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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00055 All DEV w H P Tigard, SERVICES 639 - 4171 DATE ISSUED: 1/25/01 PARCEL: 2S114AD -03900 SITE ADDRESS: 16641 SW 90TH PL SUBDIVISION: WAVERLY ESTATES ZONING: R -12 BLOCK: LOT : 038 JURISDICTION: TIG Project Description: Installation of one branch circuit for new a/c unit. 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: 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: HASS, DELBERT R GRF ELECTRIC 16641 SW 90TH PL 15460 SE PARADISE LN TIGARD, OR 97224 MULINO, OR 97042 Phone: Phone: 503 - 829 - 4146 Reg #: LIC 76751 SUP 1655S ELE 3 -484C FEES Required Inspections Type By Date Amount Receipt Rough in PRMT CTR 1/25/01 $46.85 2720010000( Elect'I Final 5PCT CTR 1/25/01 $3.75 2720010000( Total $50.60 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 OUNC at (503) 246 -1987. PERMITTEE S SIGNATURE 4 4 ISSUED! BY: �� dP,I;pr (T' rlj -rte inkA 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: 0 0 % 1a ikw DATE: LICENSE NO: /(Sss Call 639 -4175 by 7:00pm for an inspection the next business day Jan 24 01 02:48p GRF Electric 5038295747 p.1 • , i Electrical Permit Application OFFICE USE ONLY l 1c'.° r � , Date received: / ay' Permit no.: G c�aa -aao�s City ® G} v72 J By: A:a. ..' •1900.SW 4th, Ste 5000, PO Box 81Y0, Portland, OR 97201 Phone: (503)6234363, Fac: (503) 823 -3018 Milli ' TDD: (503) 033406B, Wobsite: www.opdr.ci.portleod.or.us • r • TYPE OF . PERMIT :4 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New constructioa • - ' . 0 Addition/alteration/replacement • 0 Other. • 0 Partial ' JOB SITE INFORMATION Job address: i ; . j L.(% t (�'(--,-, p t no.: ' Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: I • Project name: I f.. / A, S S I Description and location of work on premises: Estimated date of completion/inspection: 1 d r . — car ,...71 11--C— Win ou call for ins. - tion within 24 hours? Yes _ No _ - • CONTRACTOR APPLICATION FEE SCHEDULE • Job no: Fee mai Business name G x-: el e �� Description I Qty. (ea) Total no. losp Ncw rssidcndal - slogte or out Id-family per Address: l S 41.40 S, P 4 v d / S [ ., 6 dwelling unit. lacluda attached garage. City: A, 1.4 I 1 i n p I State: p 4_ ZIP: 17, 4 2_ Z Service included: 1 8 Stan 1000 sq. fl. or (as S 163 4 Phone: b Li 1 �!e Fax: 2 Q E-mail: Each additional 500 sq. Cl. or portion thereof S 37 CCB no.: 7 Ipl S . . ! Elec. bus. lie. no: 3 - y . C-. Limited energy. residential S 37 2 CitY /metro tic. no.: S ` f V ri\ Limited energy, non - residential i 5 37 2 •` 1 i----L170/ Each manufactured home or modular dwelling ^��+ Service and/or feeder S 99 2 Miaow, of superrich' , tuition (reqmirWi Due Services or feeders - Installation, Sup. elem. same (print); ;1 I ' , S ,. + r, License ha: 1 &SS" S alteration or relocation: PROPERTY OWNER 200 amps or less S SS 2 Name (print): e 1 S S 201 amps to 400 amps S I I 1 2 401 amps to 600 amps S 167 2 Mailing address: / C (p r-f-( s t ) ?/) PI. : 601 amps to 1000 amps S 251 2 City: f p ) I State: I ZIP: 9 7 2- .t- f Over 1000 amps or colts S 470 ' 2 Phone: (0 ;'1'. i 2.4 -Fax: I E-mail: Reconnect only S 61 t , Owner itufalalioa: The installation is being made on property I own i n toporary servka or or r elo - lristallatlen, alteration, or ebealioa: which is not intended for sale, lease, rent, or exchange according to 200 amps or less S 69 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps S 103 2 Owner's signature: Date: 401 to 600 amps $ 139 2 ENGINEER Braaeb circuits - new, alteration. or extension per panel: Name: A. Fee for branch circuits with purchase of A . - service or leakage, each branch circuit S 7 2 ` City: State Z1P' B. Fcc for branch circuits without purchase r f / of service or feeder fee, first branch circuit: 2 2 fi`F Phone: Fax: E -mail: Each additional branch circuit: I S 7 PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not iaeluded): O Service ova 225 amps-commercial 0 Health-care facility Eachiump or irrigation circle S 63 2 O Service over 320 arpu- rstin,g of 16c2 0 Hazardous location Each sign or outline lighting S 63 2 family derclliiags 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 0 Syste over 600 volts nominal mom residential units in one mucous alteration, or „ tens i on . S 63 , 2 m o Building over three sunies 0 Faders, 400 amps or more *Description: 0 Occupant lord over 99 persons 0 Matwfactusod mucus= or RV pant Each additional inspection ewer the allowable in any of the above: U E g i c u 4 i g t u i n g plan O O t b c r . Per inspection I I S 73 I 1 Sabmit 2 rata Of plans Nltb any of the above. Investigation fee The Above are n� applicable 10 temoorary con_aruction service. 2 , Milker Tlrttperatirappllcarlon Permit fee S. J expires lie permit is not °brained Plan review ( 25 To) $ Wilda 180dgysafterirhasbeen State surcharge (8%) S accepted as complete. TOTAL .___$......___ J O 440-46I5 0/110WCOM1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested ' l AM PM BLD Location / C� r' Sw ,O Suite MEC o / - D OD - 8 Contact Person Ph o? 4/7 5- 4( PLM Contractor � E 4--cd7/ c-- Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab 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 ART FAIL CHAN Post & Beam '// Rough In 1� Gas Line 1 , Smoke Dampers PASS PART FAIL CELECTRI_CA Service Rough In UG /Slab Low Voltage >� Fire Alarm in4 PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date 2/7/2/ Inspector _ Ext Final PASS PART . FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By -I Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Z— ? - O r 6-Q Underfloor insulation Post/beam structural - Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical fmal Masonry /Reinforcement Framing MFG - Structure set -up _ MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler fmal RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit . Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines _. Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS CITY OF T1GARD ELECTRICAL PERMIT PERMIT #: ELC2001 -60055 4* *0∎11l DEVELOPMENT SERVICES DATE ISSUED: 1/25/01 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114AD -03900 SITE ADDRESS: 16641 SW 90TH PL SUBDIVISION: WAVERLY ESTATES ZONING: R -12 BLOCK: LOT : 038 JURISDICTION: TIG Project Description: Installation of one branch circuit for new a/c unit. 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 HMI 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: • 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: HASS, DELBERT R GRF ELECTRIC 16641 SW 90TH PL 15460 SE PARADISE LN TIGARD, OR 97224 MULINO, OR 97042 Phone: Phone: 503 - 829 -4146 Reg #: LIC 76751 SUP 1655S ELE 3 -484C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 1/25/01 $46.85 2720010000( Elect'I Final 5PCT CTR 1/25/01 $3.75 2720010000( Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Munidpal 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. Thos 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 OUNC at (503) 246 -1987. f' PERMITTEE'S SIGNATURE ISSUE BY: , ice' G U • �falki / OWNER INSTALLATION ONL The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: `` nn CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: ��Kl.O . / 1 • __ i —� DATE: LICENSE NO: / �'SS S Call 639 -4175 by 7:00pm for an inspection the next business day