Permit 4 0 1 , ; . CIT
CITY OF TIGARD
PERMIT #: ELC2002 -00012
DEVELOPMENT SERVICES DATE ISSUED: 1/11/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BD -07014
SITE ADDRESS: 10800 SW 1 15TH AVE
SUBDIVISION: ENGLEWOOD NO.3 ZONING: R -4.5
BLOCK: LOT : 203 JURISDICTION: TIG
Project Description: Panel change and (4) branch circuits. Job No. J09050
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 4 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:
CORWIN, STEVEN G + JOYCE L WEST SIDE ELECTRIC CO INC
10800 SW 115TH AVE 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone:
Reg #: -1 506
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 1/11/02 $106.90 2720020000( Elect'I Service
Elect'I Final
5PCT CTR 1/11/02 $8.55 2720020000(
Total $115.45
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 -6699 or 1 -800- 332 -2344.
Permit Signature: Issued By: / Amok
ly.Q -rri .4 -dor - _
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: d1 1' , DATE:
LICENSE NO: aC
Call 639 -4175 by 7:00pm for an inspection the next business day
4110/24 /00 Tt,i1% 13. 3 i FAX. 503 59t`i .i;IBU L: I?'Y OF 7IG RD V1002
Electrical Pe 't j i e
Daterecetved / g / e . Pennit no.: 0:;\- G'.` - , ::: : /'.Z,
I , II City of Tigard
13125 $722.9 Project'appl.nt•.. Expire date:
CiryofTigad Add 131 SW Hall Rh d i'i C UL Dateisstved: By: Receipt so.:
Phone: (503) 639-41.i I g sj�n —
Fax: (503) 598-1960 CITY OF Ti late isle no.: Payment type:
Land use approval: _ BUILDING DIVISION
T1Pi :OC PERA111'
i & 2 family dwelling or accessory U Commerci: li ndtstriai U Multi- family 0 Tenant iinprovernent
New consuucdon► U Additiolaltctntica U Other: - ._ _ . -- - ____ 0 Partial
lob address: i r.; f St,.: 11.5 Bldg. no.: Suite no.: Tax map /tae lot/acceuntno.: _
Lot: i Block: Subdivision: `� _
Project name: , �, - ...., :.,4 t � Block: .. LDescripdon and location of work on premises: e ci v,.2-k c:..\ -.ix '-I .' ✓e .
Estimated date of cwnpi._Iic rah tis pet; tiocr
CONT1 ACTOR APPLICATiON -- . ';• , 'FIE SCf[CDIJI,l; • -
Joh no: ti 01;.V.,-, S 1rL.., Fee ' Max
Business name: �S r r , 6 le c L e- ev Aeacti tLttor. Qty. (ea) Total no. itrsp
Neu residnuiAl - Tangle ormut6 -1 arrdly per
Address: IS 7, L 4 SE g- A chellingueit. Includes attached gone. '
Ciry: , ri - j €-., —.). _ State: ()?--j Z :P: e- 72_ , Serrr4c
Phone: of -13 r- /'Syt�1F`uti 4`6'111 c- mailj_c ....t+c; 'dam1
f)oo 1 rt. nrlcs �__ 4
1 Each additional :WO sq. ft. or potion dweof
CCB no.: j - ;'3 0 b i Elec. bus- lie - no: 2lo'
-- _ -. 3_S L t.invted energy, resitlertli:d z
City /metrolic.no.: 1. i .tri Jed cnea non • residential I 2
1 - - U - 0 'Z Eoch m E n u f a c t u r e d hems yr n odular dwelliag
Sign re o sup .ioing eta ' ' u %required) _Date Sorvioetuttliorfender 2
Sup. elect tame tptint): • �,� , — ,��,,,,.� t ic :u;r -no. Z[, Services or feeders- Installation,
alteration or relocation:
l'ROIPFRTYOWNER' ' 2o0 amps orlen 1 ,SC',, &•b 2
Name (print): C. o.... i A .1 , 201 amps to 400 arupo 2
J 401 m slu 2
Mailing address: ( 0 43, S c> It CTS - -- — i
I 601 arnp3 to 1000 amps 1
City: ' r � cs , ej I State. : � ZIP: Cl 7 7- ? 5 Oyer 1000arnpscr volts 2
Phone: 1 Sc;•; ( Fax: I E- m.til Recce vecionly .
Owner installation: The installation is being made on' property I own Temporary servieq . or feeders -
which is not intended for sale, lease, rent, or ex.changr according to alladnn,nkerntian, orrelucaiion:
ORS 447. 455, 479, 670, 701. 200 amps or teas 2
301 amps VI doe amps fff 2
Owner's signaltre: Du,e: 401 to MO amps 2
iGINEIER • . . branch elrealte- am*,alleratien,
or extension per panel:
Name: A. Pee for branch circuits with puteliase of
Address: settled or feeder fee, each branch circuit y G.4 / le 60
City: j State: ZIP: B. Rte' fol brta cil circa 'As without purchase
ofscrvi::e or :feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
ha? c 1
h adlitiund bram_h cneoit'
PLAN LUi' IL.'1► (Plea.* %)hint Mise .(Seniceorfeederooiineiuded):
' O Send= over22$ amps-commercial O licalih -cur. fucililp Erich pump o: irrigation circle _ 2
U Service over 320 amps -ruing of I & a 2 0 Hto de vt Ic uimt Each sign or outline lightia 2
family dwellings U $uddingover .10„:00 squat? Fact Our or Signal s'rcui!(s) or a limited cce:gy panel.
]Synteinover600volte note r,ysidential nulls incise sI alteration, o rextensinte 2.
U Beikiing (matinee stories U Feeders, 400 :ants to more n , edption: _ _ _
U Ocuapar,t load o•er 39 persons U Marndnutured t.tructures or RV park Each additional Intpectlon over the Womble in any of the above:
O Egreeailtgliting plan -i adlc . -_ • Per impecnon 1
Submit sets of plans Kith any of the shore. investigation fee
The above are not applicable to temporary constra-_tion service. Other
` icon m%iarsrirswe acxpt credit carts, please cull judaditniun for note lore rnatim Notice: This permit application Permit fee $ t � y , q 0
O vlsa LIMastet expires it' apermilis not obtaMod Plan review (at --- - %) $ ...._._
Credit cud number: - _ / within ISO days after it ha:: been Stale surcharge (84'c) ...- $ —_ 2 . C
_ I.
mc accepted as complete. TOTAL $ i (� r f-('
Nmuc cf mrdbolder as s-town oat credit card
$
Cu/Molder slynatuaa — -- - Amnaral 1 410 -4G15 (4'00
I LL90- 9EL(EDS) ' 0 T- .+4oai3 apig sap d0E =Z0 ZD SD Uer
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Businesstine: (503) 639 -4171
BUP
Received Date Requested ? - 1 ? AM PM BUP
Location / 300 /l S Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 0-3 I - /5 `� ' SWR
BUILDING Tenant/Owner ELC o 90o 866 / L
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 ; K ��f � � G \104%i■
Drywall Nailing
���
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Water S he I I
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
toRICAL
Rou• - n
UG/Slab
Low Voltage
• - Alarm
P • = PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Data q �- ( / l - ° � Inspect Ext
Other:
Final DO NOT REMOVE this inspection record f om t J ob site.
PASS PART FAIL
Illr OF TIGARD 24 -Hour
BUILDING " Inspection Line: (503) 639 -4175
INSPECTION DIVISION Bausiness Line: (503) 639 -4171 MST
BUP
Received Date Requested ,L7, —a Lt AM PM BUP
/
Location )D gD° / /J — t ' "— / - 1/ - e - Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) ?- 31 �s4 SWR
BUILDING Tenant/0. whet ELC
Footing ELC c0s000
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation , V I WING ` 4.. t� f LirD
Drywall Nailing , `V �1
Firewall
Fire Sprinkler 1 ` (�� 1C�r � 1 I 1 ' (my
Fire Alarm ) G U'( �1 V \� 1G�' O F � C sTJ 1 /.1. L•L
Susp'd Ceiling J
Roof
Other: k ` I n
Final � l L ' ,5 - 7) --. � � `C>
PASS PART FAIL
PLUMBING
•
Post & laam '' I * k. l� Pa 1b s
Under Slab P ,
Rough -In Ly c v 7
Water Service 1
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan C_ �S 49zsv
Other: l
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
t" RICAL
�o
UG /Slab
Low Voltage
Fire Alarm
'
PASS Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART CV
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA �
Approach/Sidewalk Date / ` c Inspector ' d Ext
Other:
Final DO NOT REMOVE this inspection record from t job site.
PASS PART FAIL