Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 - 00092
1, 42 DEVELOPMENT Tigard, (53) 639 -4171 DATE ISSUED: 2/16/2005
�+' I OR PARCEL: 2S111DB-06400
SITE ADDRESS: 15265 SW ALDERBROOK CT
SUBDIVISION: SUMMERFIELD NO.7 ZONING: R -
BLOCK: LOT : 396 JURISDICTION: TIG
Project Description: Wire furnace & A/C unit.
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: 1 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:
RICHARD BROWN T &T ELECTRIC
15265 SWALDERBROOK CT 4120 SE INTERNATIONAL WAY
TIGARD, OR 97224 SUITE A -105
MILWAUKIE, OR 97222
Phone: 503 - 620 -2751 Phone: 503- 652 -7610
FEES Reg #: LIC 150973
ELE 26 -1105C
Description Date Amount SUP 2184S
[ELPRMT] ELC Permit 2/16/2005 $53.50
[TAX] 8% State Surcharge 2/16/2005 $4.28 REQUIRED ITEMS AND REPORTS
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 -2344.
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Issued By: , Permit Signature: j p p
■
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
05/20/2013 17:13 FAX 1 001/002
4
Electric Permit AP E E V D .FOIL OFFICE USE ONLY
City of Tigard (_ �9 R«aved �>S � ,
J 3 125 S W Dial' Illvd . lipid, OR 9722.1 p i li s t Permit Nu __ � /)
FE B 15 20 P l.rn t i —/ (! _7
phone. 501 639.11 71 f a� 503.598.1960 Wm ' Perm. In∎peet ull 1 Ina 503 539 4 175
I]:,1c Iicd4;•,tl, -� --
lol_rncr w,l�w. G �m2Lnr.u. CITY OF TIGA' ?� ' I ' t .-�° Dale 4 • —� - -- - ......
V,,tllielV�ielhutl: S¢e Pa�?c 2 t1,r
_ a_ 11.. � �r 1
— ft
Y ll. Inlgrinyliun
• I ff T - *. WQRK PLAN REVIEW -- -
❑ construction onstrltenon VAddi [Ion /alteration /replacement _
0 Please check ull lhal apply - nemollllon gihcl° ❑SCI'vice over 225 amps, comm ❑I la'rm location
loca n l
CATEGORY OF CONSTRUCTION ❑Scrw,co aver 320 amps ••• ruling I �13udring, „cl ItI,QOf)yc ft
of I- and 2•I'umily dwellings 1 or more ncv, residu,UaI
I - and 2- family dwelling 0 Commercial/industrial b Accessory building ❑SYSIcm over 500 volts nominal 111111. 111 n11C SU'LIcUIrc
El Multi - family ❑ Master builder ❑t3uildrng over lhrce si c.. ❑I 'ee(icts', 400 and s more
` ❑ Other. 1 nr n
❑
106 SITE INI'ORMATION AND 1.00A'1'lON Uecupant (null ov 9 ❑Manul'helllrcd nlrtl_luro or
- ❑P.gress /llghling plan RV park
Jul; no 905 _q ,IV t7 $rrc vt(I CI I'C 5 f 52 5 S ' 1A' �,{. rw CI It:an s - cure lirclllry ❑Oche': . - __ _ .. - _ _..
J 6 - SW Y � i LL r C.4.Jt� , Submit _L sets nl - plts µ'1t6 any of th about,
cily-Statc /ZIP: t d' g 7 Z 2_ 1 above are not applicable to Lemporary con.uuclinn service. •
Sulk /bldg. /opt du : Project name: FEE` SCHEDULE "
bererllltlrin I Qty. I I'l'ea I'gni
Cross SII'ret /dll'CC1inns to job Site New resid t.le- or multi-family entinl sins � -
nuy d welling unit.
Includes attached garage.
I ,000 I t, orIcss ener sq. rt. o 11515 o
Siihdlr I510n' Lla a(1d'I 501) r portion 33 -10
�L.ot no,:
Tax map/parcel no : UnwedUnwed w I—
energy, res_d(;nlrrl _ 75.(1(1 ,
�
DESCRIPTION OF WORK
l lilted cllergy, ncln•residentlal 75,00 - 2
_ • Fsell m or Modular -
- _ r (Iiv ll lit �, service, and/o1' feeder 90 90 2
lJ Services or feeder's irtstallatio alteration, pod /or rclaeatlpn
2. amps Or 1C$$ 50.30 - 2 -
` 201 amps to 400 amps 106 H5
❑ FROPF RTV OWNF,Ii ❑TENANT
Non,C /� / , 1�-, 401 amps to 60(1 amps I60.0) 2
J J/ 601 .)tops to 1,000 :imps 240 60
Address: Over 1,000 amps or volts 454 65 --
C'lly /State /ZIP; RceonI1cCI only 66.85 `—
Temporary services or feeders in.uallption, alteration, soil /pr -
PI1Unc ) f „I')fl , Q7 . 6 . / F ( ) relocation
Owner installatlQ This installation is being, made on property that I own which is not 20f)'Imps or less at,,1 5
nvcndCd for sole, lease, rent, or exchange, according to ORS 447. 449, 670, and 701, 2 amps to 400 amps 100.30 2
Own 401 amps to 600 an, li --
cf signalurc. I 133 75 2
- -- Date: -, _ Rranen circuits - new, Alteration, sn' csten,siun, par panel
❑ APPLICANT ❑CONTACT - " - - - -- . _
PERSON A. Fee tor branch Circuits with
13usltic5 name: service nr feeder fee, each
branch circuit 5 65 ,
Contact name: U, Oct for brunch circuits
” —
-- - without t service or (ceder lee, �
Address - each branch circuit / 46 85 . 1, 0S. 2
Flash add'I bl'itnch cr)'_ul[
C'lly /.Stole /ZIP: 6 r,5 /QS 2
Miscellaneous (.service or I'cecler rlut included)
Phone• ( ) Primp Or u ri snail circle -
Fax; : ( ) I 13 5) 40 2
E-mail.
Sign 01' outline lighting 53 40 2
Signal clrcuil(s) or limited. -
CONTRACTOR energy panel, alteration, or
Business name: T & T Electrical, LLC' extension. Describe: Page 2 2
Address 4120 SE International Way, Suite A105 Each addiUOr inspection over allowable ill any or th abo
—
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C'u h
y /State /ZIP; 1i11+'aukie, OR. 97222 Per inspcetierll e2 50
investigation per hour l l Iv nun) G2.5t1 -
Phone- )S03) 652.7610 -• ,
I Fax: (5Oi) 652 -7612 Industrial plant per hour 73 75 - -
CCF3I.IC„ 161187 Electrical I C,: - ELECTRICAL PE1tMIT FEES*
3 ���� Suprv. Lie,: 47315 _ • -
- -_ - _
Subtotal 5�
Suprv. LICCII'IClan signature, ruyuircd• /
� . / � fi /� _ Plan __view (25"/„ of permit red)
Print n_�,11 ^ma M (ARK Li NI��(s} LL : �. /5 e5 c •
State surcharge (g'7„ or ILe)
nurhorl /ed signature: roTAI. PERMIT FEE 5 , 7, 7 a
TIll permit applicarinn eRitiret, If herrnit Is dal a56alned , Bolin 11140
L Print name. -1 F HE I Dtlte: c ,2. /5 QJL (hryr :lrlc•r II I1,IV l el'll lltCeplell as cu
- ice ntclhndu4,gy :rot i,v In-County Building Indust'y Sen lei. nnaid
Itdd,6u P '. Nun her or lnspcmllolra our ovum allo,vsd
vin. I ).t' PCnncnpl` . e I] /QA 415- 41 rtlYCOM' \VLn
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: ' (503) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested CO PM BUP
Location /5 :5 , f cje i 'o C. Suite 4:13),2- OD 'IA O
Contact Person POO Ph ( ) 997 4/S / 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenan Owner I GkAived & o w ( ELc 2 $ coo 4 2 -
Footing
Foundation Access: ELC
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
T FAIL
MECHANIC / //
am �
Rough -In
Gas Line
_r• • e Dampers
in
PART FAIL
L
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
El Please call for reins section RE: Unable to inspect — no access
Fire Supply Line -
ADA
Approach/Sidewalk Date - ■ _ Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL