Permit A:z CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00202
.411 }i DEVELOPMENT SERVICES DATE ISSUED: 4/8/03
11. f I I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 101 AD -02900
SITE ADDRESS: 12755 SW 69TH AVE 201
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING. MUE
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: (4) branch circuits for office remodel, lighting, copier and microwave.
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: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD TRIANGLE LLC GARNER ELECTRIC
12600 SW 72ND AVE #200 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 - 4552
Reg #: LIC 121159
SUP 3707S
FEES ELE 34 -305C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/8/03 $66.80
[TAX] 8% State Tax 4/8/03 $5.34 Rough -
Elect'l Final
Total $72.14
This Permit is issued subjed 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 OAR - U1 =00.10 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- 800 - 332 344. ■
•
Issue By: I; ! Q 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: Q • DATE:
LICENSE NO: 4707 S
Call 639 -4175 by 7:OOpm for an inspection the next business day
05/22/2001 02:24 6427925 PAGE 01
Electrical Permit Application
Date received: S Permit no. c'5- ePo;oJ:,
. ,1 j' i I ! of i and (� 1� D Project/appI. no.: Expire date:
Ci o s A Tigard
13125 � Hall Blvd, OR�7223 Date issued: B '
H8 and Phone: (503) 639 -4171 - Y* Receipt no.:
Fax: (503) 598 -1960 ppR 0 200 Case file no.: Payment type:
Land use approval: _ - -r1RAVO N
l
O 1 & 2 family dwelling or accessory Commercial/industrial 0 Multi- family O Tenant improvement
O New construction UAddition/alteration/rep'acement ❑ Other 0 Partial
Job address: I 2-755 w to Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: J Subdivision: S�,,r#'?. 201
—
P r o j e c t n a m e ? : I Description and location of work on premises: Off-ice. R .
Estimated ' :. of corn . letion/ins . lion: i h , ,, i t Yet v. -
(Y)iN IRA( wit Aryl :ICA 1 ioN 11.1: ,ti( 11l. :DIN I•:
.Yob not Fbe Mat
Business mine: &1 Z NC g [''; Gera f c -
New residential - af�gle or mnitl- >Evnlb per Qty. (ca.) Ton, no. Imp •
Addr� : 4Z 9 .2 o Sh/ a-- 7 - - P dwellingmt (L1nchudrsatlacbedaprage.
�
City. ) rt (State 2 ZIP• q'7 /� . $ersiceineluded: •
Phone 1 Fax 2 79 E -mail: 1000 sq. ik. or less - 4
Each additional 500 sq. ft or portion thereof
CCO no.:J, /i Elie. bus. lic.no:39. -30 Limited energy, reaidential _ 2
Ci • • tic. no.: Limited energy. non- residential 2
• „ ei f r / Each itanufectwred home or modular dwelling -
•�, �. : ""'fir' *!required) Date r Service and/or feeder 2
Sup. elect name (print): .A . Aro, License no:3 7407 s 0� Drfeede>a- Ittitaltatloa,
slter:Won or relocation:
I'ItOI'I I l ON%'NI:It 200 imps or less 2
Name.(print ?: �. F 7 201 amps to 404 amps 2
401 amps w 600 amps 2
Mailing addiess: 601 amps to 1000 amps 2
City: I State: 1 ,Over 1000 amps or volts 2
Phone: I Fax: I E- mail: Reconnect only 1
Owner installation: The installation is being made on property I own 7bmpornry millets or feeder' -
which is not intended for sale, lease, rent, or exchange according to foslaQaden, Wttsrallon, orretocatiorn
ORS 447, 455, 479, 670, 701. 200 amps or lase 2
201 amps to 400 amps 2
Owner's si inure: Date: 401 to 600 2
Branch circuits -sew, alteration,
• or extension per pinch
Name: • A. Fee for breach circuits with pvtrbase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: a- free for branch circuits without purchase '
- Phone: Fax: E-mail: Each savlce or feeder fee, first bran ch circuit: 'Cr 2 ,
Each additional branch circuit: - sL. M .
I'I:AN ICEVII!1V check :01 Ih :it :iiii11 ) Mhc . (Service or feeder not included):
O Service oveY225 amps- commercial O kleelth —re facility Each pump or irrigation circle 2
O Service over:32() amps-rating of 1&.2 ❑ Hazardous location Each sign or outline lighting 2
familydwe lingo 0 Building over 10,000 squaw feet fourot Signal circuit(a) or a limited energy panel,
O System over600 volts ceminal ' more residential units in ow structure alteration, or extension* 2
O Building over three stones 0 Feeders. 400 amps or more . *Description -
0 Occupant load over 99 persons 0 Manufactured stwaures or RV park lEadi additional inspection over the allowable in any of the :Mow _
CI
Egrete/1(ghtittg 0 Other Periospecdon 1 I 7 I
Submit sets alpha's with any of the above. investigation fee
The above are not applicable to temporary construction uction service. Other
N. nu jcei es accept credit cards, please call ivtiedtetioa for sow ufonoarioa Notice: This permit application Permit fee $ - .
Visa O 1d expires if a permit is not obtained Plan review On — %) $ i
. - ...her: a: 4. - • t, - 11 t71 , O3/ p23 within teo days after it has been State surcharge (896) $ - "t34
� : t • ._ -
: it - - e° accepted as complete. TOTAL $ .
t O.kil .`, , ,. ` 4a:. .•'► .ate s '12 t Y
T* Arooual 4404615 (bootooM)
/9/ --/9-.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business,Line: (503) 639 -4171 MST
BUP
Received Date Requested 60 / Z- AM PM BUP
Location 1 75! ' ? Pk-u-e- Suite 0-0 ( MEC
Contact Person Ph ( ) PLM
Contractor 4 • - Ph ( ) 6 $ - (S3 a SWR
BUILDING Tenant/Owner — — � ✓i .� � _..t .% ELC 3 - 0 0 a0.-
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 V 1? >
Drywall Nailing
Fire Sp J
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 . rm
ma Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI Please call for reinspection RE: ?di"
Un. o inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 6 //A 03 Inspector .i , I Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL