Permit CITY OF TIGARD ELECTRICAL PERMIT -
Ak RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2004 -00124
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/11/2004
SITE ADDRESS: 07125 SW HAMPTON ST PARCEL: 2S101AC 01400
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 020 JURISDICTION: TIG
Proiect Description: Low voltage: voice and data cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
DALBEY, KURT H NETVERSANT CASCADES INC
BY BEACON HOMES 9740 SW NIMBUS
7125 SW HAMPTON BEAVERTON, OR 97008
PORTLAND, OR 97008
Phone: Phone: 503 - 646 - 0533
Reg #: ELE 34- 589CLE
LIC 150328
SUP 2903LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/11/2004 $75.00 Elect'l Final
[TAX] 8% State Surcharl 5/11/2004 $6.00
Total $81.00
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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by / Permittee Signature OfrLI 2,21
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 7:00 P.M. for an inspection needed the next business day
05/11/2004 09:47 FAX 503 641 6613 NetVersant Cascades. Inc al 001
,•fit : r • .ft` ' �. _ _ t A,: l ; b��,- ,,,; r :?i i •'li +.:i�.i.�..
le gal 'erg #.t Sic � ti . . = LN,, 4'. 1 -,. ; :
f ‘ Datereccived- /fir '' Permitn•��'4 _ Ce'.!
VA 1 11 , City of Tigard
b 1. Projecdappl, no -_ Ex • ire date:
City e gard Address: 131? SW Hall Blvd, Tigard OR 97213 ' Datc issue
`6\ n ,
{ r�� Receiptno_:
Phone: (503) 639 - 4171 ��
Fax: (503) 598 -1960 \GA e file no.: / Payment type:
r\t Or ,
-, Land use approval: . _ ,v1S
0 1 & 2 family dwelling or accessory Commercial/industrial U Multi- family 0 Tenant improvement
U New construction 0 Addidon/alteration/replacement C/ Other. , 0 Partial
;:, . ,;, ' •-- - . RM -hUOL' -
Job address: IZ S 1:14A i to -. 1 +_. ii Bldg. no.; Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: 1 t i Description and location of work on premises: I ' ,. lk: r,
Estimated date of complctio t .t pection:
..._: • CONERA.CTnR: APPLICATION: - ,., .. FEE. SCHEDULE . .:::.:,::',:i. .< ,
Yob no: Q , 1)b (i 7 Fee 1VLmx
Business name: Net II , r i K — / S • ° .. • ' Arm Qty. (ea) Total no. insp
Address: - 9 0 $I,/ A. - - S '.A are.. Inc
[gAr M _ : Stare: OR ZIP: J 704 . Service include*
Phone: (p _ -05 ; Eimmrpm E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. r. or • orcion thereof m� —
CCB no.: l SD 3 Elec. bus, lie. no: y Cuir Limited energy. residential MEN 2
City /metro lie. no.: 'milli, Utilized energy,non- residential ME_ 2
t (, . r ' , S- 1 1 - 0 Each manufactured home or modular dwelling
Si-nature of su ervisin el , (-,• '.-�') •,t Service and/or feeder ■■ - 2
En1=1=MIVAM 1,1101 License no: 31 a ci art . t• Services &0D •
1'. RA OWNER 200 alteration a s or or relocation:
. 200 s te ps ls lin 2
Name (print): 201 amps to 400 amps ___ 2
Mailing address: 401 amps to 600 amps ___ 2
601 amps to 1000 amps ___ 2
City: On= ZIP' Over 1000 amps or volts IIMIMIIIIIIIII 2
Phone: Fax: E Reconnect only 11111.111111MI0
Owner installation; The installation is being made on property I awn Temporary services or feeders- .
which is not intended for sale, lease, rent, or exchange according to ins raiIation,alteration , orreiocufiw Ell
ORS 447, 455, 479, 670, 701. 200 amps or less z
201 amps to 400 amps ___ 2
Owners signature: ___ _ _ Date: _ 401 to 600 am • s __ — 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with pumhasa of
Address: service or feeder fee. each branch circuit 2
City: State: ' ZIP: a. Fee for branch cations without purchase
Phone: Fax: E - mail; of service or feeder fee, fast branch circuit ■ . 2
Each additional branch circuit: 1111111111
• .. '.. £EAN likr_VIEW (Please- check alli that apply)} Misc. (Service or feederaotincluded):
0Serviceover225amps- mmnaaia' • 0tiealth�refacility Each.uroporirrigationcircle ■� 2
Cl Service eve 320 amps -raring of l&2 0 laudoos 1oemion Each sign or outline lighting M_— 2
family dwellings Q Budding over 10,000 square feet four or Signal circuit(s) or alimired envoy panel, EIESMill
O System over 600 volts nominal more residential units in one structure alteration. or =tension
0 Building overtime stories 0 Femina, 400 amps or mote tDeseri •non:
0 Occupant toad over 49 persons 0 Manufactured street ms or RV park Earl] additional lospectiou over the allowable to any of the above:
0 Egtess/ligtningplan 0 Other_ Perinspcetitn
UMW.
Submit _sets of plans with any of the above. Investigation fen _ —
The above ace not applicable to temporary ennytrateflou service. Other
Net 21r jerbections accept crash eared, plmso call j ea for mace inrermatiort. Notice: This permit application Permit fee $ • Ob
Q Visa 0 expires if a permit is not obtained Plan review (at %) $
l � � vv (!' j 1 Within 180 days after is has been S tare surcharge (.3%) _ $ T 6 a
Ex accepted as complete. TOTAL 1.
Name of eardboldts sus Sbawn an ctetSit cool $ 5; Q 5 gap is c6wo+e0e-t1
pmoonu
CarrbtAd sivpu+u
CITY OF TIGARD , 24 -Hour --
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
C2
Received Date Requested AM PM BUP
Location _ a �� Suite MEC
Contact Person 49(4,(,t Ph ( ) 33® -170 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR —CV
Crawl Drain
Slab Inspection Notes: �� SIT
Post & Beam tilA
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation O t J � l N ,�✓ � q�
Drywall Nailing Y V
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
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /SIB
L.6 Volta
Volta
ire arm
. l r Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
VD PART FAIL
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA — — ' / y ��//��
f e'
Approach/Sidewalk Date Inspector ►"`M Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL