Permit 1 17 Y OF TIGARD ELECTRICAL PERMIT
o u, PERMIT #: ELC2004 -00185
DEVELOPMENT SERVICES DATE ISSUED: 4/12/2004
" All 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S111 CB -01708
SITE ADDRESS: 10260 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R
BLOCK: • LOT : 007 JURISDICTION: TIG
Project Description: (2) branch circuits for furnace & a /c.
Job No. J19215
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: •
JOSEPH SKACH WEST SIDE ELECTRIC CO INC
10260 SW HOODVIEW DR 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: 503 - 598 -9685 Phone: 231 -1548
Reg #: LIC 13306
SUP 2663S
FEES ELE 26 -135c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/12/2004 $53.50
[TAX] 8% State Surcharge 4/12/2004 $4.28 Rough -in •
Elect'I Final
Total $57.78
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 - • i : 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -66 or 1-800-332-23...
•
Issu:d B • ' 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 INST • LATION ONLY
SIGNATURE OF SUPR. ELEC'N: 77�� / °�'`� DATE:
LICENSE NO: �%
Call 639 -4175 by 7:00pm for an inspection the next business day
I -)-
- •i___
Electr Permit AnpliegltiOirr,IV E. D FOR OFFICE USE ONLY ,. .
City of Tigard
41 - 1 , ), tkj 5 Received d i ,
Dawn), _7 f / 105 permit No.:64
13125 SW Hall Blvd p
., Tigard, OR 97223 an eW
5I evI
9 TO 0 ., vi i k --1-- - •-"."---
Plilic: SW.639.4171 Fax: 503.59X.I900 N\)\ 1 c... m aylAil'i- .. DAtcy s I ___ outer iNtriti
Inspection Line: 503,039.4175 el I l Dale lleady/Ily: 1 l0 Sr. rage 2 for
.....n
Intianyt. www.v.i.ligaill,or,os rx 116 - ,,, i Norliticd/Mcillod: // 6;; !.'int,i!licriirotiirlriliiroinlitin
. 0‘1 • Nt V r., 1 "IskON
TY guiAllOORIP / 7 ...__ . PLAN REVIEW
0 New construction Addition/alteration/rcpjaccinent Please check all that apply:
['Service ovci• 225 amps, coil iiii'l 011azarclous location
fii Dcmotition 0 Other:
Oserviee. over 320 tulips TIllilig DittlikIng over 10,000 sq. ft_
.... . . . ..
CATECORY OP CONNTRucTioN of 1 - a n d 2-family dwellings 4 or more new residential
,..
['System over 000 volts nominal units in one structure
. 7 . I - and 2 dwelling Li Commercial/industrial 0 Accessory building
Dlitli li hill!. over three Stories °Feeders, 400 4irlipN or mon:
El Multi-I
-. Master builder El Other: 00ectipant atut over 99 pcoons pvlattii factored sillIMIIIVS Or
JOB SITE INFORMATION AND LOCATION pHgress/lighting, plan RV park
DI lealth-care facility pOilici:
. ....... _ .. ..... ........_
Job no.: ,_..) k 9. z_ i c - 2 1 Job site address; t 6 ? 6. 0 ce__J 4,, 0 ( ,
Submit 2 NOS 01 plans with any atilt: above.
( ' i I y/Stale/ZIP: ' ) a q 7 2_f Tlic above are not applicable to temporary construction service.
, .
)EE* SCHEDULE
Suile/bIdg.hipt. no.: Project Int/11C: S4.6,1 I Dr.r.h.,,... ......, ... . . . ... .
. . . .... LQ4y. l Per. 1 'IntAl r -
Cross slreel/direclions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage.
1.000 sq. 0. or lea', 145.15 4
........ . _,..
Subdivision: Lot no.: Ea. addl 500 sq. 1i . or portion 33,40 l
..--•--• Limited energy, residential 75.00 2
'Fax map/pareel no.:
I united merry, non-resil len lial 75.00 2
DESCRIPTION OF WORK
l;Antli rninnifiu:litRal OF 1710(.1111111'
.., .
clwelli ill, service untl/Or reedel 90 4)0 2
_ __(1.. --"--e_.. A c -:-..-_,....( Services or feeders installation, altera ion, :Indio ' relocation
200 amps or less R0.30 '„?
tif PROPER'I'Y OWNI■lt. 0 TENANT 201 amps to 400 amps 100.X5 2
- 401 amps to (in0 amps I 00.00 2
Nome; Ct (
,2 ' .0 .-3 e 601 :imps to 1,000 anips 240.00 2
r
Address: <N_ 1,- x.' . `-e...-- Over m
1,000 amps or volts
- --- 454.05 2
. • . •• .. • • Itmonneet only 00.85 2
City/State/Z1P Temporary services or feeders installation, alteration, and/or
relil cat ion
Phone: ( .) ) c? g - 68._c 1 F.: c : >
06.}i5 I
.. . ......._
Owner installation: This installation is being made on property that I own which is not
201 ainpsat 400 amps ' • - - - I 00.31) 7
intended for sale, lease, rent, or cxchange, according In ORS 447, 449, 670, and 701,
401 iliop s tit 600 amps 133.75 2
Owner signature: 1.):tte: - Branch circuits 111CW, aliera ; n r te
1.0, o exnsion, per pane!
. .. ...-.-
--.... . .
D APPLICANT _I - . .. ....
0 CONTACI' PERSON A. Fee hi,' lintocli circuits w ith
service or feeder Fee, each
0.65 2
Businesg name: branch circuit
B. Fee for branch circuits
Contact name: wiiitout service or feeder fcc,
46.85 ( 1 ,1C 6( 2
cavil brailth Girl:Aril , /
Address:
Each add'1 branch circuit ( 6.65 zo..6c 2
('ity/State/Zit': miser/bayous (service or feeder not included)
Pump or irrigation circle 53,40 2
Phone: ( ) I Fax: : ( ) l .. _.....
___ . Sign or outline ighting 53.411 2
I , Signal circuit(s) or limited-
CONTRACTOR. citere,y panel, alteration, or
.,
extension. 1)eseribe: l 'age 2
Business name: WEST SIDE ELECTRIC CO.
..._.. . ..
___
Address: 1834 SE 8 1.11 AVE. Each additional inspection over allowable in any of (be above
.. .,...
-- -----. - Per iii:Tmlion 02.50
,__...... ., ..
C PORTLAND OR 97214 . _._ ...._
Investigation per hour (I lir nun) 02 50
. 7 . ... ..
....
Pbone: (503) 231-1548 I Fax: (503)736-0677 Industrial plant per hour
---..... ..... ......._ ......_ 73.75
ELECTRICAL PERMIT FEES*
CCI3 Lie.: 13306 Flectrical I; . ; 20 iSuprv. Lie.: 26638 Subtotal
2 ' 2
.......... . .. .
. • . _
Suprv. Electrician signature, required: i an ieview 05% f riTlit f
o pe eu)
.....4.-.4-",....".."-.......--- Plan
.... __ ....
c----, ._-,..- e art,e (8% of permit Ice)
cf D a-
Print name: kc , vk .,. C___.: ,,,,,,,,,, ,_,,,,.. ate: q,./ Stat soich
(- 2-.7 (
TOTAL PERMIT FEE 7 78
Authorized signature: mix permit application expires tr a permit ix not obtained within 1)00
(Lays Aker it IIMS 111 PeCtplfd igh 0.0.6,
Print name: Date: • Pee methodology set by Tri-County Building Industry Service hoard
. .._............_..-- NIMIlIttr or inspcciior”: per permit allowed.
■•■nmittli.g\t'ernAiisNiit c ParnilArip dor 12/0., 440.4615T(10/1)7/COM/WI:11
a • d LZ.90-9EL ( COS) *o3 oT-41.0aT3 aPTS 1.san ei7I:80 4,0 21 JdY
CITY OF TIGARD 24 -Hour
BUILDING . Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ /� (� BUP
Received - 3 �� /� Date Request -d �` �710�Z' 69 BUP
Location t9 2 d ' th–Suite MEC — 177/d' –S
Contact Person Ph (,73) 4/.S 3 'Vf22 -PLM
Contractor a . Ph (J d-2)
BUILDING Tenant/Owner II S''A ELC
U
Footing 5 � V -- < Lo--
Foundation ELC
Access:
Ftg Drain C-,t -\ -` G-47/ ELR
Crawl Drain �
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi reveal 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 P! T FAIL
CH I
Post& Beam
Rough -In
Gas Line
• - pampers
• • ' • ART FAIL
Rough-In C
UG /Slab
Low Voltage
Fir- • larm
I•�afi�� •ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI — El El Please call for reinspec ion RE: ❑ Unable to inspect – no access
Ar
Fire Supply Line l
ADA
Approach /Sidewalk Date 0 Inspecto / A Lid i116/s.41 Ext
Other:
Final D NOT REMOVE this inspection record from the Job = ite.
PASS PART FAIL