Permit C ITY OF TIGARD � ', !? ELECTRICAL PERMIT
PERMIT #: ELC2004 00246
DEVELOPMENT SERVICES DATE ISSUED: 5/11/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 104CB -03300
SITE ADDRESS: 13132 SW ASCENSION DR
• SUBDIVISION: HILLSHIRE WOODS ZONING: R -
BLOCK: LOT : 079 JURISDICTION: TIG
Project Description: (2) 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: 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:
GEORGE, DAVID F + MELANIE WEST SIDE ELECTRIC CO INC
13132 SWASCENSION DR 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: 503 - 771 -7814 Phone: 231 -1548
Reg #: LIC 13306
SUP 2663S
FEES ELE 26 -135c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/11/2004 $53.50
[TAX] 8% State Surcharge 5/11/2004 $4.28 Rough -in
Elect Final
Total $57.78
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-
Issued By: Permit Signature: d \
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: C �D 3
Call 639 -4175 by 7:00pm for an inspection the next business day
. •. 1cctrical Permit A ica 1 ® FOR OFFICE USE ONLY
�■ Itcl<:Iavc:d n ' / D
City of 1 Tigard 00� 6 /i f oil • � Y , _
�
I �r,,,il Nn.: C O ��
y k.• '\ I ?ale / ItY. c /
13115 SW 11101 Itivd.,' I'ip,ar(1, OIL 97223 1 V i'lan Review
Phone: 503.6;9.4171 lax: 5U 3.59X. 1_901 - v " . JI hale. /nV._ Utht' vormi'.
1,",,,,,k,,, I.inc: 503.639.1175 C - 1 - ‘G, r, M'W tlatc Ready /Hy: 1,1,1 tfi Sc4s I r 2 1'nr
Indenter: www.c i.L , ij tI.ur.us ,��/ Or �L�1 No litic'd/MLIhod: 7 / C-7 51, IUI Iv R)nua,ion
.,�Ittty_ 9 WORA PLAN REVLEW
U New construe! ion ∎ d( J( Dillon /alter;ttion /r•c1,1:Iccrnent I'h ,., cheek all that apply:
❑Service over 225 amp::: cunitn'1 Ullor:riduus location
❑ Demolition ❑ ()the!' ❑Sclvice over 320 amps r,,tin) ❑11(61(dng over 10,000 1,q. II..
CATEGORY OP CONSTRUCTION of I ' , nrl 2- lamily dwellings 4 oi more new residential
and J- famil tlwellinv ❑ connncreial /industrial ❑ Acccraory building
.. "r-
❑Sys'Ic over (00 silts nominal onus m one sU'uclurc
❑ ltuiltlinp, ovo:r lhrec stc,rics ❑herders. 400 : or murr.
Multi-family ❑ Master builder ❑ Other:
{JUcenl)ant load over 9 pursues (1Mauufacuucd sluu•InR1, or
Jolt SITE INFORMATION ,N1) LOCA'T'ION UI.y.css /Iightingpl :ui kV dark
.r1 ❑Other
/ ❑Ilealth -care faeilily
Job no.: � �� ] .doh .ilc rtlLir� ;t:: S ( . J j f e'. ; p , i submit 2 ;:cis of plans with any c1!'thu ilbuve.
('ity /St.ate/ZIP ( :r 7 2.2 j l'he above are nod apphc,iblt: (n temporary construction seivacc.
FEE* S(11E1)01.
Suite /bldg. /apt. no.: 1 1 name: ---
-._. ncncn am, (r Ft: T.,„,
--
cross street /cliredhon to Job trite: New resillcnli it siii 4` (01' nwlti -ta nlily dwelling u nit.
• ---------- includes all:whcd garage.
1,000 sq. 11. or less 145.15 rl
Subdivision: L ot rIO Zia. add 1 500 std, Il. or portion 13,40 1
...__.__.. .___.._.. . ..__..._._. Limited cnefp,y, residential 75 - 00
'fax inap /pared no.: -- --- - - - - -:- - --
- -...- __- _._.____.__.... I.imilal energy, nun rc::ulc.naidl /5.00 2
1)FSCRIP•1'ION OF WORD - ._..
I;tarh nr,,mrthahlrc(1 or mode
A dwclltg, s(..rvicc and /or rcedrt 90.90 ''
f , , `f . f-\ ( - __ r-F (' K•1 ., ? r -"1 . 4 - ( _ r;' _ _ - -- Services 01" Feeder!: inst:al:ctioo, alteration, and /nr rtk ttieu
--
200 amps or less X0.'i0 7
201 amps t0400amps 106.85 rlt01'1iltTY OWNER ❑ TENANT _ ..___- -____ =
_ --' 40I amps to 000 :unpt I60.60
/
� 1 ; • (_ �"T ;t P c7 601 amps to I,UUO ,nal)s 240.60 - --
N U Me: '
Z ' ` O 'r 1,00 or volts 454.65
------ .,.uxa,cit only bb. i_
I tty /Stitt: /7.I p_ /'l 7 7 fi r, — — Ten services Or ft•edtrs stallation, allerrlilra, :ultl /tlr
y
I ( ) 200 am
Phone: ( 5.,-).) amps
7 7 �`� I t - -- 2110 ampsurlcs ;; b0 r5 1
(oner installation. Phis installation is being made On properly that I own which Is nut 201 amps to 400 amp.: 100.1(1 3
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 070, and 701. -- ' --' ' ••••------ ._.... ._.._.. __- ._`
- 401 anld)s to 600 antlls L 1.'/} 2
Owner Si,.natul'c: ..__ - -'- Date: Branch cir ...... -- -._... ior - --
" cults.. nCty, nit(ratiun, or cxttustuo, Rte I)al
oe
❑ APPLICANT 1 ID CONTACT VERNON A. Fee for botch eircul s with
--- -- _... service or (ceder (tie, each
6.05 ?.
13uS1nesS name; bl'auc:l circuit
- -- -- - -•- II. tee for mulch circuits
Contact name: ,t0/Jt)til service or Iccdcr liar, 16.2 5 2 / - ' .," ....C .
...- .... - - -
each hrnoch circuit -
- Bach x00'1 briiiic1 circuit ( 4.05 _ ,,,- /,;C 1
City/State/ZIP: - Misccll:ulcous (service or feed not i i deded) --
- -- ' -' . _... - . --- ...... _
..
- feed('
I'umP nr irrigation circle 5 -1.40 ,
on c
('hone'. ( ) I lax: : ( ) - -...
-_.... Slgi or outline lidsluing 51.40 2
li -t nail: Signal circuit(s)t limited-
C'ONTRA(. 1'OR ciice y pane.!, alteration, uI
— _... - -
extension I. )L'11: t'Ihi•.: P:Il;(t 7 2
Business name: WEST SIDE EJ,RCTRIC CO.
Address: 1.43A 1' S AVE. 1 Each additional inspcctioa over allowable in any or the about -
- - - - ... ...--- - - - --. 1'0r inspection 62.50
City/State/ZIP: PORT ANT), OR 97214 Investigation per hour (I Irc rnhq 62. ,0
Lie.; 13306 (503) 231 -154I 1 Fax: (50.3) 7:16 - 0677 lode III 1l ,lint per hour 7:1
-- r. , ,(. Al.. , Ire Fr, rs - --
C
1 E rlii(' rl.ltn F,s
I _ S 1 --
C13 :1:106 I Electrical I -1350: Su lr Lie.: 2663S - - - 7
J � 2 I _ c---2)
Suprv. Electrician signature, required: Plan rc.vicw (25■x, o1' mania li.:c)
Print name' �� /(° !)alt:: < -. I `) ... .. - -- .- .. _ _ ...
S tale surcharge ( % n f permit fee)
_.... _.._.. _.... . .. . -- rO'rnr, rEltMrr hl?I? c- , 7 �•;
Authorized signature: This permit nppliraliou uiu lo'CS I I A hermit is [wl ublaiucd tiitain IRO
- -. -. - - -- - -- .....- - - -- tiny, aticr it h:tt bCt'n a•vrplcd as wale a`te
Print name: 1 Dale: - due uu :thndulodv:+U by 'It i-( 'ln , oly iluildiug ludus,ry Se vice n,,:u'd
.... ... ._..-- _..._.... -_ __ .. - --...
•• Number urin.vpcc,iuuv per iNermir allowed.
ill( i.tingwermaniii 1. -r -, ml A1 l'_'/o.t 4411-461,T( I WUJ('oM /wr it
2' LL90 -9EL (EDS) • 00 t2I J' Oa13 a pIS 'Isar' eSE tLO +b0 OT ReW
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lirte: ( 503) 639 -4175 MST
INSPECTION DIVISION Business Line: - i (503) 639 -4171
X03
BUP
Received �� ` Date Requested /lC� AM PM BUP
Location (� �� 5�R� C-e-14 5i cryx D r Suite MEC
Contact Person L2A- V12_ (3) � •� 1.4 534V PLM
Contractor Ph ( ) SWR ,, //��
BUILDING Tenant/Owner ELC 2 4
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing () '? flit (1.An1 U(LC ( Wt 2E F-OL.
Insulation \ • 31 :5' Nt � \ T 'Q M
Drywall Nailing ( ` Firewall
Fire Sprinkler . *S ` �Lv'� • w 1(t� ` � S N� �L �
Fire Alarm 6 NL1 G ovt V -- UL. - 3 (fotiloSi
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'
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers . ■23 -Q1
Final
RT FAIL
Imirrww / ,% //
_ . Rough -In r
UG /Slab
Low Voltage
��•• larm
`r %i`7 ❑
PART 1011 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 (Sb3j 7/
ADA - cr e&\ 1\1'
Approach/Sidewalk Date Inspector 1 �� `-' Ext
Other:
Final DO NOT REMOVE this inspection reccW from the job site.
PASS PART FAIL