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Permit A CJTY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00129 �,.� i � DEVELOPMENT SERVICES DATE ISSUED: 3/18/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AD - 01700 SITE ADDRESS: 16850 SW 72ND AVE SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING. C -G BLOCK: LOT : 030 JURISDICTION: TIG Project Description: Job No. 12388 Adding outlet above drop ceiling for TV 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: SIGNAUPANEL: 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: 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: BRIDGEPORT LAND LLC BOONES FERRY ELECTRIC INC 3939 NW ST HELENS RD PO BOX 628 PORTLAND, OR 97210 WILSONVILLE, OR 97070 Phone: Phone: 682 - 4936 Reg #: SUP 3170S LIC 88482 FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/18/04 $46.85 [TAX] 8% State Surcharge 3/18/04 $3.75 Ceiling Cover Elect'I Final Total $50.60 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: --- ri,41 p _ 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: Call 639 -4175 by 7:OOpm for an inspection the next business day Mar -18 -04 11:35A P_ , EIectr }CSI Permit ARECtgii V ED FOk 41FFI(.E i :. r tl:il" City of Tigard MAR 1 8 2004 ,: i 4.,, P / .2...e - OD - / 13125 Asir Han Mud., Tigard, OR 9 17 23 Ien Review ' Phone: 503.639.4171 Fate: 503598.1960 l Other tnepe tin lam 503.639.4175 CITY OF T � : : ,. ►. L I { pile assn Internet www.eidgard.or,ue _ ta ING DIVISIw - hroafie tec = seePsEez i ` ^g , ' Supplemental Inierminen [ W Y i::l=_9-.�; - .;::" b 'I;!. , f -1' t o ;;'. 9 , .' r' i - I ' 1 1 � ; ,. '3' r„.} .. JT _ ',,sr •may I S IOr : �':.Ir� '�Y 1 •. '&iii ,� IAS11 :� ^l[! I I�'L . �P.:1� ` + "... ❑ Now Construction 1! Addition/alt replacement 1 Please check all blab apply: ' , . ~ :, . I CI Demohtlnn ❑ other ,4 i t ( // • p.- f(7 /20 ✓ °Service over 225 amps, cormil DFtazardous location - �, x ; . � , 1 : K z z Y °Service over 320 amps. rating ❑Builds over 10,000 l :r c i f r _. ,, 1 1 ^ i jy'_Pp .W Il,1' c r; i' >>• 11l oft- and dwellings S = t l ...a.. ° . — _.. ?5 e l •- : 1,-1 I w " lY Pp 4 or more new residential ❑ I - and 2-family dwelling C omunerclW/industrial ■ Accessory building Q System over 600 volts aonofal units in one auvcone o Multi- family ❑ Master builder 0 Other 0Buf1ding over three stories 0FaOera, amps or more 'j :'. + 1to. 'I �:_ �7" , .. I l: re, .1• 'v.19 F,'�' 00ccePare load over 991utams attsattACt1M0 struentes or F : t:1: _ : 1 .' ,. _.,i-:::;:::7:;:,-t-:, :'- 0E8nm/begins plan RV park :. i • ❑Hcanb-c>tefaclity 00ther: Submit 2 sets of piatls with my of the above. (qty /Starr/ZIP: a. / � 97 2Z y The above we not applicable to temporary construction crvice Piojeaname' F.. =,r, r,, err: �r "°`y,�,T ,.:�; • ' AligirmiaM Dareno.a r Qty- p.. Tout .. Cross stteet/direntio116 to Job Bite: I jiioePIMIIIIII New residential single. or mutt! -t neily dwelling emit. Indudra attached garage. 1.00014. E. 14515 4 Lot no Es_ a4d'1500 sq. It o1 portion 33.40 l Limited energy, residential 75.00 1 - T^-� . r N,.., '4� Limited m�ta / AOe�eiidd6 1 0 ' iii�l 75.00 . ,.r Jy �,�_ - e,,'0 I . 4 , _ :, :2,.• � 1 .•.. rJ r.,, - 1 _I � ,, • r I . I: Y4,; mall ...ZL`'-1';.: Each manufatttaed Of modular 1 d elim : WOO, and/or feeder I 90.90 Services or feeders installation, alteration, antler relocation ZOO - or less NMI 80.30 K::. r" r' ' :r'�: T. r++G1"?' -s e1T-; r< a 4 �r,:.z 201 amps co 400 sores II 106.85 }- �� .- _.c__ v rt' r.,.i. �... .. 1,L.. , 3!.h::J ur�3 , , ' i. i . 401: a to 600 snips 160.60 601 apps to 1,000 amps II 240.60 Adehas: s`, _ OM 1.000 mpg invoice 454. IP: "— Reconnect only NM 66.85 Temporary services or feeders Iarmilatron, alteration, and/or Phone: ( ) Fax: ( ) - Z00 slaps or less 66.115 1 Owner installation: This installation is being made on pronely that I own which is not 201 to 400 amps NI 10030 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. C 001 to 600 amps �� � signal= Data: Bra Owner si9u n ch tertian - new, astarodoo, or enteasien, per Paw 7 ` ' ^ - - -.— -' _ I I - - 1 , . `, -.=_ ' [. � % , A„ A. Pee for bran* Yallit3 with Bt>8ineaa name awls or feeder fee each 6.65 . branch circuit Contact Hann:. B. Fee for heroin r feeder ' Wilma service o err feeder the, Addr �� each breech circuit Each amll branch circuit IMI 6.65 _ © City /StandZIP= ND:oelhneoes (service or feeder net included) Phone ( ) Fax • ( •) Pump or irrigation circle 53.40 Si . or modem • g 111111 53 40 g - mom Signal eirgKt(s) or limited- ~: 1 _ �4 7; I5::i'' ;+ " :4 i , ` , ! ; , i " ,v cnengYPanel,ai OT • extetld Desc n�e: Page 2 A.ddr : A) i • Earl, additional fag • Wien aveir allowable la my or she above ter tuszectIon i ll City/Stoical!): W -� ,70/ - 0 /Z 9'" 7 1 70 InveaO per hour p ,,r ode) 6 6' 2 2 50 _� r'' Fax rrdus4tal • lain • echoer 73. • (eii3) .$2- - 79 V _ CCU Lie.: ' 7 �� $11piv. I.i4: 3/705 T - 4k je ' c.? "?%,..i' ii .x -D, �. , • s k : '� � j �'`� Subtotal Suprv. Electriciap signature. required: ' _ _ - —° Plan review (2346 otperemt fee) Print name: . �e . Date: S.... hi ^ O Slate surcharge (8%otpe:Innfee) 1 3 � - TOTAL PERMIT YE ..../ �- Aurhenimd Signature " II* pataett sOprwr eo spire Ir a parmtt 4 stir oaraiwe4 .44;h1 n dsye d ear u tae anew ueep a eo u Print name: Dare: • lee wets 4abft, t+el by Zyi-Ca as barking industry s.,wew Do - •• Number of mgrseeonr per permit aflo r4. Evan.a.e.as. iolin.c.r erapp.eoe tans / // seateirrotvo 1mi.v cp "h d c9‘ Z7o`2 6 ,..4; a % l� CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTIONV,DI*ISION Business Line: (503) 639 -4171 MST ��!!/� / BUP Received %I 21 W Date Requested — 0 4 ' AM PM BUP Location Jl0 ? Z) Z kt Suite MEC Contact Person A q.4 __ Ph ( 5 6i2'g�� PLM ��//ii Contractor p.�-�h (( d 5 7 —( .34# cP SWR BUILDING Tenant/Owner 'GZ Z` Z2U l Z Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: __ // SIT l 2 Post & Beam c 4D Shear Anchors •/tQ■„4,X P w..ct a l�It c_ Ext Sheath/Shear �' �- O� Int Sheath/Shear 1 Framing ` Insulation ( \ • �� \� \� 1t V t Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof �' C 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 m :�• � 'ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIT 0 Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector s Ext Other: Final DO NOT REMOVE this inspection re rd fro the job site. PASS PART FAIL