Permit C ITY O F TIGARD GARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00483
'''ok DEVELOPMENT SERVICES DATE ISSUED: 8/6/03
13125 SW Hall Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CB - 00100
SITE ADDRESS: 1 / F) - ' S S A' ANT ST
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R - 12
BLOCK: LOT : 041 JURISDICTION: TIG
Project Description: JOB NO. 90264 Install 400 amp temporary service
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: 1 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:
TIGARD - TUALATIN SCHOOL DISTRICT #23 NEW TECH ELECTRIC
6960 SW SANDBURG RD 1400 NE 48TH AVE
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Phone: 503 - 648
Reg #: LIC 41868
SUP 2113s
FEES ELE 26 -418c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/6/03 $106.85
[TAX] 8% State Tax 8/6/03 $8.55 Elect'l Service
Elect'I Final
Total $115.40
This Permit is issued subject to the regulations contained in the Tigard Muniopal 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
08/05/03 TUE 12:38 FAX 503 648 3131 NEW TECH ELEC 10] 001
s
.
` Electrical Permit Applications ,
Date received: 43 ® Permit no. / - o . ?i
du4:y - of 1
. ,`11 City o Tigard Project/appl. no.; L tia . A Expire date:
City of Tigard
Address: 13125 SW Hall Blvd, Tigard, OR 97223 B Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
. Land use approval:
TYPE OE PERMIT -
0 I & 2 family dwelling or accessory Commercial /industrial 0 Multi family 0 Tenant improvement
❑ New construction ❑ Addition /alteration/replacement ❑ Other: 0 Partial
Job address: /7 ..541 5 64T Alve Bldg. no Suite no.: Tax map /tax lot/account no.:
Lot: Block: 'Subdivision:
Project name: eF -17 p E1. J jr . h cscription and location of work on premises: 7i 74 0 . r... ' s ter. i J
Estimated date of completion/inspection:
Job no: 902Ls1 Fee Max
Businessnatne: New Tech Electric, Inc l�criplion Qty. (ea) Total no. insp
New residential - single or multi - family per
Address: 20811 N9 Cornell Rd Ste 400 dwelling unit. Includes attached garage.
City: Hillsboro I State: ORJ ZIP; 97124 Servlceincluded:
Phone5 i Fax648 -3131 1E -mail: P000 sq. ft. orless 4
CCB no.: 4186 B I Elec. bus. tic. no: 2 6 -c} 18 Each additional 500 sq. ft. or portion there
Limited energy, residential 2
City /metro lie_ no_: Limited energy, non- residential 2
. '--'' - . ✓� Fla -- Each manufactured home or modular dwelling
Signal re ofsuy r sing - ectrician(required) . ate Service and /or feeder 2
f / Services or feeders - Installation,
MI
Sup. elect.. (print): i.. _� 0 ` _ License no: • g2crr ..
alteration or relocation:
PROPERTY OWNER. 200 amps or less 2
Name (print): e,, Q - ni,44477Ai . l/1 . 405,7- NQr 2) 201 amps to Ono amps 2
401 amps to 600 amps 2
Mailing address: 4 94.0 .. $,4,vv 971--gE " &I I amps to 1000 snipe 2
City: '?" Wet) State: • ZIP: a over 1000 amps or volts 2 '
Phone: So3 1-13 I -L ON Fax: E -mail: Reconnect only I
Owner installation: The installation is being made on property i own Temporary services or feeders - / '
which is not intended for sale, lease, rent, or exchange according to tnstallation,alteratia J
ORS 447, 455, 479, 670, 701. 200 Imps or less D - 2
201 amps to 400 amps --r-716t 2
Owner's signature: Date: 40I to600am.s 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: .. A. Fee For branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Pee for branch circuits without purchase
of service or feeder fee, firgt branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
0 Service over 225 amps- Commercial D Health -cure facility Each pump or irrigation circle 2
^
O Service over 320 amps - rating of lea El Hazardous location Each signor outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in oneawcture alteration, or extension' - 2
0 Building over three stories ❑ Feeders, 400 amps or mom *Description:
CI Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
Cl Egress/lightingplen 0 Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service, Other Q( t gz
Not all junsdictions accept credit cards, please call Judadicrim for more informohon. Notice: This permit application Permit fee $ s
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ T • .54 7
Credit card number: / / within 180 days after it has been State surcharge (8%) __ $ ar/
Frtplrca accepted as complete. TOTAL $ _ -
Name of cardholder as shown on credit card
a
Card)tolder signature Amount 4404615 (6/00/COM)
— Te-usi ' A e.COu i+ - — / / Si Lf 0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
ate
Received l/5 f�:3n Requeste , / — 0 � AM PM BUP
Location / Suite MEC
Contact Person j .5 Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner C- (3 () ) 'V(1
Footing U
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
Rough -In
UG /Slab
Low Voltage
'r
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE _ 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date / 2:3 a Inspe ��r L— Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL