Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00427
If DEVELOPMENT SERVICES DATE ISSUED: 7/15/2004
f JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 103AB -06400
SITE ADDRESS: 12393 SW 114TH TERR
SUBDIVISION: WALNUT GLEN ZONING: R-4.5
BLOCK: LOT : 022 JURISDICTION: TIG
Project Description: AC 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:
KUANG NGUYEN SOHLER ELECTRICAL CONSTRUCTION
12393 SW 114TH TERR 41131 SW BURGARSKY RD
TIGARD, OR 97223 GASTON, OR 97119
Phone: 503 - 490 -3815 Phone: 971- 832 -0807
Reg #: LIC 158285
ELE 34 -667C
FEES SUP 594S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/15/2004 $46.85
[TAX] 8% State Surcharge 7/15/2004 $3.75
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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699 or 1 -800- 332 -2344.
---�
Issued By: �l . Ce) �� Permit Signature:
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:
Call 639 -4175 by 7:00pm for an inspection the next business day
Jul 12 04 01:54p Joe Sohler 503- 985 -1078 p.2
Ele:trical.Permit Application FOR OFFICE USE ONLY
City of Tigard , l\\\\ "� 7 " " q J6 Permit No.:y t s 7
13125 SW Hall Blvd., Tigard OR 97223 , Plan Rovicw
Phone: 503.639.4171 Fax: 503.598.1960 � P�v N :ii-Iii ' , DaoclBy other Permit
Inspection line: 503.639.4175 �'(\ \ c \ Q _ , . Date Ready/By: Jo* - H See Page 2 for
Internet www.ci.tigard.or.us O •y \� Notified/method: ¶ ) (r- Supplemeval information
g' wo tX - - w
❑ New construction ' Addition/alteration/replacement Please check all that apply:
OService over 225 amps, corm') location
Q Demolition 0 Other;
['Service over 320 amps - rating [(Bulldog over 10,000 sq. ft. • CA1"tt3[)RY'Ol~ CONSr'F'RtJC4E(N ... of 1- and 2- family dwellings 4 or more new residential
tp 1 and 2 family dwelling ❑ Comrnercial/industrial Q Accessory building OSystem over 600 volts nominal units in one structure
Q Multi - faintly 0 Master builder ❑ Other ['Building over three stories ['Feeders, 400 amps or grace
❑Occupant load over 99 persons (]Manufactured structures of
JUl3'S'b k, RI A'I rON .AI D'LO eL`ITO ['Egress/lightatgpIan RV park
Job no.: I R , Job site address: P 373 S t ['Health-care facility QOthtt:
/ y I- ��� Submit sets of plans with any of the above.
City/State/ZIP: / . c �, ( The above are not applicable to temporary construction service.
1 Project name: 74-/c____, ':::':'. ? , x `Fa3E� : S(ptJLE::: : --
Suite/bldgJapt no.: - .
P I Qty. I Fee I Tetal I
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less t 145.15 ` 4
Subdivision: I Lot no.: Es. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.:
Limited energy, residential 75.00 2
r ' s4, •1)J�StIAT101y OF ttY01;[ •' ` �y,.. limited energy, non - residential 75.00 2
. - % Each manufactured or modular
A ` G dwelling, service and/or feeder 90.90 2
C r / t' ,...a i Services or feeders installation, alteration, and/or relocation
200 amts or less i 80.30 2
`.['' sPJtaPL RTFbW '. : I CI_'I7NA _ 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: �C
Cr. U e_ 601 amps to 1,000 amps 240.60 2
Address: 3 3 S l I Y f r; J e_ tz te Over 1,000 amps or volts 454.65 2
City /Statc/ZIP:
Reconnect only 66.85 2
ci Q r a f c) / Temporary services or feeders installation, alteration, and/or
Phone: (s753) Lilo — a 3 c 1-S I Fax: ( ) - relocation
? 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not - 201 amps to 400 amps 10030 - 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 s to 600
Ps 133.75 2
Owner signature: Date: -
1 0� F `` O�fA . Branch circuits - new, alteration, or extension, per panel
AP 'i is trrr F r` :vrJ ` : •ipxi «DN A. Fee for branch circuits with
/� service or feeder fee, each
Business name: 5 o t_F_)4. ,,f-t" c ( t ri 1 C-.p N S- . ,L, branch circuit 6.65 2
Contact name: B. Fee for branch circuits
To .4..._ S- 1, � without service or feeder fee,
I 46.85 Y/C 2
Address: L I t ? , S ', f - J p ., r Ar Je 17 each branch branch circuit 6 "65 2
circuit _ J v �'
l� i` Each add, branch ci
City/State/ZIP: s - 4 - ^ l 0 g / 9 7 / Q Miscellaneous (service or feeder not included)
Phone: 9 7 1 - O Q (Sa ?) / Pump or irrigation circle —
( �) Fa x: ! 8 . 5- - / 0 7 $ 53.40 2
E-mail: Sign ca- outline lighting 53.40 2
Signal circuit(s) or limited-
', i s-. ',. . ' C....' 7 - '7 7 ..?: __ . , 6PILKkO . " energy panel, alteration, or
Business name: • . _ / /� ,' S extension. Describe: Page 2 2
r G C_.o
r -is 0 , • Each additional Inspection over allowable in any of the above
Address: 41131 RURGARcKy RD -
Per inspection 62.50
City/StateZIP: k. GASTON, OR 97119 Investigation per hour (t Iv min) 62.50
P h o n e : ( ' hi ) S 3 _ a - a ill, n 7 Fax: ( S - 6 ) p Industrial plant per hour 73.75
- EL .tE " -
CCB Lic.: / $28 Electri ' ic.: ? `[-CC 7 0u. . Lic.: ' it -5 1../6., gS
Subtotal
Suprv. Electriciann signature, s . / / -- ' - Plan review (25% of permit fee)
Print name: 1 1 B � y VA1 e S D / 2 0 State surcharge (8% of permit fee) J
LJ 7 TOTAL PERMIT FEE (.9 ,
Authorized signature: This permit application e oa
Print name: _ xplr e a �p d is as c t m nee within tao
S h - • . ! 5 el 1 PP Lit 1 Date:7 / /, /o C{ • Fee methodology set by Tri- County Building Industry Se a Board
•` Number of inspections per permit allowed
clan uttePmaetion.e- PamvAU 17/03 een." vre∎ rummn•muc-c.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION`DIVISION Business Line! (503) 639 -4171 MST
O� BUP
Received Date Requested a AM PM BUP
Location /0- .3 / / / T Suite MEC
Contact Person Ph ( ) 6 q o " 3 6 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 020 ""e: (. 1 } 7
Footing ELC
Foundation Access:
Ftg Drain W O.L ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors 38 - . /' . O (�
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation R- _ �' c AL. d ��A 0k 1.5
Drywall Nailing nn� �� n1
Firewall Fire Sprinkler �� vwa t 2 t I 1 C
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer C7(�1
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
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
4111 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA V I' N L 2 Approach/Sidewalk Date �+ 3 ` 0 Inspector �. l� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL