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Permit C ITY O F ® I GARD ELECTRICAL PERMIT I DEVELOPMNT SERVICES DATE SSU 3/21/03 03 001 52 I „ � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110CC -15400 SITE ADDRESS: 12375 SW KING GEORGE DR ZONING: SUBDIVISION: KING CITY NO. 5 BLOCK: LOT : 006 JURISDICTION: KIN Project Description: 1 Branch circuit to HVAC. 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: JUNE NIELSON SPECIALTY HEATING+ FABRICTN 12375 SW KING GEORGE DR. 9528 SW TIGARD ST KING CITY, OR 97224 TIGARD, OR 97223 Phone: 509 - 639 -5556 Phone: 620 -5643 Reg #: LIC 66578 ELE 34 -341 CRE FEES SUP 200LHR Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/21/03 $46.85 [TAX] 8% State Tax 3/21/03 $3.75 Rough - Elect'I Final 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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246699 or 1 X00- 3�2- 234g,� ZA/1_,, ` Issued By: �( / �'�/l ,t�//tilt_ Permit Signature: A 0410/ ( ,(I )/1_ OWNER INSTALLATION ONLY 1' 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: - Z0 0 1-170Z Call 639 -4175 by 7:00pm for an inspection the next business day Mar 18 03 11:20a Specialty Heating 503 598 0718 p.2 • Electrical Permit Application hatereceived: _2 / 0 I • , D.3_00 a l 4111r City of Tigard ® Projcct/appl, no.: Expire date: Ciry ofTigard Address: 13125 SW Hall 11s 1 c �, 0 - Phone: (501) 639.4.171 Date issued: i Receipt no.: ^ Fax: (503) 598- t960 MAR 18 20 Case file no,; Payment type: Land use approval: tc A1=tr) �1 Y Or T, .a• '4,.. ")(PE OF PERIVII'I xi. & 2 family dwelling or accessory D Commercial/industrial D Multi - family Cl Tenant improve ncnt 0 New construction )• Addition /alteration/replacement 0 Other: 0 Partial • JOB SITE INFORMATION Job address: /. 3 c 1 ;yam „.o_r • . Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Su.divisio . / Project name: 4/ c , 4.�0,- Description and location of work on premises: Estimated date of cvmlilctiott/ictspcc tion: CONTRACTOR APPLICATION IMMEMINIIIIIMI Job no: 0.3 Ef Fee.' lyfac Business name ,7�.ec_ - �/ � — Desrri lion �pf �CZ - `f'�� 4 j' Newr esidentia l- singleormlti- ffamilyper — u Qty. (ca.) Ioral no.uup Address 5 i,,2./ -f p ZIP: /� 24 9 dwelling unit kuclutics attached City: 6 �1 ' I State— �1 ! - I ZIP: , f SerVirahte •ut*d: garage. C Phone :69 ' -. 3,e) Fax4 V 19713 J E-mail: 1000 sq. ft, or less CCB no.: C ie 5 7 is .t �3 Elec. bus. lic. no: ? . -- (./74 g',4.. Each additional 500 sq. ft. or portion dtett o 4 City /metro lie. no.: /l '6 X73 , Limitedenergy�rosidential 2 ,� � [inured energy, non - residential 2 / l� .d �L_ .e• , ' ` h r aach manufactured home or modular dwelling Signa of supervising electrician (required) ,, Date o ; ,k ServrCC and/otifeeder • 2 Sup. elect. name (print):/ d7 . ¢i./, es f.i,sn::. nn ,gClrizx,p Services or fecders -instringi inn, PROPERTY OWNER alteration or relocation: ZOO amps or less 2 Name (print):.1/ e // ls-- 201 amps to 400 amps 2 • Mailing ' !� 75 � 4 01 amps to 600 amps 2 6 �d? �/t . • !ma 601 amps to 1000 amps 2 City' > r1q St [ZIP: ? 7�zy Over _ 2 s � I Stt `, 1000 amps or volts Phone: 60 -g 5•`. ‹.5114 4 I Fax: J E -mail: Reconnect only t Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent., or exchange according to installation, alteration, orrelocation: ORS 447, 455, 479, 670, 701, 200 amps or teas 2 201 amps to 400 tuupa Owner's signature: Date: 401 to 600 amps - 2 Branch circuits - new, alteration, Name; or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch Circuit 2 City: State: J ZIP: B. Fee for branch circuits without purchase f Phone' Fax: E or N esvire or feeder fee, that branch circui 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) • Misc. (Service or feeder not included): 0 Service over 225 umpa- commercial 0 I care facility Machu pump or irrigation circle 2 ❑ Scrvieo over 320 amps - rating of 15:2 Cl Hazardous ioCation Each sign or outline lighting — — 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in One structure alteration, or extension* 2 0 Building over three stories Cl Feeders. 400 amps or more Cl 0., u p nrt loadover 99 persons U Manufactucrd structures or RV park = ori ptio - ., o E rrss/li htin lan - Each additional inspection over the allowable in any of the Above K g Kp ClOther: Per inspection I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary cum ucxtoit service. Other - " Not all jurisdictions accept ese it cards, please call jurisdicti for more informs Notice: This permit application Permit fee $ _ CI Visa O HlastetCani expires a permit obtained • Plan review (at — °lo) - C+Nit uunl number; f I within 180 days after it has been State surcharge (8%) $ Expires accepted as complete, TOTAL $ 2_, 9t Nntnc of Cardholder as shown on credit card Cardholder slecsa[une n,,u„:.t 440-. (its (G/ppiCOM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: < .(503) 639 -4171 MST BUP Received Date Requested 3 s AM PM BUP Location / ' 44' Suite —' g 2003°' 06/3y Contact Person !< 4 Ph ( ) 6 q O "3 Cv O 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner et 3 -00 /5 Footing 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 PAS FAIL GHANICA st & Burn - Rough -In Gas Line k tampers g iy i j FAIL LECTRICA! Servi - Rough-In UG /Slab Low Voltage Fire Alarm 1,111% 111 P RT FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S" - ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line - — -- - - - — — - — — ADA a.9 7 / Approach /Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL