Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00694
1
DEVELOPMENT SERVICES DATE ISSUED: 10/28/2004
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112CB -11000
SITE ADDRESS: 15369 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING. R -7
BLOCK: LOT : 124 JURISDICTION: TIG
Project Description: Wiring for furnace and NC.
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:
CANASO, JUDY DEKORTE ELECTRIC
15369 SW KENTON DR PO BOX 12379
TIGARD, OR 97224 PORTLAND, OR 97212 -0379
Phone: 503 - 968 -5493 Phone: 503 - 740 -9769
Reg #: ELE 34-541C
LIC 159954
FEES SUP 4075S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/28/200 $53.50
[TAX] 8% State Surcharge 10/28/200 $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 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: , �I _ c Or Permit Signature: -� pSD
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
DEKORTE ELECTRIC LLC 5 032882231 1 @/28f04 11:52am P. 002
1U /LlS /ZUU4 Va:DIS k;Ai 3VfkitllHOU L.11Y Ur 1 1t,AXV er/iVUG
DEKOFITE Ei..Er•TRIC LLC SO329822 i xwe J s , •ua... . ... - ,” • . -
'Y' ... +F<...gikW' 1 -146(, W rto Ilan
7CS1t1O11 •_ FOR .OFFICE: tl,'};: 1.!. 1'. ti.■l•> •
lectric�� �"el rliit r�pna � i 0 9 y
Q �+ . r� er /.
• City of Tigard r / , ,
13125 SW haft Blvd, TOM. OR 97223 Onicrretm:c
Phew: 503.639.4171 Fax: 503.598.1960 '''. •
speetia :• r•,•..`•, - , ,,...,, Page x for Inl►1 ire; 503,639.4175 � � t y . • Nu • ` Sapplenaeroed totbtmnien
Interact werw.d•tip�ndetus Ac. Q' 1t «.. „ ' od -^^
" , q FLAN it £vIFFl ;
a.erau ►•:e- 11 /1' .e; • i'' Piramechock that apply:
[] Demolition truotion ...".41 Addition/ ❑Service weir 223 amps, coming QHartordous looetian
Dornolitioa [ Other: ❑Sorvies over 324 amps - rating QS(IAldng over 10,000 sq. it., .
of i- and 2-family dwellings 4 or room now relidential
- •. . • ' :: ; • • Cj1.'>IEG01�LY. `U.1" �tpN13'1'(iI14:, IGtOTd - []5y9tcm wog 600 volts nominal units in one stn,:•Tt1n:
trod 2-family dwelling 0 CoromatciaUind [] Accessory building °Building over three storiac QFeedcra, 400 amps of more
Af:
El Multi f arrt ll sJ Q Ma ster builder ❑ btlta: 00ccupattt Wed over 99 parsons QManufgMured filMCtUtea or •
--.: f 10 f SITE •rkNB 1GC1(`ALTION .. ' ' QEgresan RV p 3rk sghtntg plan Qua • 9 _�� Oilcalth -+care facility
fG Imb no.: ( ��� Job site addres4: • • a-• to ems' - Submit.1 sets of plans with any of the above.
'Ciro above me not applicable to tatr}mrary ronetruceon service
CityJScoteJXJF: - N - z . ..,..-..k ❑� ''.- "D
Suitc/b)dgiapt' no.: Project Wee: c ),,,„,, �'�.c- -t ne,tlirecew go. Va. Toga no
7 , New rvidendal single- or multl•fomiiy dwelling *nit.
Crest street/directions to Job site: ',C. ----- lneladra attached ii, . e.
1,0007 i. ft. or lets 111111111M1
Lot a o.: _ Bog add'1 S00 xi, It portion et 33.40
:tiutittivisiOti: — -- Limited map, , residential 75.00
fax mop/parcel no.:
• ... limited en- , oon-ttaideatial 75.00
'2.1 /WIU Irl".1, Of WOFtX • Each tnstrofaoturcd or rn�11ar •
� ��^ dwellin service and/or lbedar 90.90 III
L a r- ,-•■ r• , ' ��� 1 0.4-r i' �� . s or Cesdern Insionatiion. ntteratinu, addlor rciocadet
. �- 3 • 200 ern 0 or less INI 90.30 gal
• 201 amps to 400 amps 106.85
Q TLrNr! NT: 401 amps to'600 imps 160.60
- 601 amps to 1,000 amps _ 240.60
Nome: , y. I,f. . • Over 1,00 snips of volts 4544.5
Address: _ i 1 I„ ay.s► RettMttt onl 66.85 2
•
1 rtnpnrary a� kt^ or feeder* instxpstiCen, altabr7ea, iutdfar
city /8taudZlk ` (7 Q relocation }
� I Fa::: ( ) 200 amps or less 66.115
f Owner 3 � cj that I own which is eat 201 to 41)0 amps MI t OQ30 L
Owner infilallo64o: This installation ta'ti'itpt 111Ad1t" on property
intended for sale, lase, rent, or exchange, ac angina to ORS 447, 449, 670, and 701. 401 mops to toto .: • , Mil 1;13.75 111111111111111
Date: Benno circuits -new, a1teaatlan or tatewaarr, ' -pauel
Owner signature: �A Poc for branch ebeune with �: N AST snrviet o r feeder fee, each 2
Gl A,Yll.1CA3!1'Y',. , . �� •... _ 6.65
branch circuit
Business name: B. Pee for bushel eimutts
wUhoel tetvioc of feeder fee,
Contact name: - each broach circuit nuenvo
Ranh neld'l branch circuit &65 6, G ( 2
Arddro8s Mtge it rennet (service or feeder treat itacl ®dad
City/State/ZIP: ' l'u or irrigation circle IIIIII 5140 MIMI 2 •
•
Phone: ( ) Fox:: ( ) si: or outline lighting all 5 -'
Signet circuit(s) ar limited -
E- mall: _ tatty panel panel. reiteration, or
• CONTRACTOR • extension. Describe! Page 2
Business name: iteXonco Electric • - .
_ _ Each itdditional Inspection aver abirivab}e u r any of the above
Address: : PO B4% 11399 �V Rog inspection 62,50
City/Stag/ZIP: PO1 tiaed OR X17212 _�_-_ .. - , , Inwefiig�ott Fix ttettr 1 Y min) 62.50
73. ��
Pboaex (503} •; 1a \
Pete: ( 503) 21111-2231 S , • CAL PERMIT PERMIT PEES •
- ,
I3
GC Lic. 159954 1eelrieal Lie : 3 54 Supev .( i c : ' + Subtotal
,/- / Poem =vim (25% of pintail foe) �
Stop rtr. FletuiCian ssignature, t egtttm! -- ^ 40M . +r .. state eutehargo (1191. of permit fee) In150411
Paint name: ,a c _. Dote: 10 _., r, 'TOTAL PE1tiH1T FEE MEM
ibis puma rpp$e*aaw etri it a p remit sot euolseawIftde 1119
Authorized signature: arm after It h a a.aa sw a bed • oeat Board
- � .1- --r . -- * k mnhocbtatrY d . Tri•Gwmb' *-- tC t°d°�1y Sa"i`s
Print mane: ., �_ �-..—•.,. _�.,•.
•
CITY OF TIGARD 24 -Hour
BUILDING Inspectiorine;_ (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / / 9 : AM PM BUP
Location /-53& - • ins.: aa ►l i Suite MEC 4ZO 4 ./ . -606 9'a
Contact Person 'h ( ) PLM
Contractor Ph ( ) 65V SWR
BUILDING Tenant/Owner ELC (90 (- - -od 6 ?
Footing
Foundation ELC
Access: fN442. of t -eA )s/
Ftg Drain - ELR
Crawl Drain -
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath/Shear
Framing f ' � / � � ( / J � 2 P � 7 _ z- -
4 L":" C-�
Insulation l) 1 /
Drywall Nailing AA-- U N./rl / Z.-d j (-1 7CLv P
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING.:-!'s , °Kn° `;; ,
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' " r-:
Post & Beam
Rough -In
Gas Line
yoke P •ers
left .
•
• ART FAIL
RICAL
Service
Rough -In
UG /Slab •
Low Voltage
Fire Alarm
4 -0 •ART FAIL 0 Reinspection fee of.$ required before ne spection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: / . Unable to inspect - no access
Fire Supply Line I ` /" I 0 ( /�All t -
ADA Approach /Sidewalk Data Inspector ` i Ext
Other: V
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL