Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00617
.^ lre DEVELOPMENT O Tigard. SERVI (503) 639 -4171 DATE ISSUED: 11/1/00 Hall Blvd.. 13125 PARCEL: 2 S 112AC -01200
SITE ADDRESS: 14865 SW 74TH AVE 250
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Installation of 5 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/ SVCI 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: 4 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:
KNHS DEVELOPMENT CO BEAR ELECTRIC
26262 S MERIDIAN RD P 0 BOX 389
AURORA, OR 97002 DONALD, OR 97020
Phone: Phone: 503 - 678 -1355
Reg #: LIC 20919
ELE 24 -107C
SUP 3162 -S
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 11/1/00 $73.45 2720000000( Elect'l Final
5PCT CTR 11/1/00 $5.88 2720000000(
Total $79.33
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 -0080. You may obtain copies f%theTe'ru es or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATUR j
E`�m� 1 J01' i :/ ISSUE BY: / 1 /, // / ,,„
OWN R 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 SUP R. ELEC'N: .A �� !�'��� � % DATE:
LICENSE NO: l C �7
Call 639 -4175 by 7:OOpm for an inspection the next business day •
OCT 27 '99 08 :49AM P.1 -
EIe Permit Application
,_ , A
Date received: /0 - -GU Permit no. Er - op
a City ®f Tigard
!RECEIVED Pmjectiapp1.no.: Expire date:
Clay ofTigard Address: 13125 SW Hall Blvd, Tigard, tiR 97223 Dateiseucd: • Byl 2 Rccciptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 OCT 2 7 2000 Case file no.: ' Payment type;
^
Land use approval: T -
O 1 & 2 family dwelling or accessory ommereial/industtial U Multi- family Tenant improvement
0 New construction O Addition/alteration/replacement ❑ Other: p Partial
Job address:
7y T r B14. no.: Suite no.;,ZSO Tax map /tax lot/account no.:
Lot: ( Block; I Subdivision:
—
Project name: `, .. - , . _ )-_ A , r -.scripfion and location of work on premises: 'J , f [d -
Estimated date of com • letion/ins .action: / 00 ' ' -
CON.1ar.r 01 APPLICATION FEE h SC111 1)111.f•.
Job no: Max
Fee Business name: oc e „ � - Descdptlon Qty. (ca) dotal no. leap
Address: p At)), - New residents'd- singlet ornada- family per
03e d rel lmost&includesattached zone. •
City: C) at+LL I State' C9✓2 [ZIP: 970z 0 Service included:
Phone: ‘;7 -/ S5 Fax: (7 ' E -mail; 1000 sq. R.orless 4
CCB no.: 0 70y'/ �f I Elec. bus. tic, no :2 /07 (,° Each additional 500 sq. ft er portion thereof 1
City /metro lie, no
Limited =tram, residential 2
�l 7 Limitedenetgy,non- residential 2
O (� 0 15ach manufactured home or modular dwelling
Sig ry sing electrician (required) - Data Service and/or feeder 2
Sup. elect. name (print): vT a, , v,s License no: C. /S—' Services or feederv- installarioa,
alteration or relocation:
200 amps or less 2
_ Name(print): 1 .4 `
gJ�,Plut j w
201 amps to 2
401 amps to 600 amps 2
Mailing address: ke 94 . ri t/L, 1) t A of R-
. A. 601 amps to 1000 amps 2
City: 00/24-0 /2-6 I S tate: w/c I ZIP; 970 Over 1000 amps or volts 2
Phone: I Fax: I E -mail: ReconneetvnlL 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 instliatloq , alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or ices
201 amps to 400 amps I 2
Owner's Signature: - - Date: 401 to 600 am • s • I 2
, 1':Nt::IN. lit 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: St ZIP: B. Fee for branch circuits without purchase `
of service or fecdcr fee, first branch circuit: I 4`• bS 6 f1,.gg 2
Phone: Fax E-mail: gsch additional blanch circuit 1 1 6, 44 /G A.&
PLAN 121.%11;1 %(L'It:tse check all that apply) Mice. (Service or feeder not included):
O Service over 225 amps•mmmer cial Cl Healthcare facility Each pump or irrigation circle I 2
0 Service over 320 amps - rating of 1862 0 Hazardous location Each sign or outlinelighling I 2
family dwellings 0 Building over 10,000 square fcet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension° 2
O Building over throe stories . 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV patio ' Tsach additional Inspection over the allowable in any of the above:
O Egress/lightingplan • 0 Other.
Submit _ sets of plans with any of the above. Investigation 1 1 I
p Y Investigsrdon fcc
The above ere not applicable to temporary construction service. • Other
Not all jurisdictions accept credit cards, please con jurisdiction far rnms 1eforrnadon, Notice: This permit application Permit fee $ 73 `1
0 visa a MasterCard expires if a permit is not obtained Plan review (at _ ) $ -e
Cre card number. _/ 1 within 180 days after it has been State surcharge (8%) ,,, $ _ S tiff
Expires accepted as complete. TOTAL $ , 79. 3 '
Name of cardholder as shown on credit card
. $ .
Cardholder signature Amount
Tmth �� ..,
r- .‘1"t”- : L DjZ cw� � .� '9 3
_ n ... cj- -a i p, -\\ b . 1 \ ��",r`k5 , _
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP-
Date Requested /1- AM PM BLD
Location /'/ ' .sue' 7 /v -' Suite , -11 _ MEC
Contact Person Jea.,., r Ph �7 ' / 3 s ' PLM
Contractor Z`2 � Ph SWR
BUILDING Tenant/Owner ELC v, 'o G/ 7
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab S C //L SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
SELECTRICAL.
Service
Rough In C'G -rte
UG /Slab
Low Voltage
Fire Air
Fi7'
•A S ART FAIL •
1. _
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: nable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date //
Other
7� Inspector
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.