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Permit :CITY TI GA ® ELECTRICAL PERMIT PERMIT #: ELC2002 -00467 Il,' DEVELOPMENT SERVICES DATE ISSUED: 9/13/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 112 B D -00100 SITE ADDRESS: 14640 SW 76TH AVE 061 SUBDIVISION: TIFFANY COURT APT. ZONING: R -12 BLOCK: LOT : 065 JURISDICTION: TIG Project Description: Fire restoration: 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( Elea! 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: i , , I By: ` - _Ara A-4-J: - 1 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 2 1(2 p DATE: LICENSE NO: 4 7' , 7d S Call 639 -4175 by 7:OOpm for an inspection the next business day FROM : KELSO ELECTRIC INC FAX NO. : 0000000000 Sep. 09 2002 01:59PM P5 J ',tt] i;.9.6 4 J SEP n a 2001 . Fol; OFFICE vst oNL :,. Electrical Permit :�puYica oaa ^ ;� iRe-•t , , � I��'LF? :Ds<�, � �_. Pig l (YD- - � [N - 06:1 1 _. co ao c 7 A ,,,oval Sir of Tigard DA tatBr p 1 est F or P it No.: 13125 SW Hall Blvd. a 1' Plan .eview Other Tigard, Oregola 97223 D W y: PerrnttNo.: Phone: 503- 6394171 Fax 503 -598 -1960 pRav1ew Land Use ' h.• .. . I ;. Aat.. : a Va.: Iuumet: www.ei rigard.or.us , ' {� Corium iur+s.: w Sae Pogo 2 for 1 -^ N rnc/Murh $ crock tut in farnation • Z4 ->�our Inspection Request; 503-639-4175 - :�:., ., E'OFWC1FtK::. _,::: : .., ' - :1 ' ' 5 'ti. :Ph RE W!fPriasiz:oh 14iisitip'P1V). ;=i;,! , . _ EE New ' • 0 Scrviceover225t ` ps- Health -care facility t commercial 31 Hazu•dous locad u• Addit on/alterationireplacemerit 1 51 Other: 0 Service ova 320 amps -stirs of ❑ Building over 10,000 square foci. r •$ai . 6 . o. 4 1 - ::P :'.A',i':4.:% : _i 1 dc2 family dwellings four or trio re residential uni5 in ! System over 600 volts nominal one strueauc (� 1 & 2-Family dwellin • COlamercial!/industrial Building eve - three sores 12 pumices. 400 amps or more 1 ADoesso_ Buildm• 1101 Muni Pamil p occupant :in at over 99 persons ® Manufactured troctutes or RV pu`k n Master Builder 1 Othor: ' ❑ Egresc/ligApng 1 n ❑ Other: 5ubmit sets of plans with any of the above. .:: - TO a art not applicstble to terepOtna y en netrucrinn lervioo• , - I �:3O8 • SIT��iIF03tMA� .>;Ok .ib'd'.L.UA' � : ': •c 4,1.4. ._._. Job site address: /� e) . , il'1 •- . "'`'.'.`ti.:;: 1 EE. ;Sscift S.UCz' r Slate n: 1 Bldg. /Apr..4: IL f hicrmbsr of int. 00tlodB er omit allowed 1?syerf orlon Qty Fes (40 Tate t PT01 eC[ Name: e: + 1 Crew rectdentlasatnyic or m akHfamtty per (Foss 5Lreet/D'.Tectiol7.S to job Site: dwell tog unit- Inetudesalsrtcbedgarage_ I Service tncktded; to00 •• fi or 145.15 4 - • 4d i• Ij.1SOO r. Or . 0 . 01 VC. - - Limned erg, y , rsiaentlal .00 �� Stl^.LI r i Y.ot #: Lima ed twit �'d en t ill 15.00 Tax rnanioarcel #: .F.achmenufaoturedliorne or modular duelling I I i . , ....._ :- p OR _.. i.. __.. service Gabor feeder j X0-90 1 Z . � � s�:rJt� err reeders - iasutll ;oR JIM - MN -tom alteration or relocation: y0.� 1 2 ion &m s or toss _ 01 MT! It0400411• 1063S 2 401 am• ter •0o afar -1 ME 160,66 . l ' PROFERIV.O..I.V. . * :? ' f,g ,!::?.: T 601 , • .. 1 a • 2QO'• 2 Over 10030 arnmor van 1111 454.65 Name: • Recorinec lv -_- 66.85 , 2 I Address: Temporary atrYiCha or food an • installation, alteration. or relocation: 66 -85 1 2 0)3m to�Omn 100. —. 1 City /State/Zip: . 200 ern.9 or less Phone' Pax: 401 to RIO am • 1111111 MOMI z : �I .. 4PP..LyC?ti7i .'_ -.iii. : ;;Ark CaNTAGT ::ERSO T ! "i.; ; =' `i Branch deceits - new, altoratioa, or ■ i Name: tateasioa per panel: �--... .t Fce for rm5efi carom veirri dw brio of 1 6.65 2 I Address: : evicc or fcede f ee aoh b�nCi+ eiryuit _ /Zip: --- A. Fee for bench sira:is without purrha5e of I ` z • + •s-.•1 = ter • .5 t !,� P Pax: Each adaidonal b •ch circuit WI 6.65 EiT 7© E - mail: — —,.R.- 13.40 - . .:: cOb'T , Job No: " " "" 75.00 . a BusincssNa - : 0 C (.- LhC • = v � a ° : Add ress: ash additional fnspeetlen over the allowable i a any of the above: _ CitviStateiZI : !i .,< a r ..: r ! Pori •- hour •min. 1 hour 62,50 Phone: ' t ' ; •• ' u L*va teL; Stl rvi5Ir1 electrician - Other. :air. -ri 1•' ^.,.... . a . ;;_ CCB LiC. Y: la< V'� :.:;: - : ;r :ectrfc�n p erm 'Pee � . �.;•.F. : . :, . Li-. #• L,l C g t Plan Review 1' -`'l am. al tar re• wire. c 25 i Print Name: IA • - r L ic. • #- . � 1- _ store Surcharge (89'. of Permit Feel S _ 7�: . 1 z TOTAL PERMIT FEE S litt Authorized ) Notie a Thls pernait app.fieatlon caplets If a permit is lot obtai Dee' , A CA ire / 4!.... taw • Daze_ 120 days alter it has ban accepted as complete. � - � - *Feb methodology tot by T're-County Bolding Indu :cry Service $nerd. - (Please print mime) __• .•... nnotn.+nonf 1. hT'FT 711117/07-'en CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / — AM PM BUP Location / 4 q0 S' G) 7 ,4,' Suite MEC Contact Person Ph ( ) 7J — 3Z 74 PLM Contractor X2 /5O / cft r Ph ( ) SWR BUILDING Tenant/Owner ELC 20 Z — 0 6 4 (6 -7 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 / / I o l _ / Drywall Nailing �� ! I (' � ( 3 `� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & 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 Rough -In UG /Slab Low Voltage e Alarm Ej Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. AV PART FAIL ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA p Approach /Sidewalk Date t^ f m © Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL