Permit CITY TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2003 -00463
,:� DEVELOPMENT SERVICES DATE ISSUED: 7/30/03
A- ` - ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134DC-10300
SITE ADDRESS: 11496 SW CORNELL PL
SUBDIVISION: TIGARD PARK ZONING: R
BLOCK: LOT : 019 JURISDICTION: TIG
Project Description: JOB NO 1838 Wire A/C and additional plug
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:
BOWKER, LEANNE MARIE HILLSBORO ELECTRIC
11496 SW CORNELL PL 21185 NW EVERGREEN PARKWAY
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 624 -0939 Phone: 503 - 439 -9666
Reg #: ELE 34 -433C
LIC 134481
FEES SUP 4240S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/30/03 $53.50
[TAX] 8% State Tax 7/30/03 $4.29 Elect'I Final
Total $57.79
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- 800 - 332 -2344.
r 1
Issued By: 1 Cg./n- ✓j&__-- Permit Signature: t z „,„." ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
' From:HILLSBORO ELECTRIC LLC. 5036013680 07/29/2003 12:59 #197 P.001
• �•r CR( re
A p lication _
FOR OF I E �ls ONLY
T
RECEIVED Received Electrical
bate/B : �; PermitNo.r4e-2OZ3 t7v 1
City of Tigard Planning Approval Sign
13125 SW Rail Blvd. Date/>3 Permit No.:
Tigard, Oregon 97223 JUL 2 9 2003 Plan Review Other
Darr!$ ' Permit No.:
Phone: 503-639-4171 Fs��5�p�59$ 6n Post Review Land Use
Internet: www.ci.tigard,ort ' ItiQ� %�e ".,r, c.
24 -hour Inspection Request: U3- 6 -4 1 75" Contact ]aria.: u See Page 2 for
Name/Method: Su 'entente' Information.
TYPEi OF",WO .
l2K'.^
■ New construction PLAN.REVIEW, ' .lea ch 'ec
tfLlCti011 ,.. ., .,. ;.': ;�•. ' :.. , < ;,� ,:...: r.:.. se k aiTthat:'a � , i ..
1
• Demolition • Service over 225 amps- ■ Health-care facility
r Addition/alteration/re • lacement ■ Other:
location
CA'rEGORX' OF; , ❑ Service over 320 amps-rating of ❑ Hazardous over 10,000 sq
square feet
CONSxRUCTION ; '. : :; ; : ''' ••? I & 2 family dwellings S p urloin
IL & 2 -Pamil dvvellin • y g oe r more residential units in
_ ■ Commercial/Industrial ❑ System over 600 volts nominal one structure
IN Access() BuiIdin • ,.1 Multi-Family
Building over three stories ❑ Feeders, 400 amps or more
y i
• Master Builder �■ Other: 0 Egress/lighting pons ov 99 ers Manufactured load ❑ Other d structures or R
? : «t; . ._� ; ;. : ;: 'J'OB;S,i`fFi"INI'O ' plan pad,
Eta 0 Other: Pa
Ri► T><oNi i d X,o. 4 rioN <` '.:', �s Submit
sets of plans with any of the above.
Job site address: �� S W • r 1.044 u. p The above are not applicable to temporary construction service.
ervlce.
Suite #: Bld•. /A,•t. #: "_ . '., ,. '.�r,: c Y] ; ri, ;: ;4 ., ; , ; , : , ;fit .,.:
l'ro act Name: )? r ■ 1 y �� Descri • uon Number of iris. ections . er . ermit allowe
Cross street/Directions to job site: New residential-single or multi-family per
Qty Pee (ea.) rota!
dwelling unit. Includes attached garage.
Service Included;
1000... ft. or less
145.15
Each additional 500 sq. ft, or portion thereof 33.40
Subdivision: Lot #: Limited enemy, residential 75.00
Tax i v isi parcel #: Limited energy, non residential
75.00
`'� + a;.its,:rrrwv >
Each manufactured home or modular dwelling
say' a b' .1`. �'e i .::... lin
bESCJ P xior' !JF:>w;1:io - _y. 't /' "• gis: ; :tg , 4 ; i ii , servicaand/or feeder 90.90
" Services or feeders - installation, _ __ __ _ ---
'
W alteration or relocation:
200 am.s or less 80.30
201 amps to 400 amps
4 to 600 106.85
PAW ' i aaJ44 ' )Ct: ' :;'ri a:k�E' 1'li:1lh' c:'i c a:+ ,:• �•„ , A , _ 01 amts amps 160.60
,'IN- :! #4,,' ;li r ;;:<. 601 to 1000 amps 2
Name: \---G- v7 Over 1000 amps or votes 240.60 2
Y1) 11tI W 4 P'S Reconnect only 454.65 2
Address, \ w 0 4 Temporary services or feeders - Installation, 66.85 y
U
Ci /Slate /z2 r. � .CC � alteration, or relocation:
Phone: L '1 _Oct e Fax: 201 amps to 400 am 66.35
,: 1 131k(r ( ''y ?i ; ". ti ai: w '' ;:v : �. '�' 401 w 600 am 100.30 2
Name:
� A E Q ap i ,'�i rZr, ;: Branelt cir Its - new alteration, or 133.75
2
s :
extension per panel:
AddreSS A. Fee for branch circuits with purchase of
V ddre ta1 l,/Zlp: service or feeder fee, each branch circuit 6.65 2
B. Fee for branch circuits without purchase of
Phone: F &X: service or feeder fee first branch circuit 46.85 2
Each additional branch circuit ■W 6.65 Mar
E - mail: l 2
M isc. S
rr � c�; r� . ,�, erviee or feeder not .§ ''�i,c '1" z "`: i w. 1 ,11 r �qM Ot included):
.!, {:.'s r,4�,.:� g '...4���Ql�f�.R'A�1` '�v2`.Yr �i �"`�h l'�eNn: ;` r .,.. r .�
,.
r ��� C': •- �:�;fifi.+Ci:��c � :•�•� ":�...i;� 4`eiw ;'•1`` �Gh •um, or irrigation circle 53.40 2 1
Job No: y • Poch si' or outline li:htin: 53.40 2
y / Signal circui or a limited energy panel,
i /(shor - a £ l t°cf I e. LL.e-- • alteration, or extension ■ �
Address: ,. Ry N wE to �r Pk r Description: 2
Business Name: 1 10
Cit /State/Z1 • : �� �i<y Each additional Ina. ecdon over the allowable In art of the above;
Phon, Per sti• ti tian per hour (min. !hour)
C
II
CB Lie. 4 � - 1 � d lnvestl tion fee:
62.50
O (�J� y Other. MN El
Supervising electrician l V ✓ �� .. , ';°, `? �:: , .:7EI'i !cal,% ermitrlie krt� ri �, h ,a : �,,z,:, .. ,::�,.. .
Si. store re•uiI'ed: ,. -� e�:, ... .,n:.�:.:- ::- ;;�,:.n ,,�:; .:,� ;:
4 r``� Subtotal $ =3 ■
Plant Review 25% of Permit Fee)
Print Name: L Lie. #: - 5 State Surchar. it Fee a 8% of P MEM
Permit
Authorized TOTAL PERMIT FEE S
Signature:
Date: Notice: This permit application expires If a permit i8 not obtained wi in
180 days after It,has been accepted as complete.
*Fee methodology set. by Tri- County lEullding Industry Service Board.
(Please prim name) 5 -1 ' 7 Cr
i:\Dsts\Permit Farms 1ElePermitApp.doc 01/03
CITY OF TIGARD • 24 -Hour
•
BUILDING Inspection e03) 63 -4
INSPECTION DIVISION Business L' • 639 -4171 MST
BUP
Received Date Requested � � AM 'PM BUP
Location l �{ ��e ��C ! �— Suite 0 3-o v LI 4 1
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - 60 'C 3
Footing C — 5 ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: — A SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ' 7 4 \ ' �� 1- T)--A6
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
PA ` L FAIL
CHANIC`'
Pos : eam
Rough -In ► lJ
Gas Line
Smoke Damper
PART FAIL
ta
Rough-In .� lrli
UG /Slab put9
Low Voltag Fir- ',lam
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
1�4i. PART FAIL
SITE ❑ Please call for reinspectior RE: • Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date I Inspector A — Ext
Other:
Final DO NOT REMOVE this inspection record fro the jo .. site.
PASS PART FAIL