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Permit i A CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00258 DEVELOPMENT SERVICES DATE ISSUED: 5/8/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BC -00901 SITE ADDRESS: 12805 SW GRANT AVE SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R-4.5 BLOCK: LOT : 029 JURISDICTION: TIG Project Description: Installation of 2 branch circuits for furnace and AC. 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: FRIEDRICH, SHERREE R HILLSBORO ELECTRIC 12805 SW GRANT AVE 21185 NW EVERGREEN PARKWAY TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: Phone: 503 - 439 -9666 Reg #: ELE 34 -433C LIC 134481 FEES SUP 4240S Description Date Amount Required Inspections [ELPRMT] ELC Permit 5/8/03 $53.50 [TAX] 8% State Tax 5/8/03 $4.28 Rough - Elect'I Final Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR. Speaalty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -80 32 -23 4. Issued By: ( . Permit Signature: 6 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELECC'N: DATE: LICENSE NO: %;. - Call 639 -4175 by 7:00pm for an inspection the next business day 05/07! 10:41 5036013680 HILLBORO ELECTRIC PAGE 02 7' Electrical Pe.�APlpl is alio n Date received:$ fl -U3 ' Permit no.: 51.4)..0.. -00� , yr � :,... City of Tigard RECEIVED FrojecVappl_ no_: Ezpirc date: CI y of 17gen, Address: 13125 SW Hall Blvd, Tigard, put 97223 Dace issued: By:: 13 Receipt no, Phone: (503) 639 -417I Fax: (503) 598 -1960 MAY 0 7 2003 Case file no.: Payment type: Land use approval: CITY OF TIGARD 1 1 _ n 1 l 8t 2 family dwelling or accessory CI Commercial/industrial ❑ Multi - family CI Tenant improvement Cl New construction addition /alteration/replacement O Other: _ ❑ Partial rt,ali x11 1 1 \I 0401 l I IO\ Jab address: j 705 S, w, a- ; Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision.: Project name: Ski.akpj E Fa, gale sex I Description and location of work on premises: 14.(t nap Is, 4 k RAT Mr Estimated date of cam letion/ins lion: Job no: # l (el! Ftta usenet Business name: H i 1. 1 s b o r o Electric, LL C 0.+7 _ ('"`) T'p owl Address: 21185 NW Ever • reen Pkw Ste 104 New r.sldarrr.w JweMlagsssit .)Ioshmbentorisslpaaha City: Hillsboro State: 0 E ZIP: 9 71 2 4 sea, ter seinardt Phone:4 3 9 — 9 6 6 5 I Pax6 01— 3 6 8 0E -mail: 1000 se.. or )ens - -- ,_ 4 CCB n 13 4 4 81 ! Elec. bus. lie. no: 4 — 4 9 9 C Each additional 500 sq. It or portion thereof , Limited -.•-• r. , =Jacobi' 2 Ci /metro lic. 0.: Limited energy, aoamesidatNd 2 •, V x,: -- 5 -7 _. t 3 Eeoh minutaetured lane or mom dwelling S . of supervising electrician (required) bate Service and/or fcodar 2 elect. tune ( Vnt): J - V License ense no; 494]. S _ Suet ekms or 6.421 -111141111114616 dseminaorre1ocetioes Il'ItI 111 It 1 1 (1.11 \I It 200 or led* 2 Name (print): 201 unps to 400 amps 2 Mailing address: • 401 wipe to 600 amps 2 601 amps to 1000 2 City: State; ZIP: Over 1000 ...is or volts 2 Phone; Fax: E-mail: Reconnect only 1 Owner i n s t a l l a t i o n : The installation is being made on p r o p e r t y I own Tespoy terms or feeders - - Ineedle which is not intended for sale, lease, rent, or exchange according to dem ' rad4a ' errelecatiees ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's si tube: Date: 401 to 600 2 Breach eircolts - new, aiteratloa, or exteaaion per pod: Name: A. Fee fly breach circuits *it pine tease of Address: service or feeder tae, each branch circuit _ 2 City: State: ZIP: B. Foe fir branch circuits wtthox perdue. ff y of service or feodor foe, first branch circuit: i � 4 '4645 2 Phone: Pax: E-mail: each additional brooch circuit. .1 4. b4 1'1 V\ RI N. 1 t ii I i'It:i t In 1. ,;tii that airyph) axles .(Serrteect feeder boa lydrwlad U Service ova 225 proproommoaoiu CI licaldrene facility Each pomp at irripdioa circle 2 ❑ Serviaa war 320 amps -rating of 1&2 O Hazardous location Each si ii or outline li 4 2 &illy dovellins 3 8uild(ng over 10.000 square sleet four or Signal circuit(s) or a limited creamy panel © System over 600 volts nominal mote tridental unite in one structure alteration, or extension. 2 O Bonding over three stories Q f eery, 400 awe or mac •Description: O Occupant load over 99 persons CI Manufactured structures or RV park ' Raab idJMeaal Glspe ties over ths elrowmhie la arty eider ahem: o Egtmilitmtng plan a Otter: Sahalt arta of pion with say of the shove. Invaslipiion fee The above ars not applicable to teisporrry eaetrretleu service. other Permit fee —._ $ -5, �� Not all jurisdictions accept credit Cards, phase tall jaritd¢tloa for maw information. . Notice: permit application Pl review SL _ •/� 11�y'j • Visa Cl Maile:Caiti expires permit es if a t is not ObtBiaOd ( ) $ u • Credit rand n umber: / / within 180 days after it urns been State surcharge (8%) $ ii a Alf Expires wed mP TOTAL . $ _ 78 ' Name of oudhalder so rbown on credit cud IODC. $ Cardholder signature _- Atmunt F - 440461$ (6bNCOM) v CITY OF TIGARD' 24 -Hour • BUILDING - Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Life: (503) 639 -4171 MST e - BUP Received Date Requested AM PM BUP Location / ' g Suite MEC 3 a d Contact Person i l Ph ( ) 6 .0 - 3& 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC ��vZ k Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab I ction No s: ¢ jeielt SIT /11 Post & Beam Shear Anchors Ext Sheath /Shear r Int Sheath/Shear Framing Insulation Drywall Nailing Fi rewal I 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 M .�HANIC L rn Rough -In Smoke Dampers 4 0 PART FAIL Serve Rough -In UG /Slab Low Voltage Fire arm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE - Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date / 1M ? Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL