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ERMIT-
CITY + F TIGARD - ELECTRICALRESTRICTED
ENERGY�V1 RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003-00039
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 2/10/03
PARCEL: ?S101AA-07600
SITE ADDRESS: 12540 SW 68TH AVE A
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 028 JURISDICTION: T!G
Proiect Description: J
A.RESIDENTIAL_ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTH-R: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
_ TOTAL#OF SYSTEMS_ 1_
Owner: y _ Contractor:
WILHELM, MICHAEL W ROSE CITY ELECTRIC CO INC
12540 SW 68TH AVE 4012 NE CULLY BLVD
TIGARD, OR 97223 PORTLAND,OR 97213
Phone: Phone: FAX 252-1060
Reg#: NW-61600001029
SUI' 2127S
LIC 3567
—_FEES i ELE f g1iJ ed Inspections
Description — Date Amount Ceiling Cover
�- 2/10/03 $75.00 Wall Cover
�IiLPRMT] ELR Permit Elect'I Final
[TAX]9'%,State Tax 2/10/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale of OR. Specialty 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 throuc
Issued by i _ (�; _ Permittee Signature -ie _
_ 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 INS'._ALI_ATION ONLY
SIGNATURE OF SUPR. ELFC'N _ _ DATE— —_--
i._ICENSE NO --
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
02/04/2003 12:12 5032821060 ROSE CITY ELECTRIC PAGE 01
Electrical Permit Application
RE V E'`v'E D Date receivcrt: Pemtit no.'
city of Tigard projectlappl-no.: Gxpire date:
c-irvn)Tigard Address: 13125 SW Hall Blvd,Tigard.OR 97223 Dateiesued: ay Receiptno.:
Phone: (503) 6394171 i Lig i 1,UU3
1--ax: (S03) 598 1960 Case file no.: Payment type
CITY OF TIGARD
Land use approval: -
U 1 &2 family dwelling or accessory ".1 Come.;,,-ial/industrial Ll Multi-family U Tenant improvement
LI New construction U Additiort/aiteration/replacement 0 ether: _ U Partial
Job address I�-J�}(� 1 �_lJ>< f Bldg.nn Suite no.: Tax map/tax lot/account no.:
- I
Project name: scription and location of work on prcmi8,s: _-
Esiin)ated date of co►n 1 n/ins CtiOn.
L,,-� � I"� A Itrx
Job no: 1j1 � [Nmcriininu Qt (ca 'foal no.Ing
Business name; Rlectric Co Inc Ncw�esidmttsl cinr1"rmnhi-ramilyher
Address: 4= ME CU11V V dwelitnRtmtt in.Inrks sitar i*-'I ryrrat!r.
City: r Z serricrfnclorkd
or an sty:
i — 1000 sq,tt.or leu
Mc additional For rtlon thonof
CCH no.: 131ec.bus.Uc,no__�`1 r. Limited energy,restdcrtual
City/ 1029 —, Umited energy,non•rea+5iential 2
pnchmanufneturedhomeorModulardwelling 2
Service nnrVorfeedcr
n or u_- sr electrician wired) Oste sen n or feeders Insist all-%
slip,eiect.name(print): R L, PQhamLicense"o' ~c alteration or relo,ntinn:
200 an[pf Or irar. 2'
2 1 amps ro 40D amps _� _
None( rine: — 40lajrvo600 amps 2
Mailing addteas - bol amps tompr.
Cites SLItr: ZIP_- over 1000 amps er volts 2
econnrctonly t
Piton: l;a%: Email: -
?etnprnry.ersieea or feeder.-
Owner installntinn:The install9tion is being made on property I own teat.natlwr.aNer+Mon.arnroranntn
which is not intended for rale,lease,rent,or ex,-hange according to 700 artips or lea, _ 2
ORS 447,455,419,6741,701. ioi nmpa to 400 ami!_
Owner's si natUro' _
Date. _ deli in 6a)amps 2
ilnt+rh circwtm•new,alta mill a.
or extension per petrel:
Name: ___._ _. A Fee for brar:ch circuits with purchase of 2
AddmeS: -- service or feeder ree,each branch circuit
States z1P: Pee Mr branch circuits without purehase 2
of tervir a or feeder fee,neat branch circuli
I9untc Il+x E moil: additional branchcirculL
iae.(8enke or Leder not Included):MASERAMWERM __
Hach a or Irrigation circle 3
❑Service ovtlW,nmp. irHrnl+h-enwfa.•:hty FachRion oroutline lightiftl —
U Qorvice over 320 amps-Ming of I dc's U Harnndaus location •aiteration,ofextensiongi c Kuit(s)or a iinittd rncrRY Pnne1 —
famlly dwrinngs U Building over 10,000 snesquare feet four or P 2
p System ever 600 vuhs nominal more iraidenHel units in onestntctutc �--
U Ituilding over thr.e nmrim U Peedern.400 nmpa fir more •peachtion:
❑nccupanl irsd ovrr 99 perauns `•l Manufactured vructurrs or RV parr )Fie addNlona (narectfnn over the aliuwable M any of the shout
Li P_grraallighungplan U other __ --- Per ins ucxi — --
Subgrilt_arts rat plow,whit any of tht above. nveed�fee ^_
jW above are.:ot mg4kAblr to temporary cooaltvctloa atetvlct. �'�►
hCtttllt for......... ......... . = �
Na alt)WIN40nm arnept area,'arra,plraae till)titiOCOM kt raises inretma++o� Nodml This permit application plan review(at �%) � y�
a Via■ t�luurc O y�O?� expires if s pctmli is not obtained State surcharge(11%) ....9 _
(p z $5 yy y1� within 180 days after it has been
�ycadnuf" v etyr'aa TOTAL. ..
r lei aeoepted at complete.
e _— "4181;5(SWCOM)
CITE( OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST ----
INSPECTION DIVISION Business Line: (503) 639-4171 BUP
Recoived Wte Re uested_ _4 AM PM RUP --_._--
Location �-i4 b Suite--b' MEC
Contact Person Ph( 1 -�
�___ PLM
� � SJ —-
Contractor
Ph(--) SWR -------- - -.. -
______ n —
BUILDING TenanVOwner �.!�_- L L ---. ELC —_-- --
Footing ELC _..--__
Foundation Access: ELR
Ftg Drain
Crawl Drain -- - - SIT
Slab Inspection Notes:
Post&Beam --- ---- � �--1 �Y-+�=- - -- -
Shear Anchors
Ext Sheath/Shear ---- --
int Sheath/Shear-
Framing
heath/Shea-Framing _--_----___ -- - - ----
Insulation
Drywall Nailing �--- -
Firewall
Fire Sprinkler _ ---...---•------------- - __ —
Fire Alarm
Susp'd Ceiling ------------ ----- -._—_ - -
Roof
Other. _ _ _- -- - - ------�.—_
Final ---
PASS PART FAIL
Pos
&Beam
Under
- --_-
Under Slab ---------- ---- -- '
Rough-in
Water Service --- ---- -
Sanitary Sewer -
Hain Drains - -'
Catch Basin/Manhole _
Storm Drain
Shower Pan -
Other: ---- ---- ---- -
Final .---
PASS PART FAIL -
MErHANICAL --
:3ost& Beam -- h-�&,,f , ; .1 �0-� —1="• Oil 6 IN
Rough-In
Gas Line
Smoke Dampers
Final VV
PASS PART FAIL —------A--- — — --
ELECTRICAL ---
Service
Rough-In -� ----•---
UG/Slab
Low Voltage __— ------ - -'--_-- -
Fire Alarm
Final Reinspection fee of required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _- [� Please call for reinsr-„ r, F u _ Unable to Inspect-no access
Fire Supply Line
ADA Date�__~7 �J..f; Inspector �'►__, -"" -Ext -
Approach/Sidewalk 1
Other:-
Final DO NOT REMOVE this instRpection record rom the fob site.
PASS PART FAIL