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Permit CITY O F TI GA R D ELECTRICAL PERMIT P ERMIT #: ELC2001 -00008 4 DEVELOPMENT SERVICES DATE ISSUED: 1/9/01 I ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BA -00800 SITE ADDRESS: 12155 SW GRANT AVE A SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: I -P BLOCK: LOT : 059 JURISDICTION: TIG Project Description: Fire repair. Job No. 43410 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: 4 W /SERVICE OR FEEDER: 40 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: SEE -ZER PROPERTIES FRIBERG ELECTRIC CO 26785 SW NEILL RD 4636 N WILLIAMS AVE NEWBERG, OR 97132 PORTLAND, OR 97217 Phone: Phone: 288 -5161 Reg #: LIC 1329 SUP 2543S ELE 26-51C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 1/9/01 $587.00 2720010000( Elect'I Service Elect! Final 5PCT CTR 1/9/01 $46.00 2720010000( Total $633.00 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 - 01 -41 0 through OAR 952 - 001 - 00 0. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. � c c , - 2� c Permit Signature: ` 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: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day 1A CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00008 DEVELOPMENT SERVICES DATE ISSUED: 1/9/01 anual 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 102 BA -00800 SITE ADDRESS: 12155 SW GRANT AVE SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: I -P BLOCK: LOT : 059 JURISDICTION: TIG Project Description: Fire repair. Job No. 43410 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: 4 W /SERVICE OR FEEDER: 40 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: SEE -ZER PROPERTIES FRIBERG ELECTRIC CO 26785 SW NEILL RD 4636 N WILLIAMS AVE NEWBERG, OR .97132 PORTLAND, OR 97217 Phone: Phone: 288 - 5161 Reg #: LIC 1329 . SUP 2543S ELE 26 -51C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT CTR 1/9/01 $587.00 2720010000( Elect'l Final 5PCT CTR 1/9/01 $46.00 2720010000( Total $633.00 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 OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE / ISSUED Y: 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 i SIGNATURE OF SUPR. EL TUN: -A ! %:• � DATE: LICENSE NO: 015 5 Call 639 -4175 by 7:00pm for an inspection the next business day ■ 12=15/00 FRI 11:04 FAX 503 598 1960 CITY OF TIGARD (j00 • q e('' Electrical Permit ;pp t Datereceived: /a /7-0o Permit no.: • .r .� of Tigard Pro ccVa 1 no.: Ex iredate: r•" Address: 13125 SW Hall Blvd, Tigar,i ' OR 97223 1 � J pp p City of Tigard Date issued: By: Receiptno.: Phone: (503) 639 -4171 ��� • Fax: (503) 598 -1960 �� Case file no.: Payment type: Land use approval: . ' , : TYPE PERA _.: ".. . 0. 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement O New construction 0 Additic n/alteration/replacement ❑ Other. 0 Partial • ,. JOB SITE INFORMATION - - Job address: 12155 SW Grant Bldg. no.: Suite no.: Tax map/tax lot/account no.:. Lot: IBlock: (Subdivision: Project name: 43410 Descriltion and location of work on premises: Electro static refinishing Estimated date of completion/inspection: • ', CO \TItACUOR APPLICATIO , . n .. FEE SCIJI:DULE Job no: 43410 Fee Max Business name: FRIBERG ELECTRIC COMPANY Description Qty. (ea.) Total no. insp New attached Address: 4636 N. Williams Avenue rage. dwelllnguait. includes attached garage. City: Portland I State: OR 21P: 97217 service included: Phone: 288-5161 I Fax: 288 -1930E -mail: 1000 sq. ft or less 4 CCB no.: 1329 I Elec. bus. lic. no: 26-51C Each additional 500 sq. ft or portion thereof Limited energy, residential 2 City/metro lie to.: 4663 Limited energy, non- residential 2 �_ ' Each manufactured home or modular dwelling ' . attire of supervisin: ectrictan (required) Date 12/15/00 _ Service and/or feeder 2 - Scrvicesor feeders - installation, Sup. elect name (p n i' 0 „, ' I it •. case no- alteration or relocation PROPERTY OWNER 200 amps or less 4 321 z Name (print): • 201 amps to 400 amps _ 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: 12 SP: Over 1000 amps or volts 2 Phone: I Fax: I E-mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchangy according to installation, alteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: D2 e: 401 to 600 amps 2 ENGINEER • Branch circuits - new, alteration, or extension per panel: Name: . A. Fee for branch circuits with purchase of • 40 266 Address: service or feeder fee, each branch circuit 2 City: I State: I 'e :IP: B. Fee for branch circuits without purchase Phone: Fax: E of service or feeder fee, lust branch circuit: 2 Each additional branch circuit: ' PLAN REVIEW (Please check all tha apply) '. M[ sc .(Serviceorfeederuotincluded): O Service over 225 amps - commercial 0 Health -care facilit y Each pump or irrigation circle 2 O Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2 family dwellings O Building over 10,1100 square feet four or Signal circuit(s) or a limited energy panel, O System over600 volts nominal more residential u nits in one structure alteration, or extension* 2 CI Building over three stories 0 Feeders, 400 amp i or more +Description: O Occupant load over 99 persons O Manufactured stn ctures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan 0 Other Per inspection I 1 I Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary consti action service. Other ' Not an jurisdictions accept crodit cards, please call jurisdiction for more infi rmation. Notice: This permit application Permit fee $ 5:81,11:11._____ . O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ i6 00 Credit card number. / / within 180 days after it has been State surcharge (8 %) .... $ Esp res accepted as complete. TOTAL $ _633.00 Name of cardholder as shown on credit card $ Cardholder signature Am( out 440 -4615 (6t00ICOM) ■ /,7 iF - CITY OF TIGARD BUILDING INSPECTION DIVISION . MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested � �/ 7 AM PM BLD • Location / Z / J S 5' Suite / MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: 1 �� n _ Slab (/ I ? SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing, _ /� ,, Firewall L �l l F �`+ F� — 26- d / AA Fire Sprinkler pl j4/4. I/7 Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL / PLUMBING; . ( ! '^ F / » / Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains _ Final PASS PART FAIL ' MECHANICAL-;' Post & Beam C r Rough In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough In UG /Slab Low Voltage F larm SS ART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before ne spection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 7 / Inspector .4 V Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION ySY F _ 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUS' Date Requested AM PM BLD Location / Suite L3 t". MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 2O o eZeD Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear • Int Sheath /Shear Framing Insulation . Drywall. Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof G� l/ f > Misc: Final • PASS PART FAIL PLUMBING . b Post & Beam Under Slab Top Out Water Service Sanitary Sewer 1 Rain Drains \ ■c) Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Fin- S • FAIL ELECTRICAL Rough In . UG /Slab Low Voltage Fire Alarm 40 1 PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk — 2‘ D / Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 - BUP Date Requested S, Z r AM PM BLD Location /2_150 $4- f`6, d 5 Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing • Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing, Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof Misc: Final PASS PART FAIL • PLUMBING M/Z l/ 5 r: Post & Beam Under Slab ✓✓ Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers - Final PASS PART FAIL (EC CTRI.CAA Service ■ C Rough In UG /Slab Low Voltage Fire Alarm ® � ART •FAIL 4/W ART Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required bef• e next ins,ection. :t City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: i' able to inspect - no access ADA Approach /Sidewalk Date ' / / D, Inspector a• j / � � Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST • BUP _ Date Requested 4. AM PM BLD Location / Z��� ski ) ?" I Suite 5 MEC Contact Person J Ph 2. �'� I PLM Contractor Ph SWR BUILDING Tenant/Owner ELC »t)/ o ) ' Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling r 4 A Roof Misc: • Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer • Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PA$ PART FAIL IkLECTRIC J S� UG /Slab Low Voltage Fire Alarm . a PASS PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk � /Inspector Date ° A 4 _ 410. 4.4 .. Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.