Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00590
��11 DEVELOPMENT SERVICES DATE ISSUED: 9/22/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 2S101 DC 00200
SITE ADDRESS: 13535 SW 72ND AVE 145
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (2) branch circuits.
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:
PACIFIC NW PROPERTIES LTD PTNSHP RC COSTELLO
9665 SW ALLEN BLVD STE 115 PO BOX 336
BEAVERTON, OR 97005 AURORA, OR 97202
Phone: Phone: 503- 982 -7400
Reg #: LIC 87402
ELE 3 -344C
FEES SUP 3934S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/22/03 $53.50
[TAX] 8% State Tax 9/22/03 $4 Rough -in
Elect'I 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 OAR 952 - 001 -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 - 332 -2344.
Issued By: �C « � 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: DATE:
LICENSE NO: 5
Cali 639 -4175 by 7:OOpm for an inspection the next business day
E lectrical Permit A : • •
E � :::; d. q �3' Pe rmi t no. ( ' i t y of Tigarr� EI VE � aJ . no : Expire date:
Cigvof7it4u,•rt Address: 13125 SW ! teard, OR 97221 —
I'1aiic: t ( ") ?i 6 ?)- 4171�e 9 Date issued: 13v: Receiptno.:
Plai e: 150 ) 6 941 2 ? 00 `� Case file no.: -- - -- 1 --
Ya) ment type:
Land use Jppro � TY wr TI GARD -
J I & 2 family dwelling or accessory t Commercial /industrial O Muitt- fancily enant improvement
O New construt.tlon J Addition /alteratiu :breplacemert •O Other: O Partial
.. • • - : • • ' • .. .
JOB SITE INFOKMA7•ION -
_)ob address: /3 ' S ,1 L • Bldg. no.: Suite no.:/q5 Tax map/tax lot/account no.:
Lot: Fiilock 1 Subdiv 1sion: —
- —
Project nu:.
n — 1 Description and location of v.ork on premises: --
Estimated date of c,n,il :Luun/inspection: - - --
' • . ... CONTRACTOR APPLICATION ION . •.'-'.",'"; ' • • I JF • S. (ill F - •
Job no: Fee Max
Business n ame: f C 1 �
Description Qty. (ea) Total no. insp
Address: �' � — ------ N,,. residential - single or multi-family per
v` c .„ X 33 r -- - — _ - - - - - - -- du elling unit Includes anal lied garage.
City: Awl; ,- I State a - LIP. _r Seniceinctuded:
PllonrR62, )4/0..) ` Fex q � 4� (� v / I E - mail• —_ I coo sq 11 or less 4
Each additional 500 s fr. u: r tbn a ereuf
' Cf_ no.:8 'ID �^
at new) }Ice. bus lie. no: � _ 3Cfey C'
— ___ -_— - - _ q p I
2
Limited enerEy.residential �— t ii. no., L 9 -- --
/ / 11 _ I.i mned energy, non -rend. • lit 2
- �/ Each manufactured home •r m:•r J el! ne f
i Stgnatu:c of superv: mg ;Icc'rt _ - -- tr., _ c Seice. and/nrfeeder - - '- 2
Services or feeders - installation.
Sup elect nail: ,I:r,nt;' 00- ( ry
,.tr ,� se no. ,, y -
a or relocation:
- PNOPERTY OWN£R 200 amps or less ( 2
N: ine (print): 201 amps to 4 00 amps - -- 2
_ 401 am to b00 amp 2
Mailing address __ \ 601 amps to 1000 amps i - 1.. 2
—
City: Sint :' 1 ZII , Over 1000 amps or volts 2
Phone: I I a�' E -tuna: Reconnect only I
Owner installation. 'i he installation is being made On property l own Temporary services or feeders -
whicl, is not intended for sale, least:, rent. or exchange .t_ :a tnstaltation, , ur reloratiun:
200 amps orl i f
9 less 2
- -- _
ORS 447 4iS. 479 6'0. % 11 20: amps tc 400 amps I 2
Chvnct a signature � � Date. - — .101 to 600 amps -- -- 1 — 2
Branch circuits - new, alt :ration,
or extension per panel:
Name: - -_ —_ — A. 1-:a fur branch circuits v. tin Pura.2.,c or
Address: _ ;en•ict.: ..ii tee.der fei. each b: inch circu. 2
City: State: I ZIP: 11. Fee for branch circuits wiu out purchase
-" `- • - -- ---- - ~ -- of service or feeder fee, :ir.a branch circuit: ( i 2
Phone: Fax. E
P r.h additional branch siruu
PLAN R 1 :VIE%V(Rlcase 'check :all that apply).. Misc. (Service or feeder not inrluded):
O Seivtce over 21_5 amps- cuauocre al ❑ Health -care facility Each pump or .mdannn circle 1 2
U Service co er ;2'i arnp, racnl, of 1 ti.:': 'D Hii. -duus location Euch sign mantle tline h n;
rhti I 2 -
familydwellings :J 234i:11111E ev,t :00)0 'qua.: 6 •et bur of Signal circuits) or a limiter: energy panel, 1
0 System over vol:. rnnnut:il more xsti. .tia' units in one st:i cture alkrati -m, or estens.on• _ 1 2
❑ Building over duce stones ❑ Fe;d: rs. 400 Imps or mare • Descri nun:
❑ Occupant load over 9') penaus U fvtanufac•ured structure, or it V pek Each additional inspection over the allowable in any of the above:
0 Egress/lighting pl 0 Odinr: —._ --_ Per inspection 1 1 1 I
Submit _,__ ;ets of plans with any of the above. investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 5 5(
Not all junsdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Cl Visa O MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number: -__ _L__L___ within 180 days after it has been State surcharge (8 %) .... $ e-1. )
E%p "` accepted as complete. TOTAL $ _ j 7, 7 �
Name of cardholder as sho„n on credit card
■ Cardholder signature Amount , 440 (6/90/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection'Cine`(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested /D -a T AM PM BUP
Location 1 3 S3S 7a .4'74 Suite) /� MEC
Contact Person ��.�h�-�� Ph ( ) 53 `E 7 se PLM
Contractor Ph ( ) SWR c-�
BUILDING Tenant/Owner ELC 3- 8 U 6 e)
Footing
ELC
Foundation
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
aggE Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date /o 2 6 3 Inspector `_ .r Ext
Other:
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL