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Permit _ CITY OF TIGARD. ELECTRICAL PERMIT PERMIT #: ELC2001 -00566 *01& DEVELOPMENT SERVICES DATE ISSUED: 11/14/01 �` '�---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DB-09600 SITE ADDRESS: 07080 SW LOLA LN SUBDIVISION: THE RAZBERRY PATCH ZONING: R-4.5 BLOCK: LOT : 016 JURISDICTION: TIG Project Description: Install 2 branch circuits for 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: 0 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: KELLY, JOHN R + ELIZABETH A CANBY ELECTRIC INC 7080 SW LOLA LN 790 S IVY TIGARD, OR 97223 CANBY, OR 97013 Phone: Phone: 266 -7878 Reg #: LIC 26071 SUP 2123S ELE 3 -112C FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 11/14/01 $53.50 2720010000( Elect'I Final 5PCT CTR 11/14/01 $4.28 2720010000( Total $57,78 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty 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: 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: a DATE: LICENSE NO: a- ( �-- 3 Call 639 -4175 by 7:00pm for an inspection the next business day • • • • Electrical Eernut A 1 1► L f n: o . . Alp, • - I • . • • Daterece -0 I P t no. 1- 56fo City Tigar Cj ( �2 a° - .,,74 - .41i` l ,j :> l II �A of Projtct/appl.r,o.: Expire date: . Clryof77gard Address: 13125 SW Hall 1 , igard, Old 9?@�U�� � �� By? P • Phone: (503) 639 - 4171 ``l' 0 y Rccei t no.: Pax (503) 598 -1960 0 G1+0 Case tale no.; Payment type: —~ Land use approval: �F Sl� • tl 14.1 & 2 family dwelling or accessory Q Corntncrcial/mdustelal 0 Multi- family 0 Tenant improvement . ❑ New construction 0 Addition/alteration/replacement O Other: 0 Partial JOB SITE 1Nl'Ortl%1A 1101\ . Job address: 0 fi , . LoL B14 no„ • Suite no.: • Tax map /tax lot/account no,: • Lot: Block: Subdivision: . Project crone: Description and It earion,of work on. premises: of E__ - • , t' _ • Estimated data of completion/inspection: V –y'i ('ON'1•RACTOR APPLICATION , FLE SC11EI)t) F . Job not Ie Max • Business name: ,,. _ _ , _ . QTY. (ea ) no. iris • • Address: 1 . --- S ! wrosiden ,7T.- ., . • otmulti- funny per d• .elrmgaalt. Includes attached garage. • ' State: fyZ ZIP: 9, 1 o t 3 Scrriccioclatloat Phone: Z - . -- -1,'-1 g Fax-266 -55 43 E -mail: woo sq. ft, or lose 4 ' CCB no,; 'Z i0 On Elec. bus. tic. no: Bach additional 0o sq. ft, or portion thereof _ 3 t.-a. C Limped energy, resideniihl MI ity /menu tic. no.: 1 -1cf Limited energy, 2 ` --�. • • .. ' • rgy,non- resideanal ��_ 2 Bach mattttt`actured home or modular dwelling •Sigttmtlte Or supervising electrician (re.ubcd) Date Service anrPo? fttder 2 • t lcense no: 2.12.35. ice or f • • • • •• irartalladoa, • PROI'I?1tTY OWNER alteration or nelocneettt II • 200 amps orlon a • Name. (prim : k\ • a Lamps m 400 amps Mailing address: — 1. 0 S , . • L� t ,r; 40 .amps to • ,_t • ,.. =� 2 z 601 amps to 1000 am– IN=M • Phone ` State: awe Leon stops or vo is • 2 . Fax: EIMMIEMIIIIIM `• weenectonly �— ) Owner installation: The installation is being made on property I own Tetnl►orarvtervitxa or feeders - . 'which is not intended for sale, lease, rent, or exchange according to installation , alteration, orretocatton: ORS 447, 455, 4'/9, 670, 701. 200 amp or less 2 Owners. sign3tture: 201 ant • s to 400 amps 2 ^— Date: 401 to .,, amps MIONOMII 2 . , • ENGINEER. Branch r'1 ,.. new, alteration, Name: or extension per panel Address: ' - A. Fce for brunch circuits With purchase of at}rviee or feeder fee, each branch circuit I 2 . City: • State: ZIP. B. Fee for branch circuits without purchase • ?hone: Fax E - mail: ' of service or federfee. fuel branch circuit: 1 ttL•8' 2 PLAN 1tL1'1! «' (Please street: all that apply) 1 Each . •ttionalbranch©rcuit ENV pp y) Misc .(Service or feeder not Included): 0 Seviriover225ampa- commercial CI Health-care beaky ' Eaah pump or irrigation circle I ❑ Sarvice over 32Q amps -racing of l�2 0 Hazardous location Etch family 'swains., Each si gn or outline lighting 2 . 0 Building over 10 ,000 square feet four or Signal cirenit(a) of a limited energy panel. "' o Systetuover600 volts nominal more residential units in onestrut:we alteradon,orextension* 0 Building over three s tore .x 0 Feeders. 400 amps or more 2 O Occupant load over 99 prr,ons O Manufactured structure's orRV park •Drarnpnon• Eachadeitional over the allowable In any of the above: ❑ Egress/lighting ,, 0 tJthrr. Submit -_ sets of Par Investigation I l plans Mtn any of the above. Inve fee The above are not appises+ble to tctnpohu- construction service. Other - -- - -.. ... . ..... Net a Jurirtlietiotl: JC4e1,e Cr,t G'. dt, p1u.Y 'mil JYt}�leflOn for more infvtmeuoti T - ... -- • -- la MaA Notice: This permit Permit fee .............. U �blastcn: x;� P application � w o,txr. ' ?' i expires if a permit is not obtained M at t ` card �11 ?. . C C I t ttn review ( ,, C 71_. .... a / h JO within l80 days after it has been State surchurge ( 8 ere : _ — y z • le t_ 1 • . „•at r,. r > r Y� • 'art,e•o omdf,ot e4 ,bo..0 ,. - ... • — accepted complete. TOTAY, „ craj, .��ra cr tcd as r -' ,.,, Lc---:-.. . _s ,a $ • _ 1 $, Cardhoidc, . iyrn u,c -- • --- . - A n d40-;o: i :6401C01.4) • 1 d Wd61 :1 Z T00Z 60 •AON 2bSS99Z : 'ON 9NOHd ONI OI�i10919 J,3Nd0 W02id CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 � — • BU) Date Requested �/ AM P 0ih 2 4 B Location 70 c3c "et/ L ti -e Suite _� MEC 2 €) /-aU 9e) 4 Contact Person VI Ph 2.4Hzy y PLM Contractor Ph SWR BUILDING Tenant/Owner ELC / 05 Retaining Wall ELR Footing Foundation Access: , t if FPS Ftg Drain C � P/4 G ( SGN Crawl Drain Inspection Notes: ( � . � S4kIarl Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post & Beam Rough In Gas Line Smoke Dampers Fi RT FAIL TRICA) Service Rough In • UG /Slab Low Voltage �i�e,4larm PASS PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / / — 2 / , U ( Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. _ •