Permit 074 '
C I Y OF TIG.� U b ELECTRICAL PERMIT
PERMIT #: ELC2001 -00489
4 I DEVELOPMENT SERVICES DATE ISSUED: 10/3/2001
I
�� 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2S102BC -00106
SITE ADDRESS: 10290 SW BROOKSIDE CT
SUBDIVISION: WALNUT ACRES ZONING: R
BLOCK: LOT : 005 JURISDICTION: TIG
Project Description: Installation of 6) branch circuits for kitchen remodel.
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: 5 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:
DICKMAN, ALFRED E + CLAUDIA H 205 ELECTRIC
10290 SW BROOKSIDE CT 7831 SE JOHNSON CK BLVD
TIGARD, OR 97223 PORTLAND, OR 97206
Phone: Phone: 771 - 5491
Reg #: SUP 3805S
LIC 34255
FEES ELE 3 -452C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/3/2001 $80.10
[TAX] 8% State Tax 10/3/2001 $6.41 Rough -in
[ ELPRMT] Investigation 1/27/2005 $62.50 Elect'l Final
Total $149.01 •
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 is if work is
suspended for_more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregafi Utility NotificationjCe . Those
rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules o 41- t qr esti. s o''U C -at 503)
246 -6699 or 1-800-33-23 • • .
Issu By: / L � � I l Permit Signature: X /�����j�
i OWNER INSTAL -ATION ONLY
, i
The installation is being made on prope : ;::/ •: S1 . 'ter'de: - sale, lease, or rent.
-I ' ,
OWNER'S SIGNATURE: .lG� DATE: /X 7 a
w -,-/.---_- �� f
C • RACT • - INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD
BUILDING n Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 6394171
BUP
Received Date Requested ( ° g AM PM BUP
Location Suite MEC
Contact Person ��� Ph ( ) PLM
Contractor Ph ( ) SWR �� G
BUILDING. Tenant/Owner ELC a6 / - 60 9- o I
Footing
ELC
Foundation Access: -
Ftg Drain 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
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
Final
PASS PART FAIL
ELECTRICAL
Service
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL
SITE Q Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line 1
ADA D 1 ' ��' Inspector \ \I 'Ck.S -\ ( Approach/Sidewalk p \ U Ext
Other:
Final DO NOT REMOVE this inspection record fro the job site.
PASS PART FAIL