Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00355
AoIl, i�� DEVELOPMENT SERVICES DATE ISSUED: 6/16/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S111 CC -19100
SITE ADDRESS: 10345 SW GREENLEAF TERR
SUBDIVISION: SUMMERFIELD NO.5 ZONING: R -12
BLOCK: LOT : 250 JURISDICTION: TIG
Project Description: 3 circuits: AC, furnace and service plug.
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: 2 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:
MICHAEL WALTERS BOB'S ACTION ELECTRIC INC
10345 SW GREEN LEAF TERR 2700 NE BURTON ROAD
TIGARD, OR 97224 STE A
VANCOUVER, WA 98662
Phone: 503 - 684 -1295 Phone: 360 - 254 -7200
Reg #: SUP 4322S
LIC 53136
FEES ELE 37 -431C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/16/2004 $60.15
[TAX] 8% State Surcharge 6/16/2004 $4.81 Rough -
Elect'l Final
Total $64.96
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:
0/ a � di
1//‘ ` jL /' A , / " � Permit Signature: � j
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
d 50359810130 CITY OF TIGARD @03
•
• !lip " 11 10
it Ap licatioa # FOR OFFICE, USE ONLY
T igard C�, i V E D a R e c ei ved, / / " 57 ,, .6,� Permit No. t a f -C�U3 5s
Hall Blvd Tigard, Tigard, OR 9722 Plan P.evin f
?hone: 503.639.4171 Fax: 503.598.1960 �
• i v 200 'r"�r 47i ti , \ at
Ddl3y: Otlrcr Permit.:
Inspection Line: 503.639.4175 -ir ► ' ji Date Ready/By rori+ Sec Pagc 2 for -
Internet: vnuw,ci.tigard.or.us Noti6ed/Metbed: 1 /� Supplemental Information
nm •ro , z• , V ♦ T,1, i ;Z pat lste „ 1
'177,70.777,., .1 ; . 1 ,
t .Ni t �' j 5i�f) �` 5 t�; 1� ' + r.y� r l 1' •r h a ■it 1 �,t F 9
t 01 1 r �l Ci��(I74 .!Ill - ' .)
i 1 ...� .,:.. , N1 Y s 4'" � ril s' i n: t. 1.tl'�Ptt� aurikw` ..,
'r� 6 :ltl�. a. �:, cL a 'te t!'. j t.. �'.TI'.i :.,.. �Y..ail,.,a:e �s. � • � 7'�'fkL } l�l
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, cornm'I ❑Hazardous location
❑ Demolition ❑ Other ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
; T7i j 1 / it • . 5 T ie n `; tII'f, l{ .11 4kii P D die; Tifi oJigtf>rtr rrj 1.';'',, tr tj ^t d , mfg of 1 - and 2 - family dwellings 4 or more new residential
4.'" h:llhlihkil'.Jtdr: r�I kcl.Grri T�!Ir1'YratiL. :l, ,. :' i r , r_•aa!f�•, i .rR :._ I� ,l. L,. ... '
® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal unite in one structure
❑Feeders 400 amps or more
stories r
v ton
Buildirt over threes
❑ Multi- family ❑ Master builder ❑ Other_ ❑ g persons Manufactured structures or
pecupant load over 99 crsons ❑
t, i . i�1''3,1i - �i'�t"''', * ri 1S�Inrl:
r lr lili•; r t :��'nc trills l
ft!f�]'i I t i 7 . 1 10 : :l I hting RV park
I1rr f-...v.I,.i1 : 0 11 , �tt' : J .al�tt,�,rl r♦ ..,ASI ,4 r, 1 !•sits .l+lt.. ;- finT_,.ti .t- .- .ru, °a..r� .'.1v ❑Egress/lig
'r{-J.. k.. ❑Other:
Job no.: J s a dd r ess:
01-care f aci li ty
04 -507 10345 SW Greenleaf Terrace_ Submit sets of plans with any of the above
City/State/ZIP: OR 97224 The above arc not applicable to temporary construction service
Ti and . „,- 4 ta..ra.. . r r.
g I I t l lia a :.....11 . , 1 1.k a t � Q ry ' N7 " ! " i.i:: ,
Suite bldg. /apt no.: Project name: i)teeetptron Qty. Pee. Total •'
Cross street/directions to job site New residential single or multi family dwelling unit.
Includes attached garage.
1,000 sq ft or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
- Limited energy, residential 75.00
energy, non- residential
Tax map /pares no.. Limited gy, 75.00 2
rz rte, 1 1 1 t 1 n.+^ r D ti i7 it •7tjl >,a h. Ir . Ill y, . Il r+t -
o r t I t VIII " I f A�1:� S � ,Y; . u ...\,.(r,71 i t L +, o4i tie ',f;1 r e .: Sti: h' Each manufactured or modular
�iR...,,i...et� ±
, .alr ,�.1��L ..ni,. L •ts$:.I 1.�.1� t..�tu::iwJ.Lt,.U... .,:r•
dwelling, service and /or feeder 90,90 2
3 circuits for furnace, A/C & service plug Services or feeders installation, alteration, and/or relocation
200 amps or loss 80.30 I 2
,rr�eM r - �s.n:- ara�-� ,, ^!r �, t�- t a ,; .$, � t,,. ii�r 4 " ., 201 amps to 400 amps 106.85 I 2
.,,P.1 ' r!!!! �' l ; . 1ltis i, SI' ' r 1 j i F ,. , , . 1 Y•, $1 A':
F - � , i E lti L • iI fi rk' f a •} :0 ' 4f r':' r A l . �1A°i:4zi3O4.. � i. a � 1' . '; i rr Vdi �l1 133 - ;:JI , str..t,. Igl t 2, IF,�' -, - ,
t11'fi.� ;x�::, .
. a,,rt,t, :. x;.! t: :,,i.:!.LI_JLJ•.ai..ln. a'.... ,.:,_..�.x L .Li 1 401 amps to 600 amps 160.60 _2
LceaJ.,) r
Name: Mike Walter 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address:
10345 SW Greenleaf Terrace Reconnect only 66.85 2
City/State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or
relocation _
Phone: ( 503 684-1295 Fax ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 I -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: 1 I i Date: Branch circuits- new, alteration, or extension, per panel -
3�.: a,'.., : tff.,11 7 iilil ` U�?ly �:.wi,. �i "' 1.$1i I; t ]�6xgi�gy�ni j , f y `l�0..zA ;,, i r111L!iiri:. A. Fee for branch circuits w
service or feeder fee, each 6.65 2
Business name: branch circuit
- B. Fee for branch circuits
Contact name: without service or feeder fcc, 1 46.85 46.85 2
each branch circuit
Address: _ Each add'l branch circuit 2 6.65 13.30 7 1
City /State/ZIP': Miscellaneous (service or feeder not Included) i
Pump or irrigation circle 53.40 2 '
Phone: ( ) ( Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuits) or limited-
'. it f � 1f itm, iii:'; ' ., rA�;lttC(, � I i rLt + yi6 S i4, .,,' I � .�: ° l } . • F t +''I' r energy panel, a lterati on, or
.11L LLe- ..:..1... T L( I•' sn.sl.tlr i._r .e � ,.. • 4I1.d..t11M1 1,. i
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Each additional Inspection over allowable in any of the above
Address: 2700 NE Burton Rd. "A"
Per inspection 62.50
City/State/ZIP: Vancouver, WA 98662 Investigation per hour (t hr min) 62.50 •
Industrial plant per hour 73 75
Phone: ( F ax p ". -Rg.. t' :`a ° ,<° lit '�. ' I' �,'',. .
360 254 -72 : ( 360 ) 254 -8219 i' ��,; ,�I;' t �-MISI'e�� i,1!:'I tSI ,•,1 ��tt4.. ;i .:r., : .
CCB Lic.: 53136 i Electrical Lic:: 37 -431C1 Suprv. Lie.: 4322S Subtotal 60.15
^ Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fcc) 4.81
Print name: Kevin Br sel e / f Date: 6/10/04
/ / �, � r'✓ � TOTAL, PERMIT PFRrT FEE, 64.96
/f �
Authorized signature: '/ This permit application ecpirea it a permit Is not obtained within 160
/ days after It has been accepted at complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
-- - •• Number of inspections per permit allowed.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received Received Date Re•uested O Cr AM PM BUP
Location S 411 ! ' ice Suite MEC G - 0
Contact Person Ph ( ) PLM
Contractor Ph ( SWR
BUILDING Tenant/. .�.:r2� Gl t `S
7o - SG 0 ELC oO LL - TIO �
Footing c* 1� _
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 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 Line C l 14
1
Gas Line
Smoke Dampers
‘S FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fi larm
:1741 PART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA /
Approach/Sidewalk Date ,� � Inspector ,L r_ Ext
Other:
Final DO NOT REMOVE this inspection record from the Jo ' Ite.
PASS PART FAIL