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Permit 4 CITY rOF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00318 DATE I DEVELOPMENT SERVICES ISSUED: 6/2/03 -�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 CA -10300 SITE ADDRESS: 09801 SW KABLE ST ZONING: R -7 SUBDIVISION: TAMI PARK BLOCK: LOT : 010 JURISDICTION: TIG Project Description: (2) branch circuits for furnace replacement and a /c. 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: O'HARRA, PATRICK D + MARIA C A OWNER 9801 SW KABLE TIGARD, OR 97223 Phone: Phone: Reg #: FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/2/03 $53.50 • [TAX] 8% State Tax 6/2/03 $4.28 Rough - Elect'I Final Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. Al! work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in O 521=0©. 0 through OAS -00 -0100. You may obtain copies of these rules or direct que 'e s to O UNC at (503) 246 -6699 or 1 -800 -3 -2344. ��/j Issue B �I � I , , i► I ' � Permit Signature: OWNER INSTALLATION ONLY The installation is being made on p :.erty I own which is not intended for sale, lease, or rent. • OWNER'S SIGNATURE: % . 4 DATE: 6/ • CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application ,- i Mgr y1 ? , OFFICE U SE ONLY < , �i+ a Date received: � 5 Permit no.: „3 qo3/$ dk •... City Of igard Project/app. no.: y∎e date: ' e • City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: ' EOReceipt no.: Phone:. (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: '.t c.. S.' S i; .` -•` v ' t ✓ r {` e„ ".. ra ,, i j Sh ,,F � , , _ I ��..�:�,� �<._�� . .p 3: _..,_ �_��..m���: .� - - ��,,.�: z. „; TYPE, OF- PERMIT c- . �,,,�,. �,��.r� , . � . >�. -; ... �.: -� p�� ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial • , ,... ---,,..:.,;.<,:_s-:;';.,,,::::::', _ . A ,; ,.. ,t_ JOB SITE ;INFORI♦IATION , g_ . TM.? , s .� w � - Job address: `8 a/ 5 &. K- . • Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: Project name: zed ' V - , C Desc " and location of work on premises: Estimated date of completion/inspection: -06 = s ;' `I CONTRACTOR: APPLICATION : a , , . ' , FEE; • . 5 t Job no: Fee Max Business name: Description Qty. (ea.) Total no.insp Address: New residential- singleormulti- family per dwellingunit.Includesattachedgarage. City: State: ZIP: Serviceincluded: Phone: Fax: E - mail: 1000 •. ft. or less 4 CCB no Elec bus. 11C. no: Each additional 500 sq. ft. or portion thereof ___— Limited energy, residential MEM 2 City/metro lic. no.: Limited energy, non - residential ___ 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder ■ 2 Sup elect. name (print): License no: Servieesorfeeders— installation, al alteration or relocation: .`, PROPERTY :OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps __ 2 Q D1 — 401 amps to 600 amps ___ 2 Mailing address: 'So/ SGJJ 0 i — ilr• Got amps to 1000 amps ___ 2 State ZIP: F72Z . .. over 1000 amps or volts - __ 2 Phone: �- Fax: E -mail: Reconnect only MES.- 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sa ease, rent, or exchange according to illation ,alteration, orrelocation: 200 amps or less I 2 ORS 447, 455, 479, 671, 0 . / 2 _ , Date: ✓ Ar �Z 401 to 600 � p amps ___ 2 Owner's signature: — 4 Pe ✓! . .':',,`'' - ;.`.' 1 s. ENGINEER > ' Branch circuits - new alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of J � G % l Address: service or feeder fee, each branch circuit 7 2 City: State: ZIP: B. Fee for branch circuits without purchase 11■ 6 Phone: Fax: E - mail: of service or feeder fee, first branch circuit: Each additional branch circuit: MIME i. • ' PLAN REVIEW(Please check.all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps-commercial ❑ Health -care facility Each pump or irrigation circle EN amps-commercial 2 ❑ 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 extension* ■■■ 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Descri tion: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other: Per inspection __ Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee $ ,� • 5D Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Plan review (at %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained a Credit card number: / / within 180 days after it has been State surcharge (8 %) _ ab Expires TOTAL $ 5 7. 7 q accepted as complete. Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6 /00 /COM) CITY OF TIGARD - 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION . Business Line: (503) 639 -4171 • MST BUP Received Date Requested 6-3 AM PM BUP Location V ( C Suite MEC - Contact Person Ph ( ) PLM Contractor Ph ( ) SWR p� BUILDING Tena i!_ f ,a 2 (` 9 ELC 3 — �d ��/o Footing ELC Foundation - Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear - Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler . s — �� - & PM 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 ,C UG /Slab + ' Low Voltage L Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL E l Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA 4/3 03 / Approach /Sidewalk Dete ! Inspector 3 Ext Other: �yd Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL \