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ELECTRICAL PERMIT-
CITY OF TI OARD
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT ELR2001-00271
13125 SW Hall Blvd.,Tiqard. OR 97223 (50'11 639-4171 DATE ISSUED: 10/31/01
PARCEL: 2S 101 DD-00900
SITE ADDRESS: 14010 SW 72ND AVE A
SUBDIVISION: ZONING: I L
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of data telecommunication.
A.RESIDENTIAL _ B.COMMERCIAL_
AUDIO & STERE(): AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARW BOILER- LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALAKM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL #OF SYSTEMS: 1
Owner: �--------------�--- Contractor:
TARK.IAINEN, REINO J A AND TICE ELECTRIC
MARILYN J PO BOX 15009
20895 SW I_EBEAU RD 2139 SE BELMONT ST
SHERWOOD, OR 97140 PORTLAND, OR 97293-5009
Phone: Phone: 233-8801
Reg #: uc 166
SUP 25865
ELE 26-1260
FEES V `— Required Inspections l
Type
By Date — —'Amount Receipt r Low Voltage Inspection
PRMT CTR 10/31.'01 $75.00 2720010000 Elect'I Final
5PCT CTR '10131/01 $6.00 2720010000
Total $81.00
This Pei.nit is issued subject to the regulations contained in the Tigard Municipal Code State of OR. Specialty Codes
and all other applicable laws. All vrork will be done in accordance with approved plans. This permit will expire if we rk is
not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon I2w
requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are,et forty: in OAR
952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions. tc OUNC at (503)
246-1987. j
Issued by _ Permittee 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
LICENSE NO: ----- ------ ---...----- --- — _. — -
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
10/30/2001 15:45 503-872-8290
TICS ELECT.SERL+.DEPT PAGE 02
Electrical PermitApplication Page 2 Of 3
City of Tigard Datereceived: /D,/5d O l'crrrlitno.:���2
Prolec
Address; 13115 SW Hall Blvd,Tigard,OR 97223 Vappl.ao.: Expire date
-
CO
rry ojTigord _ _
Phone: (503) 639-4171 Date issued: By , Recciptnu.•
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _
U I ei:2 family dwelling,or accessary M Colnnlercial/indusit•ial U Multi-family
U New construction M Addition/alteratiorVreplacernent U Other: FJ Tenant improvcmcnt
U Partial
1
Job address: 14010A SW 72nd Ave
ubdivision: -- Uldg. no.; Suite no,: Tax ma :
map/tax lot/account no.
fit: Block: S — ---
Project name: p 401 Descri tion and location of work on remises: InStall voir� & Data.
Estimated date of completion/inspectioRMT 91111T
n' -----
Job no: 22.0594
6lusincss name: TiCe Electric (.o Few i►t.a
' Drrcriptian Qt ea. row 00.enelr
Address: Box 15()09 Nervrrsldential airtgkmsnuld•fam0yj+er --- {
City: an State: OR ZIP: 97293--5009 Service Included.-�o des anatltMRarage_
F 3-8 M, -mail: — 1000 sq.A.or less 4
CCB
no.; ( Efec.bus. ic. no- �1 7�r Bch eedidond 500 .n.or rtion thereof -
City/rne ro tic,no,: 01 Umltedenergy,residendal 2
Limited anwgr,non-reaidenUd 2
SI
0/30j01^ Fishmanufecluredhomeormodular dwelling Mt re of name
rvlsin elecVlclan(re irrd i bete Service and/or feeder_
Sup,elect,nae(primBerr
): I ien or feeders-InclatIxII0n,
- l.icenseno:
alterelien or relocalloni
200 amps or leas `
Nerve(print): _ Tam to400.mile -Mailingaddress; Y — 401 amps to 600 amps _2 __-it : of emo0p 2
State: ZIP: Over 1000 amps or volts
Phone: Fee: E-mall: Raconnectonly l
Owner installation:'I'he installation is being made ort property I own Tenrpor.rrarrocesorfieders_
which is not intended for sale,lease,rent.nr exchange according to butallatlon,site ration,atrelocadoo:
ORS 447,455,479,670,701 200 amps or leas 2
I 201 ammo 00 camps 2
Owner's si nature: Date. 401 to boo jam ,
2
Srsutt t ells new,■Iteral em,
_Name, orexleraloa per panel:
Address;
-- -- -- A Fee for branch circuits with purchase of
----- service or feeder lee•each brunch circuit 2
Cit _ State: 'LIP: B. Fee for branch circuits without purchase
Phone; 1'ax E-stat I: of service or feeder rne,first branch circuit. 2
Hach add oval rrrtch cirwlt
Ise.(Basica'or-10—Re r not Imcleded):
O seMeeover 225amps-eomrnercid 0 Health-care facility Each um ornrri etioncincle 2
U Service over 320 amps-sting of I k2 O Howdous IoeaUon Each sign or out Ise lighlinjl — 2
godly dwellings O Building nver 10,000 square feet four or Sijlnd circuh(s)or a limited energy pulel,
O System over 600 volts nominal more residential units in one structure altenUon,or extension• 75. 2
O Building over twee stoma O Feeders,400 amps or mom
O Occupant load over 99 persons O Manufactured structures or RV putt abeserl tlan:^ o r> r ---
O Egrea✓IighUngplsn O Other — __
>tAch s dM I hU on over file allowable In any of the alw�e•
Subsalt seta of plats with any of tine above. PerinspeeUon --� --
Invoalon fee The above are not applloable go temporary con."mirtion serrifk. otter
Nd dl)WIO iotionr smgx ereean cards,please WI jurisdiction rat room InfomwUoa Permit fee.....
Nntla:This permit Application ••••••••••••••••
. $ _
vlss VV
L3 MalterCsrd expires if a Plan review -
p permit is not obtained (at �) S
cftdR1c.d nnmeer 4E133 4910 0014 (32,7_X01 a 02 within 180 days after it has been rl:lle surchetge(896)....$ ~
—� ""p fat— accepted as complete. T(�TA L
Name r n Ant n own ane t tea .......................
___ Dttlef slptgan Atneunt
M(LuiU ftvOtLCpMJ
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST _
Received __ _---.Date Requested f?UP
1 � AM pM BUP
Location n1
() d!� 7'� rTL`�— Suite--- MEC
Contact Person Ph
Contractor�� �r�L PLM
Ph —
( — ) SWR
r1gDrain
ING — nart/tDwnerELC
—tfc.nELC
Access:rain _ El,R Ob! - 60 �Inspection Notes: - SIT
Post 8 Beam _ _
Shear Anchors -------
Ext Sheath/Shear --- —
Int Sheath/Shear
Framing - - - - --
Insulation ------
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm '—
Susp'd Ceiling _ --'
Roof
Other.
Fina'
PASS PART FAIL -
_PLUMBING —
Post&Beam ---
Under Slab
Rough-In
Water Service
Sanitary Sewer ----- ----- _ —
Rain Drains
Catch Basin/Manhole --
Storm Drain
Showei Pan
Other:
Final - — - -
PASS_PART FAIL_
MECHANICAL _ _ --
Post& Beam
Rough-In 4
Gas Line - ---
Smoke Dampers
Final _
PASS PART FAIL
ELECTRICAL -- -- — -
Service - —P59903D
Low Voltage -
Fire AlarmEl _
Reins __---- _
PART FAIL Pection fee of$_�_ required before next inspection. Pay at City Hall, 13125-W Hall Blvd.
8 _ __ — n Please call for reinspection
Fire Supply Line '— ---- -- U Unable to Inspect-no access
ADA
Approach/Sidewalk Dawte ' /� �- Inspector �'
y_
Other: -------- _ ��—• -- -IExt -
Final -
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.