Permit F
_ Y OF T I CAA R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00468
4 ' "'& ucVELOPMENT SERVICES DATE ISSUED: 9/13/02
= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112BD -00100
SITE ADDRESS: 14620 SW 76TH AVE 053
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT : 065 JURISDICTION: TIG
Proiect Description: Fire restoration: Install 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/ 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: 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:
BOROS, STEFAN A + FIVIA KELSO ELECTRIC INC
PO BOX 1890 545 SE 3RD
GRESHAM, OR 97030 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 -6360
Reg #: LIC 116254
SUP 4270s
ELE 34 -433c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 9/13/02 $73.45 2720020000( Elect'I Final
5PCT CTR 9/13/02 $5.88 2720020000(
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 of these rules or direct questions to
Permit Signature: (1)7\
Issued By: Gc� J
c --ek_ V (.uitc
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: a t DATE:
LICENSE NO: c) Y) S
Call 639 -4175 by 7:OOpm for an inspection the next business day
FROM : K r INC FAX NO. : 0000(?)00000 Sep. 09 2002 01 58PM P3
•
SEP n 9
EleCtit 2002 .
. . .. am OFFJCIL, ISE ONLY! '.;, ..',,:':,*, • .;,.:,. -,' :,...: ..,-, _./
4 4. •,,, , •
, --; ti.,(Al plc:calved r)
7, ,,,,," -
City of Tigard . Date/13y: 1 -1q.-‘2 BI3 IL eCtri:C41 -- -d -1 5 1 00 --- CO 4 / &
It No.,
037,74,- );;., VI ?Phirmin A MVil
Test Fo r iS T- j r;---1 .---. 2 Sign
p it No.:
13125 SW Hall Blvd, Man Rzvicw Other
Tigard, Oregon 97223 DaterlEly: rermt;No, ---I
Phone: 503-639-4171 Fax: 503-598-1960 ;.,, • Posl Land Usa 1
Dateility: cam No.:
Internet: www.ci.tigard.or.us iii A li ----
Conuct /wis-: 0 Scc Page for .
s . - -... -,...,..
24 Inspection Reaquest: 503-639-4175 - - 3..r,--ririmt 1 , papptemetttai Information.
nTE7OF WpRICf,:;•;ll.11.'.il.i:Ti:il:;;:l.ii;;T;;';:;:,g..!„.` 7P00.il.,RE,VIEWI(Plase="chi'eltiill4fit!iiptily),.1;:%:
1 New construction El Domolition Ej sorvioc ovar 225 arrva 101 Ilealtn facility
co rnmercial P Hazardous loUon
E Arldirion/alterationire. lacer/lent E Other: El service over szo atno-sing of 0 Building over L 0000 squat; fc“,
:' ;;;•':' . '.. - *:''''';': . -;" . "::'".C2 ,6 1.' : OK?, er'CQNSTRU e; II lot'll'.;:!:::: 1142 family dwellings four or mot raldenzlail urils in
• 1 as 2-Famil ' thvelliii . k [II Com3ntrcial/Indi2strial 0 system ovrt GOO vOlts rtiOn11011 Ono smictire
0114 Buitiling order dame stones Feectere. 400 Imps or morr
0 Accessory Builainz ISI 31 °coup= ;a2Z1 over 99 persoos Maaufactured struCtUres or RV park
I Master Builder SI Othcr: 0 Egrotallighting plun 0 Other:
;': • . 40B siTEIN7.0R.NTATION add 1-70(.7;t7rION.f 7. i•;.:1!"'1.-. Submit sc121 af plans %nth any actin above. ,
The abovo are not applicable 10 tempOrlity con nruccion acri ice.
Job site address: 200 S ,L) l(pell .. ','-::',',. !
Suite 0: B itig IAD:A' : -
,c, ri,,,mbir Of las ittatitstii tr • rrclit allowed
Proi ecr Name: allitiAd146 , fiverintion ' Or:) Pre (cc) Totai i
• New re611dcanal-grigla or ittaltl-f4 7111Y pr 4(
Cross st to job dwelling volt-Includes attached garage.
Service 10044;
t000 Sq. ft or lcri 145,17 1 4
g.+ Il, orvonion thereof n.46_1_ l
.. 1..lnlized energy. TOCIdariall 75,00 2
Subdivision: 1 Lot #t: Li m istd evarrav non re-Eden:ill ..
75.00 2
Tax map/parcel. #: p..,oh manufactured he or modular dwelling
'..''.':... ' . l" '.:',' • ". TES.CfniatION' diF.WelfR.14 2::::."s :::1 _Isrvict andlor re.de 9C.90 2
Servicou o feeden .. instillatioc.
MI L - IL* II - alsoratioo or roloonbon:
200 unos or less 3030 1
• 2 in to 400 arra 10d______. 2
401 ampreo CO eraps 160.60 2
,
.:PROPMTYlOWNP.P2:.;::: ; '1.. - :::imPriltis'liW ::::::.,'l.i f' in'rg To 1000 aff:371. 240
Oyer 1000 amp or volts 454,66 2
Name: Xsconneet only 66.85 2
....
L Address: Temporary tworvieos or fix-dela • Instaltution,
a ntratIon, or reocntion;
LCity/State/Zilo: 200 :ma or loss -
, 66.85 1
„.__
Phone! PaX!: 2Q1 ainol to 400 revs 10030 2
. . 401 to fa an2E 133.75 1
i .. .',.k.pplIciANFT',. -...•.::', i„.11111;CON-TaVar. . - —,----,-1
Branch 4rearts - new, alteration, at
Name: etetasion per pancis
-..
.A.._ roc for Yranub circuits :wiz purchase of
Address: - ss: sorvitt or fccderfte, Mch brane circuit 6.65 2
Ciry!StareiZip: B. Foe for branclz circuits 1.7i:bout pumbaso or 4do c. 2
‘,. t. . ,..-.4 1 • ,.. fa , . t t . • . ■ ■
Phone: I Fax: - . !th ackitinetai brunch circuit
• Li 6.65 a . (0. 2,
E-rma: Misc.(Servica or feczlnr• not isriclUclocl);
:=,.....::.:,:,:.,, .; Tolt .; • :i :.:,!‘;; : ,:., Eat urri ___p_ortrrignSon circle 1 n.40 2
Eros gip, or outtline liklItirrpr„ 1 53 2
.40 _ .
Job NO: . Signal cirontr(a) or •
limited waoray panel, '
• alter orariantion* 75a -
Blisiness Narric: tt$C) ftL-7.111Z...,_.---- _.
— .11cacTrtstion: . r
Address: 51c -c f j - L I
Each additional las • cation over the illootblc la an of the above:
City/State/Zig : NI Lai* 4' Pe_I-Ltc ,.■otir- min- t howl_ ! ! 6250 Phone: Fox .- (' ; loycati _17100 r=1
1
C CB Lic. 0:
e 4f, lg. • 1_,1. ft: , ' 4 - 1 — i 3"C ..-, &
riatTei •-• .i••• )•4•:".;F: s'': ' -
Supervising electric= i Sutat.a.1 ' $ IlLm4p_.
St : a -tura required: _.,....—.. ......--------"" Plan Itevieiw 2Vi
5 ii Permit flee 3
....----..
r Name: .0 , ..;„ jai= Li0.. #L____40" - 70 s._ : st.t. Surchar: c 8% of Permit Fee 3 '
, ifilif
- To-rm, PERMIT FEE J s . • */111111
Authorize - d t nil
xotiece :penult appncitIon empires if a parrait is oat obtaiuc • withiti
1 . AV / ,
Signal:0"e: Illi..„ f _ g.,. _ . Dare: I ( 3 18D day; Rftlir it has boon s000ptod to templet*.
*Fee ethodology set by Tri-Couaty Iluliellng Industry Service litoarii.
----------C17'.---14e m
print tiaras)
•
J C T Y T T JC1 I T 1' 'I non 1 tT:tT 7A(17.'q7/P0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 -
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
// BUP
Received Date Requested (' 2 ' AM PM BUP
Location (7 5 �> I c(G 7,) Svc 7 A 1,4 Suite 5) MEC
Contact Person Ph ( ) 7 - 3 Z 7(- PLM
Contractor / � P /So Ph ( ) SWR
BUILDING Tenant/Owner ELC ��� 2 q d'
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
Drywall Nailing
Firewall It e Fire Sprinkler cote -` ���
Fire Alarm , c
Susp'd Ceiling J
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab 1
Rough -In j
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 FAEIT FAIL
ECTRIC
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
. ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS PART FAIL
Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Dated. 5� G 2 Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL