Permit A 4
' eITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00402
.14.41i11‘ DEVELOPMENT SERVICES DATE ISSUED: 7/2/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S 101 AD -02900
SITE ADDRESS: 12755 SW 69TH AVE 100
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: Installation of (2) branch circuits for lights & receptacles.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TRIANGLE TERRACE LLC GARNER ELECTRIC
12600 SW 72ND AVE 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 - 4552
Reg #: LIC 121 159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/2/03 $53.50
[TAX] 8% State Tax 7/2/03 $4.28 Rough -
Elect' Final
Total $57.78
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 OAf3,952sA0 0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
1-800-33 -2344. �\
Issue By: s jiiiS11A. Permit 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: J DATE:
LICENSE NO: g '-) 75
Call 639 -4175 by 7:OOpm for an inspection the next business day
08/15/2001 00:35 6427925 PAGE 01
Electrical Perini !; III: cation .
. (j Datereceived: ?/,2/05 't no.: g�.�•do
`, t :. . 1 i! city of Ti<g :: _ a G V O p3 Project/appl. no Expire date:
City of Tigard Address: 13125 SW Blvd, Tigar On 73 Date issued: ed: By: Rcccipt no.:
Phone: (503) 639.4171 0- .�\G,P \Q CA� rti e no . : Pa t
Fax: (503) 598-1%0 ,`� ac ' \\\S +
Land use approval: \ \5t .
71 "1 111. t'l
01 & 2 family dwelling or accessory '• Commercial/industrial 0 Multi - family 0 Tenant improivement
O New construction 0 Addition /alteration/replacement 0 Other. 0 Partial
JOB sill: IN1.01 - UAIION
lob address: __ ,' -.Kt a! - 1 aV Bldg. no.: Suite no.: Tax trap /tax lot/account net:
• Lot: Block: Subdivision:
Project name: Description and location of work on premises: 2. Z s et ,
an ilAJ, .:R• , a , ,1 - , • 1 1 . , 0i; 4441.%- ... .;:ra.C. •■
(ON RAC IOIt Al 11ON 1.I ':t': St'IILDULE
Job no:
Business name: ' ! ay 1l C ' ' ' Qb• Total Pia
t�. Ilk /dal dal - ale* or ®1H-family per
Address :� 0 .4 02 = dh rD6lgtotlt .Ilteludes attachedgarage.
___ r.� • , 0 ZIP: 1 '2,3 - serrloeincladod:
Phan•/" . ` 5y 1000 a.. ft. or less 4
- Each additional 500x•. ft. or portion thereof _MI
CCB no.: Elec. bus. lie. no:3 — Q Limited en , , residential =Mel 2
Ci . • sic. no.: r'
u Limited energy, non -rear dal _ EMI _ 2
row. . •, �0.3 , Each manufactured home or modular dwelling ..
*•S e`,. r: t , i r � f �s r-.:rrii ,:ilr? -/i . t - •tilled . Service and/or feeder 2
:
Sup. elect name (print): J �i 'III License no: 707— alteration feeders relocation:
tion: -Installation,
AItBTatioq ar ralocatitm:
I'ItOl'I ?R i 1 OWN/ :R 200 amps orless 2
Name (print): 1 ' 1. ! - G.. a - � `, , 01 amps to 400 amps _ =_ MEI
� 401 amps to 600 amps MI M_ 2
M � MI MI �. .fi 1 I I II IM 601 .• a to 1000 amps ME M_ 2
C i t y f W l State: ZIP: Over 1000 am. or volts 1111111.1111 _ 2
Phone: 0 Fax: E -mail: Rpwanect onl _ Mi _ M=
Owner Installation: The installation is being made on property I own Temporary services or feeder' -
which is not intended for sale, lease, rent, or exchange according Co lresf ansdlao ,alteraiion,orrelocation:
700 amps or legs III II 2
OILS 447, 455, 479, 670, 701. 201 am • s to 400 .. • MI=_ 2
Owner's signature: — — - -- _ Date: 401 to 600 am . _ M _ 2
l•:N (; IN I I I t Branch drenits • new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
City: State: ZIP: T' •
Phone: Fax: E - mail: Each additional branch circuit: IM !l111111
1'1. :\\ RINI! :11 (1'Ir :1 check all that apply) Misc. (Service or feeder not Included)t
0 Service over 225amps-oommerttia1 0Health -care facility Esebpurnporitrigationcircle �� 2
0 Service over 320 amps - rating of 1&2 0 Hazardous location • eh s :. or outline lighting MI M _ 2
family dwellings 0 Building over 10,000 square feet four or Signal eircuit(s) or a limited enetgY Pena ■ E- II.
0 System over 600 volts nominal more residential units in one structure alterarion,orextension*
O Building over three stories ❑ Feeders, 400 amps or "star •Deacti • ;on:
0 Occupant load over 99 persons 0 Manufactured structures or RV pads Each additional inspection over the allowable In any of ***bees
n EelestilildttiegPlett ❑ Other. , Per• : •. :..;on =lien
Submit _ mete of plans with any aide: above. leveed: ation fee
The above are not applicable to temporary couaructlon service. Other
Not NI mom steep steep neat cats, plaints can jurisdiction tor more tnloaaadoo: Notice: This permit application Permit fee $ .- 53 . SD
11 Visa D , < __- _ _ expires if a permit is not obtained Plan review (at _ 98) $ —
. _. - 0 ' within 180 days after it has been State surcharge (8%) .... $ :_el. R'
' i' L a „ accepted as complete. TOTAL $ • g
on =die card
C>aIdttoldar Aspatore Amoont , 4404613 (6 )
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION . ; Business Line: (503) 639 -4171 MST
1 � BUP
Received Date Requested AM PM BUP
Location l a- � 5S ID /4)"e- Suite l o MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 - ao �D �--
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
w+' PART FAIL
$ 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date ' / 2 , Inspector d Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
/� PASS PART FAIL /�