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Permit CITY OF T ELECTRICAL PERMIT PERMIT #: ELC2002 -00181 DEVELOPMENT SERVICES DATE ISSUED: 4/23/02 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112AA -00300 SITE ADDRESS: 14200 SW 72ND AVE SUBDIVISION: ZONING: I -H BLOCK: LOT : JURISDICTION: TIG Project Description: (9) branch circuits, sub -panel and wiring for misc equipment. 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: 8 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: ASGARD L L C BECK ELECTRIC INC c/o GERBER LEGENDARY BLADES 9318 SE CHURCH ST 14200 SW 72ND AVE CLACKAMAS, OR 97015 PORTLAND, OR 97223 Phone: Phone: 656 -7396 Reg #: SUP 1326S LIC 00002629 ELE 3 -5C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 4/23/02 $100.05 2720020000( Elect'I Final 5PCT CTR 4/23/02 $8.00 2720020000( Total $108.05 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 -008 u may obtainopies of these rules or direct questions to \ l Permit Signature: � j sued By: r #,/ o f of / /(.. 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: L & . � �/ �'1'� ��—� DATE: LICENSE NO: / 32 Call 639 -4175 by 7:OOpm for an inspection the next business day Apr 23 02 10:49a beck electric 503 - 656 -4397 p.l . i ElectricalPermitApplication Date received: Permit no.: Ett. „,_._Oa/ &/ _> ,'I 1!' City of Tigard Project/appl. no Expire date: City 0! Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPI? OF 19[1011 O 1 & 2 family dwelling or accessory OCommercial/industrial O Multi - family 0 Tenant improvement O New construction 0 Addition/alteration/replacement Cl Other: O Partial JOB S1 IL INFORMATION Job address: l4iaU0 FLU 72'— Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: 'Block: 'Subdivision: , Project name: !Description and location of work on premises: 5 Lt o_pulp/ t : . U J trt Vlo ev I . C . Estimated date of completion/inspection: 1 . , CON 1 RAC "[Olt APPLICATION FEE. SCH1:Dh, L Job no: Fee Mme Business name: j e G lit 1k.. Description Qty. (ea) Total no. imp Address: ` 318' SE Clues . New resklendal le ormuld-tamilyper dweBinganit. Wades steadied garage. City: Clak,tswr‘c.S I State: 041 ZIP: 91'1015 Serviceincloded: Phone: (D S tP -131 b I Fax: (05,0-(13q1 E -mail: 1000 sq. ft. or less 4 CCB no.: (p ,a9 I Elec. bus. lit. no: ,3 Each additional 500 sq. ft or portion thereof Limited energy, residential 2 C'ty /metro lic. no.: 0? Limited energy, non- residential 2 V./ 4.. 4 73 - 02_, Each manufactured home or modular dwelling Signature of s hng electrician (required) Date Service and/or feeder , 2 Sup. elect. e (print): W:4_1 r J ._ License no: 13 j Services or feeders installation, alteration or relocation: . 200 amps or less 2 Name (print): p B\c cLe _ 201 amps w 400 amps 2 Mailing address: 401 amps to 600 amps 2 601 amps to 1000 amps _ 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: ( u j(pj IFax: E - mail: Reconnect only 1 1 Owner installation: The installation is being made on property I own Temporary services or feeders - . which is not intended for sale, lease, rent, or exchange according to insmUetiem,atiesatian , orreiocatien: ORS 447, 455, 479, 670, 701. 200 amps or toss 2 201 amps to 400 amps • 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: 'State: 'ZIP: B. Fee for branch circuits without purohase Phone Fax E of service or feeder fee, rust branch circuit / rf l p 5 2 . Each additional branch circuit. g if.t.s I Si .40 1'LAN 1(1.1'1E11' (Please check all that appl) ') Ml sc .(Serviesorfeedesnotincluded): O Service over 225 amps - commercial ' O Health -care facility Each pump or irrigation circle 2 0 Service over 320 amps-rating of 1&2 0 Hazardous location Each signor outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuits) or a limited energy panel, O System over600 volts nominal more residential units in one structure alteration, or extension* • • 2 0 Building over t stories 0 Feeders, 400 amps or mote *Description: 0 Occupant load over 99 persons 0 Manufactured structures or RV pails Each additioual inspection over the allowable is any of the above: 0 Egress/lightingplan 0 Other. Per inspection 1 1 1 1 Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jwisdicliom accept aunt cards, please call jurisdiction for mote information. Notice: This permit application Pemut fee $ /00.05 OVisa 0 MasterCard expires if a permit is not obtained PISn review (er — %) $ Credit card number: 1 / within 180 days after it has been State surcharge (8%) ...• $ � ' Name of cardholder as shown on credit card accepted as complete. TOTAL $ / D d U� $ Cardholder signature Amount 440.4615 (6i00/COM) • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 7_a % AM PM BUP Location f �o� �� �� ��U"� Suite MEC Contact Person Ph ( ) PLM Contractor _ Ph ( ) 7 3 fk SWR J BUILDING Tenant/Owner 0 '5 J7$' ELC a Doc ad 67)1 Footing Foundation ELC Ft Drain Access: Crawl Drain C,4) 111- 2 f a� ELR \� Slab Inspection Notes: SIT �\ Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation P r 1 Drywall Nailing 1 � � A Firewall C (►�tl m71., Fire Sprinkler Fire Alarm . C( �L 1)1S Susp'd Ceiling Roof .P■s g. Other: {� Final ,�� 4d>>N C k\K N\ PASS PART FAIL ��� PLUMBING LA t "'� � C .I 2 (*AA, Post & Beam 1)c)S� Under Slab Rough -In _ ` � _ ; , , Water Service -- - = - Sanitary Sewer aL4 O o� 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 � /A' 0- ova F= :lar - J. PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIT ❑ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line j / ADA Date '" - 1"-- 4 7 1 7` ' " C3 Z Inspect A, I. / Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL