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9220 SW INEZ ST
CITY OF TIGARD 24-Hour
BUILDING Inspection. Lire: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
9UP -
Received —___— Date Requested lJ AM PM BUP
Location G —Suite MEC
Contact Person ? —_ Ph( ) g - – 7 3� PLM
Contractor _. _—_-_ Ph( ) _ SWR
BUILDING _ Tenanl/Owner E L C - C�G ��(�s73
Footing ELc _
Foundation Ac,;esS: 1 ��
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: r SIT
Post&Beam
Shear Anchors - -
Ext Sheath/Shear _
In!Sheath/Shear —
Framing T
Insulation
Drywall Na,'ng - -
Firewall
Fire Sprinkler - ---- - - --- -
Fire Alarm
Susp'd Ceiling
Roof -�
Other:
Final -! 0/
PASS _PART FAIL --�-
PLUMBINGI
Post 8 Beam -�-- __---- -
Under Slab
Rough-In
Water Service - --- --
Sanitary Sewer �F
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 A _ _—
UG/Slab
Low Voltage
Fire AI_arm
JAS PART_FAIL ❑ Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
WE 0 Please call for reinspect) RE: A _ Unable to inspect-no access
Fire Supply Line Q
ADADate P
Approach/Sidewalk Inspector___ - -___ _. __.. Ext
Other:
Final - DO NOT REMOVE thla Inspection recor fr m the Job site.
PASS PART FAIL
� ELECTRICAL PERMIT
CITY OF TIGAR®
PERMIT#: ELC2004-00543
DEVELOPMENT SERVICES DATE ISSUED: 8/25/2004
13125 SW Hall Blvd.,Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S111A0-06900
SITE ADDRESS: 09220 SW INEZ ST ZONING: R-4.5
SUBDIVISION: PENROSE TERRACE
BLOCK: LOT : 014 JURISDICTION: TIG
Project Descrip;ion: 4 brarl,,n circuits for upgrade.
RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS _ 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: SIGNALIPANEL:
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 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1100 amp: ,_— —v PLAN REVIEW SECTION
1060+,,mplvolt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect onl�r: _ SVCIFDR>=225 AMPS: —_ CLASS AREAISPEC OCC:
Owner: Contractor:
BROWN, KATHERINE BOONES FERRY ELECTRIC INC
9220 SW INEZ ST PO BOX 628
TIGARD,OR 97224 WILSONVIL.LE,OR 97070
Phone: 503-598-2339 Phone: 682-4936
Reg #: SUP 3170S
—_ --- LIC 88482
FEES _ ELE 3-2230
Description Date Amount Required Inspections
j ELPRMT] ELC Permit 8/25/2004 $66.80 —
(TAX]8450 State Surcharge 8/25/2004 $5.34 RoughFinal Elect'I Final
Total $72.14
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 wi;l 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. Y7u may obtain copies of these rules or direct questions to OUNC at(503)
246.6699 or 1-000-332-2344
Issued By: k /A__' _ Permit Signature: _
OWNER INSTALLATION ONLY
The installation Is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNATURE: --- DATE:_
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPPRR.—E-�LEC'N: __ _—__._. DATE:
LICENSE NO: _ 1L�� --- ---- — ---------- —
Call 639-4175 by 7:00pm for an inspection the next business day
'' 20. 2004 9: HAM BOONES FERRY ELECTRIC _ N�. 1?'S'9 P, I
Flecincui rermit PRUCR ! C ' '
Cit,A'Tigard `" �' Reoe,ve .
13125 5W Hall Blvd.,Tigard,OR 97223
Date/B ; aZ�-�i/.—urs P«,trl�, 4(-C'l6y�
I,' ��l 11
Phone: 503.639.4171 Fax: 503.598.196$1!i.) Flan Rene pan Re, OtherPertait.
Inspection Una: 503.639.4175 pate Ready/By: JUrv: See Pege 2 for---
iterriet www ci,tigard or us Neufied/Method �y�]�r�St�u�pG'p�leyrneZe 2 tnrarmaoon
❑New construction ,;tRqddirionWteranon./replacenleltt Please check all that apply
LJ Demolition U Oilier ❑Service over 225 amps,comtn'1 ❑Hazardous location
❑Service over 320 amps-ranne ❑Buildng over 10,000 pq.ft.,
of I-and 2-family dwellings 4 or Mort new residential
1-and 2-family dwelling ❑Comrnercial/industrial L]A s.cessoryt,,.ilding ❑System over 600 volts nominal units in one structure
[J Multi•famil ' ❑Master hwiflel (�l 0$rrr ❑Auilding ever three stories ❑Feeders,400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
_ ,< El Egress/lighting plan RV park
Health-cue fads Ot
Job no,; 6 - Job site address �Z� SW Mp Z ❑ ry ❑ her
- - Submit,1,sets of plans with any of the above.
City/State/Zlp: ?� A„ Q R eI 7G e��f The above are nor applicablr to temporary construction service.
SultcPoldg./apt.no: Pro ect name. O �
,P 0wr1
_____ Qty Pee. rate] ••
Cross street/directions to job site: Plow rtsidential single or tnulti•family dwelling un{t.
-- _ -- Includes attached garage.
_ 1,000 sq.it or less 4
Subdivision: - ------_I Lot no.. - 6a add'1500 sit.ft.or portion 33.40 1
Tay,snap/parcel no --- — Llrnited energy,residential 75.00 2
- - 1,imited energy,non-residential 75.00 2
y > Each manufactured or modular
L^ k S - �n� �r Il �ivk C� IQlC 7pc
dwelling,service and/or feeder _ 90.90 2
Services or feeders installation,alteration,and/or relocation
V 200 strips m less 80.30 2
pp 201 amps to 400 stripe 106"85 2
i .ii:r i~;i_. 401 amps to 600 arrips 160.60 2
Nartte: rte. -- 601 amps to 1,000 amps _ 240.60 2
,ddress: C7 S O-er 1,000 amps or volts_ 454,65 2
kccr-meat only 66,85 2
City/State/ZIP _ - 'Fempornry services or feeders Installation,sitsration,and/or
Phone: tiod
t 0 -eq S,t�33 Fax: 203 any
2QJ strips or las _ 66.85 1
Owner installations This Installation is being made on property that 1 own which is not 201 amps to 400 amps 100.70 y
intended fir sale,lease,rent,o:exchange,according to ORS 447,449,670,and 701. 401 a s to 600
tap amps 135.75 2
Crivner sigrratute _ gate Branch circuits-new,alteration,or axtegsloo, er anei
_
�• �. .r,,, .� o.n_• '. �, � A Fee for blench circuits with
service or feeder fee,each
Business nwm: broach circuit 6.65 2
Contact name: ----Y--� -- -- - B.Fee for branch utrcuits
without service or feeder fee, 1 46,85 2
Address: '- each branch circuit
-- _. Fach add'I branch r+rcuit ri 665 2
City/State/ZIP: Miscellaneous(se..vice nr feeder not included)
Phone:(_ ) �Fgx, : ) Puntp or lmgation circle 1340 2
--
Siss or outline lighting 53.40 2
E•tnalh Signal eircuit(s)or limited
energy panel,altarstion,or
~� extension,Describe Page 2 2
Business name; booms Ferry-Electric__ __
Address; p.09OX 628 Each additional Inspection over allowable in any of the above
--- _— Per inspection 62.50
C1ry/StttteJ7.IP; WilBont►111t3 OR 97070 Investiptionper hour(tiumin) 62.50
Phone:(5 03) 682-4936 Fax. (503) 682-7946 tndusatal lantperhour 73.75
CCB I,ic,:8 8 4 8 2 Electrical Lie.:3_ C Supry Lic, 411 B S subtotal s 60
Sup rv.Electrician signature,required- - Plan review(25%ofpermit fee)
Print name: ,h Hi§rro Date State surcharge(3%of permit fee)
-- TOTAL.PERMIT FEE 7 Z ,
Authorized si(;rtahtre: Tbu permit applies on expires T a permit is not obtained..ithio iso
Y days ager It hat been accepted as complete
Print ileitis'
Date: _—-—�� ' Fes methodology set by Tri-County Building IndwtryService Bard
ee Number of iwwLous per pemut allowed
I;Wulldina�►rnrdts�Bt"GPetotMApp.doc 17/07 41J.�615T(1t1e2/CT.1M'WBa