Permit = CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00214
DEVELOPMENT SERVICES DATE ISSUED: 4/16/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136CB-07100
SITE ADDRESS: 11181 SW 81ST AVE
SUBDIVISION: HERB + PEGGY'S PLACE ZONING: R-4.5
BLOCK: LOT : 012 JURISDICTION: TIG
Project Description: Service change, (1) 200 amp or less service. Job No. 6404
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
AMY TULL NEW TECH ELECTRIC
11181 SW 81ST AVE 6950 NE CAMPUS ST
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 690 - 6302 Phone: 503 - 648 - 1900
Reg #: LIC 41868
SUP 2113s
FEES ELE 26 -418c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/16/03 $80.30
[TAX] 8% State Tax 4/16/03 $6.43 Elect'I Service
Elect'l Final
Total $86.73
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 th 0 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth1icrOAR 952- 0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -80 332 -2344.
I sued By: U Permit Signature: j
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 INSTALL ION ONLY
SIGNATURE OF SUPR. ELEC'N: ' DATE:
LICENSE NO: v ` /l4-, •
Call 639 -4175 by 7:00pm for an inspection the next business day
04/11/03 FRI 07:07 FAX 503 648 3131 NEW TECH ELEC IZ 001
•
Electrical PerrnitA,pplicatnon
Datereceiyed: , y u 03 Permit go -: FiC _ co g/ tX
A
City TY Frojec
y of �
� � - ; uappt, no.:
City of Tigard Address: 13125 SW 1111.1.8M, ! ig 1, 97 223 Date issued: ,
Bys., Receipt no,:
Phone: (503) 6394171
Fax: (503) 598 -19 APR 11 2003 Case file no -: Payment type:
Land use approval: cm/ OF TIGARD
•
IIIEIIIIMIIIIIMIIIIIIIIIMIIIII TYPE OF PERMIT • i
0 1 & 2 family dwelling or accessory .eComn rciial/industriai ❑ Multi - family 0 Tenant improvement
Cl. New construction U Additic n/alteration/replaeement ❑ Other: ❑ Partial
. . JOB SITE INFORMATION
lob address: 11 I ,..91A q -f -- 94,4__ Bldg. no.: Suite no.: Tax map /tax lot/account no -:
Lot: Block: I Subdivision:
Project name: •' - ..( J Descric don and location of work on promises- s ' _ ' ,
Estimated date of co Ot tetion/inspection: - e
CONTRACTOR APPL1CAT •
Job no: (p pee Mart
Business es name; N w Tech Electric Description Qty. (ea.) [ To1 ( no hop
New residential - stogie or mull- family per
Address: 695_0 NE Campus wad dweludgunit IncluditiOlicited garage.
City: Hillsboro J StatcOE 12.IP: 97124 Serrieebcludea
Phot )3- 648 -1900, (Fa648 -3131 [E -mail: 1000 sq. f. orless - a -
CCBno.: 41868 j Elec. bus. lic.no: 26 -418C - Each additional SOO sq. f . or portion thereof
Cif metro lie. no.: _ Limited energy, residential 2
Limited energy. non- residential 2
. f.�i L _1 -. • _ /_ • Each manufactured home or modular dwelling , - -
51 . - of supervising electrician (required) Date 2/ —/t)— of Servieeaad/orfader 2
Sup - e l e c t name (priot): - `, , , _ _ A a.._.t-- 11 no: 3 r Serrleea orfeedeea— ittstanition,
alteration or relocation:
• , ' PROPERTY OWNER zoo amps or less f 87).' 86A 2
Name (print): , - i T i 1 201 amps to 400 amps
4 - 2
Mailing address: - Sc - gS' I s Ave.. 401 amps to 600 amps 2
601 amps to Soon amps 2
City; Is r`f cc -r c -, _ State: 0 ZIP: g 7 2.23 Over moo amps Or Volts 2
Phone: so z, , - p ( • Fax: E -mail: Raeonnect only _ J
Owner installation: The installation is being made on property I own Temp otaryserNcta feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocattoru
ORS 447, 455.479, 670, 701. 200 amps or leas 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
' ENGINEER . Branch circuits - nett, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: • • service o r feeder fee, each branch circuit 2
City: (State; I'JP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit 2
Please: Fax: E-mail: , Each additional branch circuit:
PLAN REVIEW (Please check all tha apply) IV1'isc. (service orfeeder riot lncladed):
Cl Service over 225•amps -eomnv ecial 0 Health- carefacilit Each pump orration circle 2
- ❑ Service over 320 amps-rating ofl &2 QHarardouslocatica Each sign or outline lighting 2
family dwellings Cl Building over 10.700 equarc fret four or Signal clmliL(a) or a limited energy panel. '
Cl ' System over 600 volts nominal room residential ututsin One arueturc alteration, or extension• 2
C Building over three stories 0 treaders, 400 amp i or more *Desalption: -
la Occupant toad over 99 persons O Manufactured stn iewres or RV park
Each additional Inspection over the allowable k any of the shovel
la Egressllightingplan p Other:
Per inspection I J J I
Submit, _ sets of plans with any of the above. V investigadon fee . V
The above are not applicable to temporary construction service. Other '
- Nol all Jutistfcdana wears =TEL en more please Jurisdiction far nte inkainaadoa- Notice: This permit application Percale fee , $ 5C3.,')
y Visa 0 M expires if a permit is not obtained Plan review (at _ %) $
Credit card n /tit /O Sl• within 180 days after it has been Stare surcharge (lira) .... $ l0 , N 3
7) R K' ei t a. Ex accepted as complete- TOTAL $ 8'4.7 3
N •. • ea,ditn - . shown on cardlt end
s b. Z Trust
.� , _ Account # 41868 -
. .. - signature Anion , •
004615 (6,0e/com)
4it ..
CITY OF TIGARD 24 -Hour - a
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received Date Requested L/ — 7 AM PM BUP
Location / i' l S164 -ems Suit MEC
Contact Person Ph ( ) ( 5 -9 L / 3, PLM
Contractor Ph ( ) SWR
BUILDING. Tenant/Owner . ELC 3 --0=92---/5
Footing
ELC
Foundation
Ftg Drain Access: ) V. ELR
Crawl Drains `t * \� U '
Slab Inspection Notes: a-- 144 -
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling (\ , I� y' /, j
Roof 1� \ \I t -1 VJ ��. �S '�J \L � � S� k \ p ( [
Other:
Final
PASS PART FAIL �( i,
PLUMBING �� �� c\--\ ■ �� in Y" `
6
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 !i
Rough -In
Gas Line •
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
ate' -°
El inspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• SS P RT
SIT El Please call fo reinspectit RE: 1 El Unable to inspect – no access -
Fire. Supply Line r /
ADA D / / Inspector 66.!
�j �� �/ C' Ext
Approach/Sidewalk
Other: «<
Final DO NOT REMOVE this inspection record from the job site
PASS PART FAIL