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11720 SW GAARDF ST
CITY OF T IVHK^ w ^DELECTRICAL PERMIT
PERMIT#: ELC2004-00075
DEVELOPMENT SERVICES DATE ISSUED: 2/18/04
13125 SW Hall B!vd..Tigard, OR 97223 (503) 639-4171 PAROL: 2S110EA•01400
SITE ADDRESS: 11720 SW GAARDE ST
ZONING: R-4.5
SUBDIVISION:
BLOCK: LOT: JURISDICTION: TIG
Project Description. Installation of(1)branch circuit. Underground power supply for cable
SF
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: v PUMPIIRRIGATION:
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):
_— —SERVICEIFEEDER ,V 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, IN PLANT:
601 - 1000 amp: — PLAN REVIEW SECTION
1000+ amp/volt: -4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only_ SVCIFDR—225 AMPS: _ CLASS AREA/SPEC OCC:
Owner Contraci.or:
PATRICK LYNCH EMPIRE ELECTRIC COMPANY
11720 SW GAARDE ST 2014 SE 9TH AVE
PORTLAND.OR 97214
Phone: 5C,3-614-1903 Phone: 503-777-3108
Reg#: LIC 147727
GLI' 3-5210
--FEES S(m 31e2S
Description Date Amount
_ Required Inspections
(fa.l'(zt\4'I') GLC'Pcrmit I� �i-t $46.85 -- �- —'� -
ITAX) K'!„State Surcharge -: 1� nFinal$3.75 Rough
Elect'I Final
'notal $50.60
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 Ppproved plans. This permit will expire if work is not started wPhin 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: 12t -� Permit Signature:
OWNER INSTALLATION_ONLY
The installation is being made on property I own which is riot intended fcr sale, lease, or rel.t.
OWNER'S SIGNATURE: DATE:_.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:_...__
LICENSENO: -.,._-- ------ --- ---------.�_�., �_�---
Call 639-4175 by 7:00pm for an inspection the next business day
2-16-204 4: 18PM FROM EMPIRE ELECTRIC CO 1 503 777 4152 P. 2
"Ej�echjcy1 Permit Appbieati r-C", a
itagis IMMIX
City of TigardAece,vea
131M SW Hall Blvd.,Ttptd.OR � t\ Da��_ �[_l �1_ PerndtNo.:�L�q nIgo
0 S
Phone: 501.639.4171 Fox. 503. 8 'WPlan Rcntw
1'1 _Date/A Odttr PanMc•
hltpcction tine 503,639.4175 ((�� -- -
Internet: www.ci,d rd ,p Due Rem/dy � 1w � f9 Sac Pgc7 I�r
Ifs tn.uf NatiGedrlMetbod'
_ �(�j •.1 �_ 7
supple-ental tafarwwftw
w `j 1 PLANREVIEW,
I
New construction []A t� uorllrrplael:v=t i Please check alt that apply:
Q I)err101i[I0n
C1 Other QStnvtce over 225 amp.,comm'I ❑)laurdous Iocahon
[]Service over 320 wraps-rating [JOuildnL over 10.000 ft•.
" �Ai7tjEG4l;Y OA.,(,QN,�)fRUCTIUIV'' !' i e4I;,Ih of I•and 2•fartily dwelling% 4 or more new residential
❑l•and 2-family dwelling D Uorrun tial/industrial Acc:tssorybuilding USystem over 600 volts norninal units in one structure
❑1lulh Tamil _❑Master builder ❑Building over thrcc stones ❑Fcedcrtmo
,600 amps of re
1-- � �t' ---
_ []Oceuputt kmd ever 99 penons ❑My,ufacuued structure or
�S i ��It4I1'E IN . .,. 1fc []EgreWi8hunrplan RVpark
Job no.: Job Fite addles- OHeallh•carc facility mother._
117.7n -RI.1 -Uayrria Si_.
Subrttft J-soca of plans%nth any of the abcve
City/Statevzv: Tigard , 0 R The above are nut applicable to te,nptmry conttruchon service.
sulwilldg./kA.no.• Project mete! -
--- ----�- P,epy,•ta._ _ QV. � ree Taal
Crags i ttwt/directions to job site: New residtptiat tingle-or multi-fan»ily d**Wna unit.
- - Includes attached jaralt _
1,000 sq.R or lest 145.15 rn
£iuixLnsion' - '4 Lot no.: Ea.add'I 300 sq.R or portion 33.40
Tax ntap/nareel no: Limited anergy,residential 75.00 2
-�--
i .;',' '' aESCRI)Pilbtd'1<1�;'�t1oRK titnitedclergy,non-rctidrntial 75.00 z
•.;'1; I, F -- Eceh nunufsctured or modular
r•';
Owelling.service and/or leedcr 90 90 2
Ui7dertlraun�l Power 3Up lY far C8b_�e _ Servixtsorfeeders inratlation.alteration.snd/orr_etneation
200 amps cr less 80.30 2
zoo sups to deo amps 1 OG.ts t
Now; 401 ornpo to 600 amps 160.60 2
/-q 7/ _' / ���� 601 amps to 1,000 arms 240 60
_. 2
Address: `/f�'A S<<7 t�Ar ( S7 . nvv►,Duo amps or volts 434.65 2
Rrtortneetonly __ GG RS v 2
Gty/5tatd71"P: Iamporary eervicts er feeder-o insullaaioo.alteration,ond/or
Phooc: cation
2 Fax ( ) 00 amps or leu 66.81
Owner iaatallation:11-is installation is being nude vn pteperty that 1 awn which is not 7.01 amps to d00 arrp• 100.30 l
intended far Sale.Inose,rent,or txehangr,according to URS 14-7,449,670,acrd 701. apt amps to WO arr>p� 133 75 2
Owner signattue: Date `- — —
_ Branch sircults-gtw,altrradon,or oxforision,per panel
ftmorr-- A.Fee for branch circuits Niih
�• w � �1 „ I,•n,, 'I' '',, ,�I t�e^rl'
service or feeder fee,each
Bustrimname: Empire El.t?etric Co. brattchcircuit 6.63 t
`-�"-- ~ rb Fre for brunch ciicu,ts --
Contact nes M:131 k G London wfthotu service or rccder fcc.
Addoeos. 201.4 SE 9th Ave. - -- -- —SEh branch circuit 1 46.83 gg.BJ 2
-- -- ----- Fach,idd'l bench timuit 6 67 2
City/State'ZIP: Portland, OR 9721_4 P1lstehaneouR 1--"ce or feeder not locluded _
Phone:( ) per: - --- Pump p im�anon circle 3}d0 2
503 �„Zj-3108 _��031 777-4152 5lptortw;linelighting ^33.40 z
&mail: Signal citcultrs)or limiied-
71a!i_ I; aeaG Cgt11R it 1 i,l i1' energy panel alteration.or
-- extension.Describe Page 2 2
9wineastlatrn: _Empire Electric Co. _ _ _ _
Addiess- 2014 SE 9thAve. Eacb additional Inspection Durr allewable In any of the above
— Per inspionec
citylstatam! Poi tland, OR 97214 lnvesrago,_on_perhour(Ilumin) - 62.50
Phone:(503) 777-3108Pa* (503_? 777-4152 lndustn'.1 vises r hear — 73.75
CCB Lie P.lecaical Lic.: i - "- ` ,:JC[:C(.'iitiCAL PB�far'���-
__1._4.ZZZZ— . a q- 1 Supry LicaSubtotal- 4C85
Suptv.Electrician signattlfe,roquired: /' ':?r, ?�;�,..; ` Plan renew(25Y.of permit(n)
d4- -
mritrimt:0avid Manwill-er Date: 2/16/04 -_ State aueeharte(gtSorpennitree)
TOTAL VERA'I?•a EE
Authorized 11$nature TIw lreemhapputsdoe n,rs,it it ptrsWe it mai obtained-Wo Ir0
--" day.after It has been aecepnd :a tomplrtr
Print name' -- DatC — ' Pn mtth0*40ay act by Tri-County Bundles a ludumv Service Beard
Nuadxt of kap"nom per permit allowed.
,us,atuettrn,drtcetc.en,atAo.esc toot ..o.e,sitioarcowwie
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
Received _ _ Date Requested Z AMPM BUP BUP
- - -
Location 72 h Q- ------- Suite _,_____.-------- MEG
Contact Person -_ D
-------------
{— Pht - -) ' 77- - - PLM
Contractor
- Ph( ) ---- -- SWR
BUILDING Tenant/Owner ELC
---------------------
Footing -
Foundation Access: ELC
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post$ Beam -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear - - --
Framing
Insulation A\ Srt Drywall Nailing
Nailing - - _-
Firewall
- -- -
Fire Sprinkler —-- -__
Fire Alarm , 0 .A \j
Susp'd Ceiling - - - - _ --
Roof ` -
Other: --,--- _
Final
_PASS PART FAIL - --- `-
PLUMBING-
-
Under Slab
Rough-In - - - -- - - ----- -
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other:---- - -- - -
Final -- '-
PASS PART FAIL
MECNANICAt.
Post 8� Beam �1
Rough In -
Gas Line
Smoke Dampers
- - 3
Final l, -----------__- _� - -----..
PASS PART FAIL �� - ----------_--- -
ELECTRICAL - - -
Service
Rough-In -----~ - --
UG/Slab -- ------ ----
Low Voltage
*FiAlarm PARTFAIL - Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE; ___- _ CJ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Z ` 4 Inspector b
Itxt
Other; —�
Final
PASS PARI FAIL DO NOT REMOVE this Inspection record from the Job site.