Permit A ..-__ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00328 .
�I DEVELOPMENT SERVICES DATE ISSUED: 7/9/03
..� I � 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
/p ..5
SITE ADDRESS: SSW 68TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT : 029 JURISDICTION: TIG
Project Description: Job #03- 04262: Electrical work for new office building.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS 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: SIGNAL/PANEL:
MANF HM/ 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: 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: SVC /FDR >= 225 AMPS: CLASS AREAISPEC OCC:
Owner: Contractor:
ROTH, J T JR + THERESA AMP ELECTRICAL CONTRACTORS INC
12600 SW 72ND AVE, STE 200 1573 SE HOLMAN AVE #3
TIGARD, OR 97223 DALLAS, OR 97338
Phone: Phone: 1- 503 - 831 -0585
Reg #: LIC 117422
ELE 27 -65C
FEES SUP 4783S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/6/03 $421.25
[ELPLCK] ELC Pln Rev 6/6/03 $105.31 Ceiling Cover
[TAX] 8% State Tax 6/6/03 $33.70 Wall Cover
Underground Cover
(additional fees not listed here) Low Voltage Inspection
Total $772,67 Elect'l Service
Elect'I Final
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 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 O. ' • -I • -:1110 through OAR 95 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -800 -3• -2344. / /
Issu • d By: • 2 74 ` 6 /_ . � Permit Signature: , / /�� j i1
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 IN TALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ''..' ,'( 97 674.--4,--• DATE:
LICENSE NO: 47,5 .6
CaII 639 -4175 by 7:OOpm for an inspection the next business day
04/17/2003 09:35 FAX 5035981960 CITY OF TIGARD /o Y'1 ? / i _ f 11002
e FOR OFFICE USE O \Ll'
EIectrLc3l emi Application
�� e' , f 0 Pena : Ete Pea3 -oo3 -
bv Planning Approval sign
City of Ti Ord Da, ,,: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 may: Permit No.; „ `I
Phone: 503- 639 -4171 Pact: 503 -598 -1960 PosPost-Review Ret" Land Use
Internet: www.ct. onus ' ; <::, = Date/i3y: Case No -:
7, , j. ' -- Contact 1 I Pa See Page 2 for N
24 -hour Inspection Request: 503-6394175 Name/Method: 17/ Supplemental Information.
CO 3647 t
f' 'i "' . �
i . . . It • evs?��cc�f'ar�� : . a_ > i, ' •; ' � . �_ r -: r :'._. „ .e ' cull:: e,!tbl"g1Ci81X1:li4b iiiii •; : '•.:',,.�, .
�::�.Zjfi =:i'11y1P i!phls{a►�lt': ,1.:'•`1 s_I:�x 5u• ;tlV..ti_ J. �t. a --
Ne'w , :N construction ❑ Demolition se rvice over 225 amps- ❑ Health-care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ der: ❑ sa -vice over 320 amps-rating of ❑ Building over 10,000 square feet,
r� ►4 ' :.-: l: i �'"�: Th.; ;;- • N' ::? 1 & 2 family dweilin
�� �.,��..�?'�: �r'?`:1�:'�!D]F(. ill•'=:' 3G�tlllie "���? °�_•�;:' °`:�;;`�;_� r 8S for or more residential units in
❑ 1 & 2- Family dwelling ►.:! Commercial/Industrial ❑ Systcm over 600 POlts nominal one structure c
❑ Building over three stories M Feeders, 400 amps or more
❑ Accessory Buildi 1 ■ Multi - Family ❑ occupant load over 99 persons Manutretured structures or RV park \-
❑ Master Builder 111 Other: ❑ Egress/lightingplan ❑ other:
rag 1k 1' $ : , ° . 6N .� ' ,. wM r Submit acts of plans with any of the above.
Got- 7 d
"!';' The above are not a • • Usable to tem • ors construction service. c+.
Job site address: /aSo S 61 8' A 1./ ,a I '- :k. 0..r: _ ^iiv:''r,�1:Aih•:1_' Iv 1G 1{,,n!l.1_:rivi"7b•`i;•4,i :�-
Suite #: 1 Bldg. /Apt. #: Number of inspections per permit allowed _
Project Name: e --3-0 o Q 1 n 6 , Description l Qty Fee (w) Total
2 - New r i d a multi-family gara ge.
per
Cross street/Directions to job sate: '
dwelling unit. Includes attached garage.
CDC ttia 2 0 •F S vj (� Service included:
mom. R or teas 145.15 4
a_ "1 G7 s C .S .Q V e Q /JO ST Each additional 500 sa. R. ar portion thereof 33.10 1 .
Limited cnar y. residential 75.00 2 `.4.- _ Subdivision: I Lot #: Limited energy, non residental 17 4T>r} / 75.00 , - 4- S 2 a
Tax ma L • ' el #: - , trun►�>ttt borne or modular dwelling 90.90 2 °
'�'4E' 'r,G . �nli h7 �, �; ;a a y r s . 6 YD',p' :;let'8, ,
services or feeders . tnatalladon, .2 / (90 . 12v
._ 14 r w CJGm. •: "....a-it t i .0 Le-1 6 r alteration or relocation:
J A was
�� 201 amps to 400 amps ,. / 106.85 / 0 6. r s 2 `.. 200 amps or less
401 amps to 600 amps 160.60 2 • -
5 ) . Y. i ' Vl:ei. : _. r ;') ; ; 411 ��.._ 1-0-0147:77,77 7 Fli :T.4. . 240 5
601 Ms to 1000 amps 4 2
. t. - \ t Over 1000 amps or volts 2
ROW' c l i v ( .' Reconnect only 66.85 2 1.
Address: 15 -�Ci gr '' 'tom— 3 Tempos services or feeders - installation, d
alteration. or relocation: 66 85 t
Ci /State/Zi.: O1 On i or Icss
P' 1 a mps to 400 amps 10030 2 >
Phone: 503 433q n ax: 1 U 1 ,1.2.1111 401 to 60o amps 133.75 2
Ei _' A.01' * c ' 4. Ui�® -r
" ; ik'r•,"' Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 1 )
Address: service or feeder fee, each branch chock 6,65 r 3 9 , /b 2
City / State/Zip: B c' B. Fee for circuits without purchase of —
service or feeder foe, fast branch circuit 46,85 2
Phone: I Fax: Each additional branch circuit 6.65 2 '
•
E M. p Misc•(Service or feeder not included): "
- ri;
• ' ' ! .,/ ! -. -GUI' li v fix ��. ..� -- s ly - c— . r 4-'4 -'11'- ' T .. i? Each 17121 or irrigation cirr1e ,
Bus .�
.. . • c i . N :. u 53.40 2 '
'• � . �� Each sign or outline l 53.40 2
A
Job No: C53 + 042407--- ' Signal circuit(s) or a limitedencrgy panel, Business Name: alteration, or X031 Page 2 2
�I 1 / L [- ( rkt l _ ✓ pescri o
Address, Each additional Inspection over the allowable In an of the above:
City /State/Zip: Per inspection per hoar (min. 1 hour) 62.50
Phone: Fax: Investiation few _ - ? j
CCB Lic. #: 1, t7P-.2 Lic. #: 2 (.05C, F ,.� ,- y��� Y i:. «, .�= six r�'"� ,:
= a � :.' ^'
:Y . x11 a�
Supe electrician Subtotal ia .
sit nature required: fL / v _ % of Permit Fee SEW '
Print Name: , v Y g 2i c / c r / L I. Lic. #: 1 t ) . 5 3 S , — p • "" t -eel 1 -/ •
TOTAL PERMIT FEE $ - • O. C IP •
Authorized Notice: This permit application expires if a permit is not obtained - thin
Signature Date: 180 days after it has been accepted as complete. '
*Fee methodology set by Tri- Coonty Building Industry Service d.-- -
(Please print name) r , ' 1
i:lDsts\permit Prams VilePenmtApp.doc • 01/03 C - - 1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503j i -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171 BUP
� Z
Received .3" z( I Date Requested _ p ID /Z AM PM BUP
Location / z5l 5 [�O Suite MEC
Contact Person l '- F`Q-S't Ph 45 O 3) 1; t -- 6 cSFS PLM
Contractor ,4-Yr ms s? • Ph ( ) SWR
BUILDING Tenant/Owner — 00 Z P
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing I
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /6117
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
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
UG/Slab
Low Voltage
- :r
wir
PART FAIL
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for r inspecti n RE: Unable to inspect - no access
Fire Supply Line
ADA / r ; Insect ��- : Ext
Approach/Sidewalk Date _ p
Other:
Final DO NOT REMOVE this inspection record from th Job site.
PASS - PART FAIL