FAIL ----- ------ --- ------ -- ----- ------------- -
Backfill/Grading -------
Sanitary Sewer
lcrm Drain [ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Bassin
Fire Supply Line [ j Please call for reinspection RE: - [ )Unable to inspect-no access
ADA
Approach/Sidewalk --i �-
Other Date /„�-� -- Inspector _- ^—I Ext
F pial ""
F Asa PART FAIL PO NOT REMOVE this Inspection recon! from the job site.