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Permit • 9-1 —0 & �� Ia- -f/l t Lam/ _ - - / ELECTL PERMIT CITY OF T IGA PERMIT #: ELC2004 -00040 i DEVELOPMENT SERVICES DATE ISSUED: 1/29/2004 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S135AA - 01400 SITE ADDRESS: 10215 SW HALL BLVD SUBDIVISION: METZGER ACRE TRACTS ZONING. C -N BLOCK: LOT : 037 JURISDICTION: TIG Project Description: Install (6) branch circuits. 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: 5 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: INTEGUMEND LLC BOONES FERRY ELECTRIC INC 9495 SW LOCUST ST PO BOX 628 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: Phone: 503 - 682 -4936 Reg #: SUP 4918S LIC 88482 FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/28/2004 $80.10 [TAX] 8% State Surcharge 1/28/2004 $6.40 Electrical final [ ELPRMT] Investigation 1/29/2004 $80.10 Rough - (additional fees not listed here) Elea! Final Total $229.10 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. Issued By: &ale-A-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 • CITY OF T I GA R D v ELECTRICAL PERMIT PERMIT #: ELC2004 -00040 I DEVELOPMENT SERVICES DATE ISSUED: 1/29/04 13125 SW Hall Blvd.. Ti lard. OR 97223 (503) 639 -4171 PARCEL: 1S135AA-01400 SITE ADDRESS: 10215 SW HALL BLVD SUBDIVISION: METZGER ACRE TRACTS ZONING: C -N BLOCK: LOT : 037 JURISDICTION: TIG Project Description: Install (6) branch circuits. 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: 5 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: INTEGUMEND LLC BOONES FERRY ELECTRIC INC 9495 SW LOCUST ST PO BOX 628 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: Phone: 682 -4936 Reg #: SUP 3170S LIC 88482 FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/28/04 $80.10 [TAX] 8% State Surcharge 1/28104 $6.40 Rough - [ELPRMT] Investigation 1/29/04 $80.10 Elect'I Final Total $166.60 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 1-80 32 -2344. Issued By: . e,A.. C— I azAJ Permit Signature: G} _ 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: 3 / 7 0 S Call 639 -4175 by 7:00pm for an inspection the next business day Jan -27 -04 04 :23P rq � P_ '' `f' : Ele Pe 111 , : '..,' �r ; . r� o n � ivcid 1 ' r ay® DatriRy' / ak -123 4 r f',/ pettmdt No.' City of Tigard JAN 2 7 2004 Planning Approval , Permit ; — Date/By: Pe No.: 131 25 SW Hall Blvd. CITY OF TIGARD . Plan Review Other Tigard, Oregon 97223 ^'A' � �t f Date/By: Permit No,: — UI 13 1 ®N Post- Review Land Use Phone: 503 639- 4171 8X: i %a.' ci, Date/B : Case No.: Internet: www_ci.tigard.or.u5 _ d j. I' ctm luris : See Page 2 for 24 -hour Inspection Request: 503- 639 - 4175 "" - ^ Name/Method: - .,_1:K.A Supplemental Information, : �t?V - x �*' - s a - ^'.i• RE (ei a silk i ghat a 4 p1y .5 ` - _ ?r . - .F. ORK?'`� :i: �,it���i' ,y wt ;PL'AN' Y�iEW.' Pl • New construction Demolition — 171Te7;ice over 225 amps ❑ Health -care facility commercial 0 Hazardous location Addition/alteration /replacement Other: ❑ Service over 320 amps - rating of ❑ Building over 10.000 square feet. • • *:'i,• ..'0ATCGOR F,1 `oNSTRU •'` ?' ' . ' f' I & 2 family dwellings four or more residential units in • [] I & 2- Family dwelling ommercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three Stories ❑ Feeders, 400 amps or more • Accessory Buildin : • Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV part. • Master Builder IN Other: 0 Egress/lighting plan ❑ Other: r Submit _ sets of plans with any of the above. �v� srrE •n�o • ON lit a ,ax ON 'ar;,x Job site address: 1 O 1 ) s Ski 1 all p / v r The above are not a lie-able to tern ra construction service. -_ Suite #: I Bldg. /Apt, #: T Number of inspections per permit allow.,. Project Name: �� it a .I• o'er J 1/ Description 4 � Qty Fee (ea.) Total Cross street/Directions to job site: New residential - single or multi-faintly per dwelling unit. Includes attached garage - Service Included: 1000 sq, ft- or less 145-15 Each additional 500 sq, ft. or portion thereof 33.40 • Sul)di ViSi011 :, _ I Lot #: energy residential - 75.00 Limited energy, non residential 75.00 Tax ma 8/ arc el Each manufactured home or modular dwelling ? r 1F ... 2 I . :1 r • -4 1 _ service ancVor feeder 90.90 ^1 .r x.3'1' Services or feeders - insullatlo4 A V " N C r I. Cy' 3-1.-,4;:e" s T alteration or relocation_ 200 imps or less 80.30 ., - 201 amps to 400 amps 106.85 401 amps to 600 . amps 1 160.60 P1 .. � . {z . - a fk 7, : r 601 amps to 1000 amps 240.60 1'ROPEIt1'Y i , %' s';_ i r ,ek ' i, . ,_ , Over 1000 amps o 454,65 1 r volts Name: /n '1. , < t/,-, v.,, 4_- L I t Reconnect only 66.85 Address: *7 s S v / r3 e v : / 'r 1 Temporary services or feeders - installation, alteration, or relocation: City /State/Zip: e %J \ 0 iE' 7 7 :2. L i' 200 amps or l ess 66.85 •._ Phone: Fax: 201 . to 400 amps 100 -3 401 to 600 amps 133 -75 APPI.IC API> :, a .,. 4 r Br anch eireuitx - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address. _ service or feeder fee, each branch circuit 6.65 B. Fee for branch circuits without purchase of — City /State!Li _ _ � � 1 service or feeder fee, first branch circuit l 46.85 Li t; . a S Phone: I Fax: _ Each additional branch circuit -. .5 6.65 ''s • - E -mail: .. Mise.(Scrvice or feeder not included): < „ 1 . �. -,,, c'- F_.. pu mp ar irrig circle 53.40 'tk = �" `' , t " Y ''' �` R O� "Ih ' . - '' "r''�`' Each sign or outline lighting 53.40 Job No: : . Signal circuits) or a limited energy panel, _° — ahctation, or extension Page 2 Business Name: Boones Ferry Eleetr,i,r De Address: P . 0 . Box 6 2 8 - - - Each additional Inspection over the allowable in any of the above: Cl [y /S[ate/Z,lp: W x ] $ O ri v j l l e - Q . R � 7 0 7 Q Per inspection per how (min. 1 hour) G2.50 . 1110110 : 82 - 4936 Fax: 682 -7946 Investigation fee: CCB I.ic. #: 8 8 48 2 / . 1c-sr- Other: .51; A' 4 .. -'" . ' i �°,: ' i Subtotal $ - -- 3 ' 7.7.30 ' - Supervising electrician / - 8 0 1 0 signature ref uircd: .�/ � _ Plan Review (25% of Permit Fcc) $ _ :— . i ' /� � - -- 4 - S tate Surcharge (8% of Petmil Fee) $ 0' . ` C` — Print Name: ��� o r>� I,ic. #: S 1 �ll� i TOTAL PERMIT FIEF $ 96. s o .... Authorized Noiicc: This permit application expires it a permit Is not obtained withit Signature: • .._ Dale: 180 days after It has been accepted as complete. "Fee methodology set by Trl -County Building Industry Service Board- (/' — .._. (Please print name) .. . — - -- • ( - "d 1 1 'g/ ' Leta t"-- -- i :U)sts\I'rrn Foi iris \F.IcPctmnitAplt.drx 01 ; 0 3 / t, d '7. eix'#) , 1' - ' 2 /Z AGD ti t e 20'l0 CITY OF TIGARD 1/29/2004 13125 SW Ha11 Blvd. 11:49:06AM a aiNikt �i��� Tigard, Oregon 9722 (503) 63 9-4 17 1 Receipt #: 27200400000000000337 Date: 01/29/2004 Line Items: Case No Tran Code Description Revenue Account No Amount Paid EILW004- 00040 [ELPRMT] Investigation Fee 220 - 0000 431510 80.10 Line Item Total: $80.10 Payments: Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Credit ard - to O©] °a3P Man= BB +01144,x,' Fax 80.10 1 Payment Total: $80.10 / SALES DRAFT ' ' CITY OF TIGARD ` � 13125 SW HALL BLVD \� T OR 97223 �" '503) 639 -4171 4 3 1347988364795 \ I " ..)1/4j---.. 4 TID :43:884;0::0::01THU 79367 DATE : 0 104 11:4:6 \ ' e 4 ' jj k ACCT : 140 $0441413229 VI ik BATCH : 621 4 TARN b: 3390 1 1 \ A ik/ - MOUNT : $80.10 d /` f THANK YOU. PLEASE CONE AGAIN, PROVAL: 019284 S CODE: B (ZIP CODE MATCH) Page 1 of 1 cReceipt.rpt CITY OF TIGARD 24 -Hour (f . , BUILDING Inspection Line: - 503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested — O AM PM BUP Location I 1 :C - - N.1 S Suite �y MEC Contact Person A$1 Ph (',�O 3 )' 9 ` 4 1b PLM Contractor .at b W � �l. tv7 a Ph ( ) SWR BUILDING . Tenant/Owne ELC y� Footing ELC 1 — ba 0 H b 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 PARR ,P� Service FAIL CC TT Rough -In UG /Slab Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. '■••-.21/� PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date S Inspect c a Ext Other: Final - _ DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour . BUILDING Inspectioti Line (503) 639 -4175 INSPECTION DIVISION Business Line: (503) .n ips IMr. %, MS � v4 % } J/ � : ■, v im ■_' Received Date Requested, 9 7 AM ' __! • ; BUP `= ' Location JO 2_1 L pL a.1L 6-&) - Suite . -K MEC Contact Person Ph (S03) (082- 9 3 Co PLM Contractor "W.' /A 2_40 —L:� _ f • Ph ( ) SWR c / BUILDING Tenant/Owner L C �'�i ?� Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam " Shear Anchors Ext Sheath/Shear Int Sheath/Shear QD @Rto 6- fL I I P(4)76 ‘60 � v FvTv Kg Framing 1 1 Insulation ® A Z75 �L ` Drywall Nailing °°�� Firewall Fire Sprinkler Fire Alarm P�V e SQL ?(t t1 R : N 4 Susp'd Ceiling n r ' Roof N '6-. 1 1'�L� -. 14)We - x3 ()s0 Other: (� D,,��� [`' Final ��11\ - a(L ) C6 1 F V9S1Y 1 >I.. LE tic 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 j Low Voltage larm Fin I AIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA ,1 Approach /Sidewalk Date `I • Inspector N 6 B L Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Liner (503) 639 -4175 INSPECTION DIVISION Business Line (503) 639 -4171 MST ,D BUP Received / 7 0 Date Re uested aneVO �`' AM PM BUP Location `(1 � a Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( 't2 493 ' SWR BUILDING Tenant/Owner eP.ce44.,vv■ Oak - 4111M -7,05 Footing Foundation ELC 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 S Fire A \A) L �h� 00 'v l larm , y\ \ ` O { R Ceiling N � I f Othe Other: VNJ 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 tN c t j Q�� - ough- n ab Low Voltage Fire Alarm Final ❑ 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 — Inspector Ext Other: Final DO NOT REMOVE this Inspection record fro the jo site. PASS PART FAIL I I VI I I I II 11.0 - • • - -. BUILDING Inspection Line: (503) 639 -4175 • MST ;PECTION DIVISION Business Line: (503) 639=4171;: BUP lived Date Requested �' O AM PM BUP tion 1 ) ��� < 1 -A-. 1 -A-. Suite MEC {- act Person � `\ Ph ( ) �f 9 ' 4 4 -6 / n PLM ractor b \° .,. {)\ Ph (— ) SWR A 605i-0 ILDING Tenant/Owne ELC I � )ting ELC - 660 1b. indation Access: Drain ELR wl Drain b Inspection Notes: SIT I & Beam :ar Anchors Sheath /Shear Sheath /Shear ming elation wall Nailing wall Sprinkler Alarm >p'd )f per: al SS PART FAIL UMBING. ;t & Beam ler Slab igh -In ter Service )itary Sewer n Drains :ch Basin / Manhole rm Drain awer Pan ier: al ASS PART FAIL :CHANICAL ;t & Beam ugh -In s Line • oke Dampers al ASS —PART FAIL EC-T-RLCAL vice ugh -In 1/Slab v Voltage Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. AS PART FAIL I E Please call for reinspection RE: ❑ Unable to inspect – no access Supply Line A oach/Sidewalk Date — c J Inspector l!' - 1 - •7 Ext ier: al DO NOT REMOVE this inspection record from the job site. ASS PART FAIL