Permit CITY OF T I GA R D ELECTRICAL PERMIT
,, PERMIT #: ELC2002 -00466
At 1 ill
DEVELOPMENT SERVICES DATE ISSUED: 9/13/02
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112BD -00100
S.i'E ADDRESS: 07520 SW BONITA RD 009
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT : 065 JURISDICTION: TIG
Project Description: Install 1 200amp service and 5 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: 1 W /SERVICE OR FEEDER: 5 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:
BOROS, STEFAN A + FIVIA KELSO ELECTRIC INC
PO BOX 1890 545 SE 3RD
GRESHAM, OR 97030 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 -6360
Reg #: LIC 116254
SUP 4270s
ELE 34 -433c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 9/13/02 $113.55 2720020000( Wall Cover
Elect'I Service
5PCT CTR 9/13/02 $9.08 2720020000( Elect' Final
Total $122.63
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
/
Permit Signature: r (3/43 / , f i/ Issued By: ■ ��
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'p DATE:
LICENSE NO: ° — 7e 1
Call 639 -4175 by 7:00pm for an inspection the next business day
FROM : KELSO ELECTRIC INC FAX NO. : 0000000000 Sep. 09 2002 01:57PM P1
rif=z), • , i ' 'LT.!' !•
f . - t 7 -r-' 3, . -' ' ,•,: ...-.)
U Id t= ilili° " ‘-
••• SEP n o 2 . 91 - - •
. .. .. .. .. . ..., ..„. .., .. /
Electrical Permit Applicationok fick- •
,,,...._,..Accejifesl
131377,DFT,37 I)... - : .tii,43 --r - ea -c) _ Permit No
City of Tigard Test Form Plaratimg Approval Sig
Datc/T3,3
Permit No.
-
13125 SW Hall Blvd. Erin Review Other
Tigard, Oregon 97223 DawHyt ParrrirtNo,.. I
Phone: 1103.639-4171 Fax 503-598-1960 Poeu.Raviow LAnd Us*
Dstchiry . coo° No.:
Inlettlet: WWW.C.Ltigarrior.us ,111.4 Cantu; hiris,: El 5;;r Pagc 2 for
24-hour lupe ction Request: 503-639-4175 "'"- ''' ' -- Nstarimethod; sum{ mot tal In (grill. dell,
•
:::: ii7.f.y:;:. •''- r::.•,.. .!' •
. New construction • Demolition 0 Servico ONTT 225 amps- 0 Health faciii1y
commercial 0 Hazardous loati a a
Di Additon/alteration/re.lacemerft 0 Other: 0 sarvee ovcr 37.0 tomps of C1 Building over 10,000 square 2cl.
:: - - V , t.L a a I51 1 ,t, 2 family riwtninzs four or more residearial urtiIS in
1 & 2-Family dwelling ' • Commercial/InduStrial 0 Sythcol ovor so° voas nominal one stricture
PI Building ovrr Corte stor.es IQ r-ocdota, 400 traloa or :no=
A ll Accessory Building bt.4 Millti-Family DI occupant load over 59 person: Di garsufaztured Itructures or RV pu7k
101 Master Builder A Other: 0 Ep plan 0 Otar.r:
Submit gutzurpitus with ani ortho above,
-- .:: . ..:;JOB'SITE .:;'4,
The Above arc not applicable to cemporory corrytruction sorcitt-
I Job site address: - 15j0 51,? E ,..,t,•,:,.,..,...,,,,,, ; ; , :. , :.;..,.:!::.::_c;,•..:.z . . ,, . :..._
Suite : Bld ./Apt.: 9' Numbsr of irtgpstctioas pr permit allowed
r' . Description QC/ Pt! (e a.) TOW I
Project Name: i .A iv a il lb . I
haw MSide-iii1a1-311310 or rtlilIi-01 per T
Cross sueet/Directions to job 'te: dwolro a alt. Inchulas attached garage-
Strvice IOCIO4SiO;
1000 sq. ft. or Icas 145.15 4
..-.., t.1::• te.. 5 •n %.,.. • 111MYMENIIIIIMIi
tied energy. raiderirlal • 75.00 113
F-R713.divisi — un
on: 7 Lot #: ignited - 5 Tvl ,;t1OnELI1 73,00 Z 1
MX rnspinarcel A: Eiehateautamtai home or modular dwelling .
-.-... - ''' ,': ''' ''''-. InSC134".Zr.ON WORIN:7-:F-.-'''IT'i'::: .t..:!•;'- semce andit'r f6140 90.90 2!
• Serricos or feeders - Icstallosioa, I I
4...) alt.:ratio° or relocatloo:
' 200 unps at lest _ 1 3030 U.,..3D 2 1
' -- 201 II MP/4 tO 40d Zip d 1 KIS 2 1
401 mom to 603 amps 160,60 2
'Iiil l'gOPTRICIWN ' '..:.. 01 4nT74 t° 1C130 "73 240 1
— " Over 1000 amps or volts 454,65 2
. =14 er Asoorsocct Oo[Y 66.85 2
',..
Address: Temporary cervices Or feclihr3 - If15111101:1014
aherarjoo, or retocatioa:
City/State/Zip: 200 =OS OT loss 66.85 - I
.
PhOlae: Fax: 101 amn$ tO 400 bing i;TO. "gFr 2
233,75 2
''' II.ni:C T :•,' 4°1 tt ' 639 2PP
Brooch sirculta - new, altersti DA, or
Name' e2tensioa per pa •
•...r.,-..;-...---.—...--------.-t...t-••--. -
.... Fee for timid circuit, with purchase or
6.6$ -i,7 2
Address: turvice or feeder fte..,cech larartch oirouir
City/State • 13, Fee Mr branCh 6-c without purchase or
service or fog& foe- fi rst branch circuit . ,--- 46 -§ 5
PhOnC: Fax: _ P-sth additional brach circuit . 1 6.65 t 2 . • -
E-mail: mice..(Servi cc or feeder not irialu
. , ::•.:.....i'':CONTRACTOR"' :•-,':- *.:'•:':.•::•1-,::i.•.i.i.;:, .......,_2Earli . or irg n circle 5140 2
Each ai or outline li • MI L S3.40 2
Job No: sopoilyilvait(a) or a limited ans-rgy pool,
Rusiness Name: • ' - ' te- r (•-• _Iii .c___,
. • . ' II
"Dericryptiom . 75,00 , '2
Address: 5 e •; ;
L_gj2 ii115 t ■ ( - E additional inspection over the allowable in an of the above: __
, Per i , :t .- hour - min- I hour 1 i 62.50
r f•• •
Phone: .!. , - ,f, f A ... 1 .Fax:
CCB Lic. th F ' ,..4„MIUSE1111MOUC , al5cr. , ,
• • IIIIIINII
. .;,,,:4,...:.,::::..,..,:.::.i:,..,:.c,..;,. ,•,;• -•,-.`..,':.::, :'.'''i'' • ''.;'.. • , . •
Supervising electrician 'IC
1 • 41■■• 1. ! Su total i S
1 signatilre re • uir - d; • Plan Review (2.5% of Permit Fee) $
Print Name:. , 27:11 - kill= Li;.: 14.9 '
. Stoic Sun:barge OM of Permit P'ep)
TOTAL PERMTT FEE S l (0 ,
Authorized °> / r . Notica This permit oppliention c.spIrcs If a permit is not obtsiscsi reit illa
Sigrarure: Ilk , . 1■._ __,4 . Am e—fral■Dato: . no nays attar it has bon ICCeptsti so complete. Fe rizethodoloty "thy Tri-Co lustyBuildiug Industry Service goo rd.
(.1'I0asc plias nonce)
— •-••••••• .... • • • ., V V V ••••• nA6TANO^e,S, "VW, •T •.y .7,n,,n7/on
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INS ECTIbN DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /U 2 AM PM BUP
Location 1,5—Z, 0 5 w L? a'u - 1d Suite MEC
Contact Person !—/ Ph ( ) '70-7z-7 G' PLM
Contractor k P /50 C -c*i <. Ph ( ) SWR
BUILDING Tenant/Owner ELC p 0 Z 0 4 N6
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT /
Post & Beam
Shear Anchors
Ext Sheath/Shear
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
Water S he
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
Fina
PASS PART FAIL
�EL'E A L
er _
Rough -In
UG /Slab
Low Voltage
Ei Alarm
Fina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
__aar PART FAIL
SITE _ Li Please call for reinspection RE: Li Unable to inspect — no access
Fire Supply Line /�
ADA ; Date f 7a7 1
Inspector L�
Approach /Sidewalk / ) P Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL