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Permit ELECTRICAL PERMIT PERMIT #: ELC2004 -00440 DEVELOPMENT SERVICES DATE ISSUED: 7/19/2004 'll CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 102AD -01600 SITE ADDRESS: 09033 SW BURNHAM ST ZONING: CBD SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Emergency -meter change only. Job #07 -28 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SCOTT, JERRY D + NATALIE C E C COMPANY 10060 SW PICKS CT PO BOX 10286 TIGARD, OR 97224 PORTLAND, OR 97296 Phone: Phone: 503 - 552 - 5503 Reg #: ELE 26 -45C LIC 49737 FEES SUP 4040S Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/19/2004 $66.85 [TAX] 8% State Surcharge 7/19/2004 $5.35 Total $72.20 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By: � - Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day 07 19:52 5032205347 PAGE 02 le x 'lica! Per mit Application - ,4•.,.,.::., 0: , rok ()III( . 1 ,. . l'sI' t)N1.1' • • - - City of Tigard - t, ElEEZ '9-t1t' 13125 SW Hall Blvd., Tigard, OR ;' 9722 .) Lu Pemit lvo.: L E C,_ _ ao y5/0 Phone: 501639.4171 Fax: 503.598.d'960� / /»• a, i DaLd$ ( Otbc In spection Line: 503.639.4175 . temet: www,ci.tigard anus - w otie cthod. Eafo tq K �� .,} �,a�. , .. , ;, ��. �:':S %c, ":;'^'>�:�!.., ... ... .. • Supplemental P � r r n on u 1� 20 � / + p ry „ +. :: '.: 1 : . 0 4 No to B Y' Page for ,.: , . ,.h, ..,.... � „a e'•• .... .: .. : . . ... ., '” " . '. .::-: :'T:i`. ^ . :t '.�!5 rxR; "Y.:'x's::'.;'•.; r:t +c New . ,... ,:;: ❑ construction _...' , y E t/ r- • E`�re lacetttcnt r. • . _ .. Pl ease c ..:.. ;;.,...... � i' ... s.!,•rc• > }` ❑ Demolition Q1 G t Drab g W al ':: i ': » 1; .x..... ;air De o l , t n ... .. . AIMING i j�, : © tr lon y ° ,� al heck 1 at appjy. ,. .... i� +" r: ; .. •,ten -::: lltNpid�r„b `� . 4 �ctt( 2�a�,' � •, {.r ( • � ;i (; 1 .. . � r ( r . ; °�'' .. U S rvt 320 ['Service over 32 amps corm') ❑ HHui tdous location d o over 10,000 sq. R., .. - e g "; "" ` :''' ' ". "`. . r of 1 and 2 family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal unite in one structure ❑ Multi- farrtily ❑Master builder ❑Building over throe s tories Feeders, 4 Other 400 amp '�� 7 : r."• :'? xS'!J, %Cbfylig(I�'r"'?'!:,,f }.y�;. , . , .., .: 1 ! ". • c; .r;r, r . ,.c.,m ,,�,,,..., „ ,,a,, 14;.� } j : G t ,, S. •r -,.., persons rC {�3}y �.4.. ....:..... ...., ,,.. : ._ ,. ,� ..:.4... ... • >,., '; : ,,..... ❑0 cupant load over 99 a Msnufactu d lIl�e..�tl.:n , .... p t "p ,�,... t. f :,,.. °::!':r.::::: p structures 0 7 ^t_ /Atil4rr ..., , 7 8 7: .^... .•e: : ; , . ....� ;.`,w.._ m ., , .... '�,•_",l.l .�., „: ;6t:'r ,� _];!r.: v� Y ... N^ 1 r: .- .- ,.,.:..i.r:;:::~::.._.' vii;:. i; .:.: i � :...::.::.... aQ .::;i: € ❑Egress/[ightingplar RV park t lob no,: Crl . a g Job site address: ❑Health-care facility ['Other ['Other !73� `� W �U N ` "t .00,, S Submit 2 sets of plans with any of the above. City/State/ZIP: -- ' tar r o ( '''‘ 1 The above are not applicable to temporary construction service. Suite/bldg./apt. (. . . . • P Project t : '. :;.; -a . :.:I : . , 11; ... :i' : ;i &i,•, "'i i g, „,. i,1 }t r„ { fig 11 ) S , �4� C N( t at SI' .,- ' "" °'" ?^� i” Nr ;, 'F:.:' � L x„ ;;tr. , . . �i " ^,.,x "r >t'i, � ' Cross street/difections'to job site: Atevlptloa Qty. Fee. Toted Now residential single- or multi-family dwelling unit. Includes attached garage. • 1,000 sq. ft. to less 145.15 4 '" Subdivision: _ I Lot no.: Ea. add'! 500 sq. ft. or portion 33,40 I Tax map/parcel no. Limited energy, residential 75.00 2 j �(� ,(,� }f�l� yls}rtSZa' WS v,m, , r :: , ;u Limited 7 :l 1 1, t,t i R� �Sil t tY iP l,`i,",Tt,�,.ti, ` r ,yi; I i I t i a'''%' i.t. "' 1 :r_ 1 s s S 75.00 2 f �. • , t , ,, _ ,;.it, E, l.f ,,, , . 'f ?� :;;' 1 .:, (� tk Eac manufactured or mo. ular ME `Met' ze.r e 7 — \\ t C 'e e, O F dwelling. service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps r er F ,: ",,M yr ^, less A •. �> , ^,:. : .•, ,w, ,7::t :lr..w;>wr�,. tw2 : rr . : :, i +;;>w,2 9 ,,4 •r^r. or 1 5 80,30 2 ,i S$1!it r '7 , klE;i:1T -r �.i 1 ?w ; {rs u k? , 2 ' r ` a , , ' S lr {)1S Yr q '�.4 .:: . .3' ( 201 amps to 400 amps „i . Ix • , 1 > , ! : ; ; ?a ,,, > amps 106.85 2 Name: 401 amps to 600 atnPs 160.60 z 601 amps to 1,000 amps 240.60 2 ' Addrest;: Over 1,000 amps or volts 454.65 2 Reconnect only y 66.85 G(..r�s 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) relocation Owner installation: This insta Lion is being made on property that own which is not 200 amps or less 66:85 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 201 amps to 400 amps 1 - Owner signature: 401 amps to 600 amps 13333.75 2 .75 2 Date: A. Fee for branch circuits with Branch circuits — new, alteration, ' }. t , + rby4 t c«x; ^ �> , ...r : ., < � ^:� ., t »•r,' .. r \ , � f ftI r 10>ta, or extension, per panel '' p rcp }lf q { ; R J� p `' iji I 1” t t t i t tSVi0: r tali 1i>'+ Fm , i,r^ ^3 d ( {N m)ti7. •tat ate tK • 'l(; s oe }�,F,x�. b i a _ , ,t,(ay.. ,.�,, , ,,m, a, w,. .d,.u.. 5.,•,,.+,,,.. ,n,,.ti.,ty 1^'�, d „ -, .q....0.."6•1 ' service or feeder fee, I i each Busi>ess name: branch circuit Contact name: B. gee for branc circuits without service or feeder fee, 46 -85 2 Address: each branch circuit' ----- Each add'lbranch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not Included) Phone: Pump or irrigation circle 53.40 2 ( ) Fax:: ( ) i Sign or outline lighting 53.40 2 E -mail: i S al circuit(s) i - � tor' . •. ,,;:'>.a.. a r o., "l t or •, .,r ,..�.�..11 .. ,.. a.,... 1: a� ;4a.,.l,a,......a..t.;...i.•l,, y ,Y....ft�8 ". �'y ^vj.',':5 °'; � , .t`, ever r , , t. , .t 'ii'� ;;:1,, "( energy panel, alteration, or „•...,..,,5,.;::,,, +...,,,.1:., rLrt'i,.,,.,"L:: r >.,,., <'.!.c>is; *::,'<sa .... .... ....,; . , e ...w ,., .,(2: extension. Describe: Page 2 Business name: t C Co r t A "-'4 Address: (� Q 0 t 0 � g L Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: V J \14 C M o, \ 7 1 177 Investigation per hour (1 hr min) 62.50 Phone: (s.p'l a � U'-S 1-1 Fax (Sol ) Q,�1S -3 o \2 industrial plant per hour 73,75 t (Y,K, na s fo'4 r , , �.k�,.; -.. t r, ,1 � ;r CC Lie., u,,c a 1 Electric. Lic.: ac-, , s igt . Lie. 4 . `r r t;a :,••w 1, ,,.Ettr,r`�,.')�s_.., ..._ : Subtotat MIME +131 i,+�I a1 Supty, Electrician signature, required; ��i k ,ISI ► Plan review (25% of permit fee) IIIIIIIIIIIIIM 1 � State surcharge (8% of permit fee) Print name: Date: 7 _i s-^ _. O`� s . g TOTAL PERMIT FEE n , ...D 0 Authorized signature: This permit application exp . ;7 a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: - Fee methodology set by Tri County Building industry Service Board " Number of inspections per permit allowed. ■ Building ,Permia PermitApp.doc 12/03 440•4015T(10l07/COM/W5B CITY OF TIGARD 24 -Hour 'BUILDING Inspection Line: 1503)639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Re•uested 9 - 3-0 AM ' PM BUP Location > A A ./ Suite MEC • Contact Person Ph ( ) Z Z., 0 PLM Contractor Ph ( ) SWR 1 �/ BUILDING Tenant/Owner !� � �/ j_ ELC Dd T /U Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: �` SIT Post & Beam � T IN4k 5 (r4K Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ��+ �" J t 7 J ) l Q � 1 �L-,1 l' t 11 M Susp'd Ceiling Roof Other: N b � Q 1 1 a'' ' Final PASS PART FAIL PLUMBING Post & Beam Under Slab Water Service 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 Rough -In UG/Slab Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. �'F PART FAIL SITE Please call for reins•ection RE: Ell Unable to inspect — no access Fire Supply Line ADA d # Approach/Sidewalk Date Inspector yl / / i Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL