Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00388
DEVELOPMENT SERVICES DATE ISSUED: 08/06/2001
'� 13125 SW Hall Blvd.. Tiaard, OR 97223 (503) 639 -4171
PARCEL: 2S 110CA -00200
SITE ADDRESS: 11990 SW IMPERIAL AVE. LAUNDRY
SUBDIVISION: KING CITY ZONING: ?
BLOCK: LOT : JURISDICTION: KIN
Project Description: Job #311 Remove hot water heater from dedicated meter and reconnect to building meter.
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: 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:
WESTON INVESTMENT CO GEORGE + SONS ELECTRIC CORP
2154 NE BROADWAY PO BOX 339
PORTLAND, OR 97232 CLACKAMAS, OR 97015
Phone: Phone: 654 -8634
Reg #: LIC 35600
ELE 3 -117C
SUP 3185S
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 08/06/2001 $46.85 2720010000( Wall Cover
Elect'I Final
5PCT CTR 08/06/2001 $3.75 2720010000(
Total $50.60
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699 or 1 -800- 332 -2344.
Permit Signature: / ,
(7)1 Issued By: )
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: 6't (7 1+11[..-. DATE:
LICENSE NO: ,3 �5
Call 639 -4175 by 7:00pm for an inspection the next business day
•
Electrical Permit Applica
•
Datereceived: Permit no.:,;;„ , 00/ _a23,.
r ) City of Tigard .
Project/appl. no . - Expire date: -
r -- City of Tigard Address: 13125 SW Hall Blvd, Tigard, O 97223 Date issued: r -
Phone: (503) 639 -4171 t Receipt
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: • =
TYPE OF PERMIT • -
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial al Multi- family ❑ Tenant improvement
❑ New construction LII1 Addition/alteration /replacement ❑ Other: ❑ Partial
• JOB SITE INFORMATION -
Job address: //'?90 5 h ,, •,,! ai 1 Bldg. no.: Suite no.: Tax map /tax lot/account no.: " '
Lot: (Block: su bdivision: /A/44l'A i /t - ,wG C�Ty/4P
Project name: Description and locatt6n of work on premises :: ge ue 4fo /n f -Q,7er a vle
Estimated date of completion/inspection: Q I ed ill e7c t° co, h e * • 14 tvt v
CONTRACTOR APPLICATION • — �• "c:, ,. r - - - :- - : ' F FEE SCIIEDL>I E ' ::;.: - .
Job no: . 3// Fee Max
G'e m r � •e_ See•,, I c_G7 2 Description Qty. (ea) Total no. '
Business name: c�,
J New residential - single or multi- family per
insp
Address: Pa 5 331' dwelling unit. Includes attached garage.
City: Cc.lcMs 'State: az 1 ZIP: "70 /. Service included: .
Phone: 6$' V 86 3 7 1 Fax: 6'53 -ig861 E -mail: 1000 sq. ft. or less 4
CCB no.: _3,5600 1 Elec. bus. lie. no: // 7 _ C Each additional 500 sq. ft. or portion thereof
City /metr iC. no.: Limited energy, residential 2
2 Q QS Limited energy, non- residential 2
Each manufactured home or modular dwelling •
Signature of supervis g electrician (required) • Date 7.- -t Service and/or feeder 2
Services or feeders — installation,
Sup. elect. name (print): �' z, , License no: /, S= 5 alteration or relocation: •
" ' PROPERTY OWNER • .. ... ' 200 amps or less 2
s
Name (print): t° .A/ p • /h 201 amps to 400 amps 2
Mailing address: ,2/ s y , f 4 (w'9 y 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: ) 2:7)1( 1 State:DR 1 ZIP: 7 72 /o2, Over 1000 amps or volts 2 ' •
Phone:,z 9 02/ Y7 1 Fax: 1 E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders - .
which is not intended for sale, lease, rent, or exchange according to installation, alteration,orrelocation: •
•
ORS 447, 455, 479, 670, 701. . 200 amps or less 2
20) amps to 400 amps • 2 ' '
Owner's signature: Date: 401 to 600 amps . 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: 1 State: 1 ZIP: B. Fee for branch circuits without purchase / ;
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: / V& - 2 -
Each additional branch circuit:
. PLAN REVIEW (Please check all that apply). Misc. (Service or feeder not included):
O. Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 '
O Service over 320 amps -rating of 1&2 ❑ Hazardous location • Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extensions - • .2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
O Egress/lightingplan O Other:
Per inspection f I I • 1 -
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ V ' S
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ �' 7 S
Expires accepted as complete. TOTAL $ , S� 6 O
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00ICOM)
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q� BUP
Date Requested T-'" (D AM PM BLD
Location I l 5 9 0 -/YYI ffJLL-O---e)
kct -uite MEC
Contact Person Ph PLM
Contractor Ph SWR
,BUILDING , Tenant/Owner ELC gob/ --0_383/
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing :�� L !iik•� ACC / C .��
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling g/6/e) Y�
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post & Beam
Rough In
Gas Line r
Smoke Dampers
Final -
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire
ASS ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain • [ ] Reinspection fee of $ required before next'nspection. P at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Plea II for reinspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk �.
Other Date Inspector � Ext •
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.