Permit t ' CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00739
DEVELOPMENT SERVICES DATE ISSUED: 12/23/03
F mt I I 13125 SW Hall Blvd., Tioard, OR 97223 (503) 639 -4171
PARCEL: 2 S 113 B 0 -00600
SITE ADDRESS: 16060 SW 85TH AVE
SUBDIVISION: SEWER TREATMENT PLANT ZONING. I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: TPS building. TI add 3 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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 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:
UNIFIED SEWERAGE AGENCY KEC ELECTRIC INC
150 N 1ST AVE 1281 NE 25TH AVE UNIT K
HILLSBORO, OR 97123 HILLSBORO, OR 97124
Phone: Phone: 503 - 439 -0904
Reg #: LIC 99267
SUP 4489S
FEES ELE 34 -426c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/23/03 $60.15
[TAX] 8% State Surcharge 12/23/03 $4.81 Rough -
Elect'I Final
Total $64.96
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 -3 -2344.
Issued By: 2 , _ / Permit Signature: 0'h �z,�2 ' 1�e (-?. .7 -
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: 7Y' �� C
Call 639 -4175 by 7 :00pm for an inspection the next business day
El &ctiical Permit App lication FOR OFFICE USE ONLY
Received Electrical
^��1 C Date/By:OPV•03 B4. Permit No,: 0- • U
RECEIVE() Planning Appro al
Sign
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
� ,
Tigard, Oregon 97223 DEC 2003 Date/By: Permit No.:
u
anLd use
Phone: 503- 639 -4171 Pa •119 �PQRD ,b„ ,, , Post- Review -Review , Date/[? : L a d se _
Internet: www.ci.ti ard,o tn�N ISI.. - l i Contact duns.: 1$1 g
See Pa e 2 for
24 -hour Inspection Reque . hP-MT �5 `— — ' I "� Name/Method: 7 / Su lemental Information,
/Lei- Ce 7' V x /Q C(( ? d
.. . .. ±_ - �: A1�I:;REVIEI��'lease:i:Iiec
. . . . . ... .. . _.. . T1!PE •Q.� ?R4'_.aRIC.:: • : �.. , ., . . . .. .. k;atl'thatir�aPP . _
— 171 construction n Demolition ❑ Service uvt:r 225 amps- 0 calth ogre facility
commercial ❑ Nazardous location
Addition/alteration/replacement _ 0 Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
. .:_ _':-':-::' :`. ::= .GATEC.ORY OF'G N c11QN. � IG 7.
'':: '• 1 . family dweiltn2s four or more residential units in
Ill I. & 2- Family dwelling E o nu n erciaWlndustfial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
I1 Accessory Building_ ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
0 Master Builder [] Other: U S any of the above.
E � Ili tin plan p outer
plans a
.
f with
r� °
Submit sets 4
.. dQB�SIT�p�IFOXtl1�A�'IOI� a, } � ':,.,•;
.. ..".: . :: . : , : : 71 . :::.]' . :d T � The above are not applicable temporary construction service.
Job 511.0 address. /4 a Co ...........::, :.. -:':.-zi IEIa'';' bCtopbo,. x.::;:` ?.'_�;:;:i:::`:::::= :":::: : ..: . `:
Suite #: Bld JApt. #: Number of inspections per permit allowed
Project Name: CGr! 5 - vril AM TP 5 4 Description Qty Fee (ea) Total I
New reslaeut -swt to or churn campy per
Cross street/Directions to job site: dwelling unit Includes attached garage -
Service Included:
1 000 sc. 11. or 1t: s5 145.15 4
Each additional 50) s•. R. or .rtion thereof 33.40 1
_ Limited en y • residential 75.00 2
Subdivision: I Lot #: _ limited energy, non residential 75.00 2
S / arcel #: E ch manufactured home or modular dwelling
Tax m p a 9a90 2
;;DESCRIPTIU r' service and/or feeder
RK''' i feeders - installation,
C (
.• - � Services or
f,'el 714 — . T alteration or minentinn: '
200 am.. or Ices 80.30 2
__ _ — _ 201 amps to 400 amps ill 1G6.85 2
401 ms. 160.60 • 2
- :... 'OOP, - ? It i_i c 41 :;:i;: 1� + Cab . `• •`;4 i);'''. :.•g! :' 601 am to 1040 a 0 .6 2
:... Over 1000 am • . or volts r
Name: _ Reconnect only II 6 6.85 2
Address: temporary services or fee e e - installation,
alteration, or relocation: GG.85 t
CI /State/Zi _ _ 200 am.. or less
Fax 201 mu to 400 antis 133.75 2
Phone: col to 640 am.
'L:ICAk?71 '. <'... =...:CONT ' .' Branch circuits - new. alteration, or
Name: extension per panel:
- A. Fee for branch circuits with purchase or 4 65 2
Address: _ service or fader fee, each branch circuit II
City /State /lip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 2
Phone: I Fax; — Each additional branch circuit 2
E -mail: 53
Mise.(Service or feeder not included):
a ch ' oa CitC 2
,,.. , . • °•-rn ......... .. _ .... • � -IC•A. X57= :i tit'; E ach s� g
Job No: Signal circuit(s) or a limited energy panel, 2
f��. �� < i alteration, or extension Page 2
Business Name: ..t G ; G J.-e r)escrlpoon:
Address: q F' J Ai As A v, #4, - Each additional inspection over the allowable in any of the above:
City /State /Zip: per i ation per hr,r mi 1 hour 62.50
Phone: - ' 0 O Fax: , ) 3 , 3 V Investigation fee: . •
Lie #: 3 qa 6 c Other: •
:....:
Lie. #: aj 5 2 G � ..� � .• , � � ,;�.. �.::�:, .: •'�-•..',,� • �:: EIt `cti'1iCa]� ~i �it'4T'e.�es•, .., r-
Supervising electrician Subtotal $
Pl R ev i ew (25% of Permit Fee) S
signature required: ff , �.
•
Print Name: 1-. oar 1 Liu. TF: er FS 5 State Surrhargc (A %of Permit Fee) $ —
TOTAL PERMIT FEE $ to
Authorized Notice: This permit application expires if a permit is not obtained within
Signature; Date : 1.1211 days fter it has accepted a complet
methodology Tri -Count Buildin • Indust ry Service Board.
(Please print name)
i :\Dsts\Permit Porms\ElcPermitApp.doc 01/03
CITY OF TIGARD 24 -Hour •
BUILDING Inspection'Line: 2503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/_ _ // 7 BUP
Received 05' Z • � ge / -1 Requested AM PM ..BUP
Location /6 es Suite MEC
Contact Person l /4 • ir Ph ( 4 /39— t 92 PLM
Contractor /'= Ph ( ) SWR q
BUILDING Tenant/Owner ( &rr,-1 U1;1 4)12) � . eV 3 —DO 73
Footing
ELC
Foundation . •
Ftg Drain Access: ELR
Crawl Drain -
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext She
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
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 0 ,� N` ` I D E`I r f /_ 1 1 g 9
MECHANICAL Y i� `� `N (O V
Post & Beam V, �nA A q ���5 Q 1 J —G f f IQ
Rough -In V' ' Y" ll vb l� v -C T I r
Gas Line l (, W �`�[Q 1•'
Smoke Dampers � "" . � � 0 `i4 '' \ • 3 V g '-
Final a n4( z - a 1 c35
PASS PART FAILL 1 /
ELECTRICAL (\1 L f 0 3 3 r) 3 la -
Service / /
Rough -In C J�� J 6 � L n ` i• ` _ b _
UG /Slab p
Low Voltage ? 1 lc d d �, 1-=P
F.- -m
Vet, Reinspection fee of $ required before n= inspection. Pa at City Hall, 13125 SW Hall Blvd.
- T �• RT FAIL
SITS Please call for reinspection RE: - Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk D / Inspector ' ' f. - - - Ext
f
Other:
Final DO NOT REMOVE this Inspection record fro the Job = 'te.
PASS PART FAIL