Permit A►
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00327
M . DEVELOPMENT SERVICES DATE ISSUED: 6/9/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 70 HOME TURF
SUBDIVISION: SP. BAR ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Sign lighting.
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: 1
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: 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:
13500 PACIFIC CORP CARRICK ELECTRIC
38345 W. TEN MILE RD. 15832 NW CLEARY CT
BEAVERTON, OR 97006
Phone: Phone: 503 - 645 -3761
Reg #: ELE 34 -439C
LIC 120169
FEES SUP 2295S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 6/9/2004 $53.40
[TAX] 8% State Surcharge 6/9/2004 $4.27 Rough -in
Elect Final
Total $57.67
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: 6„,,L. Permit Signature: �%t(1a11JL� .
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: et 55
Call 639 -4175 by 7:00pm for an inspection the next business day
06/03/2004 16:47 FAX 5035981960 CITY OF TIGARD 1¢JOOS
. N '� -��(- O 61 2_ 41°135
.
icai Permit Application I OR OFFICE USE O l .1
City of Tigard A FRIW121111rall / � "/�
137.5 SW Hail Blvd.. Tigard, OR 97223 Plana •
Phone; 503.639.4171 Fax 503.598.1960 p • Other Permit
inspection Line: 503.6394175 _AL. _i_I! Pa may; FRIMMIEEiliEMI
Internet: www.ci.tigard.or.us Noa5ed/Metbod:
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__.�_._ r I__ -_.. _ . ' . .. • +, r,i - �- .. ' '" r• - y •ti k- . .
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J.:.
.1 New construction 0 Addition/alteration/replacement Please cheek all that apply:
r . , lidon El Other: DService over 225 amps, comm'l ❑Hazardous location
- ' . �_ -- � OService o v e r amps - rating []Bunting over 10,000 sq. R., •
°`' : , ` �; a • : r'eabra k -n� � , ':! of 1- and 2-family dwellings 4 or more new residential
❑ 1- end 2- family dwelling .1 Commercial/industrial 0 Accessory building []System over 600 volts nominal units in one structure
❑ Multi -derail ❑ Master builder O Other ❑Building over three stories OFaders, 400 amps or more
••��••�� OOccupant load ova 99 persona OManufctured abuctmes or
-- .. ' i _ _ ..,2:',' ` _ . '� ` „. t1Y ^ - - - - : '_ ., : 0E�+tm
essgPUm RV �
Job no.: 545' Job site address: 1 5 c S' 1 . i u e Q G i , OHealtb.eare facility OOther:
Submit E sets of plans with any of the above.
City/Slate/ZIP: . a ® q 1 /� Z 3 Z The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project dame: L 4 C� S „ N ,, '�r��tttt , ; w a
J _ o.re�m. Qtr• lee_ Taal street/directions to job site: New residential single- or mulWtamily dwelling unit.
Indode, attached garage.
1.000 sq. R or less 145.15 4
Subdivision: I Lot no Ea. add'1500 eq. R or portion 33.40 1
Tax map/parcel no_: •
Limited energy, residential 75.00 2 •
-r .: - .:- . -• ; - -- ,_ Limited eaagy, nontpidential 75.00 2
- - - - - - - - - _. ��= _ _L:la:..- �. IA:� Each manufactured ormodular
dwelling, service and/or ftede __ 90.90 , 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
1
- , .•tb .v. .1. 1.:i -- - • :•Y .-
.- �. • 201 to400 106.85 2
l •_..I.. . • - ' - ' 1. '°.i:u . ' ' " A.a r 1 401 amps tow) ow ` 160.60 2
Name: l -I bis - 0o �l A C ■ l t C.- �.UR -Q 601 amps to 1,000 amps 240.60 2
Address: Ove 1,000 amps or volts 454.65 2
S 1.46 w T �.v rn 1 t..E �,
• Reconnect only . 66.85 2
4 n/State/ZIP: w r TO L M t b Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.301 2 . •
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 snips to 600 amps 133.75 2 •
der signature: Date: Branch circuits - Pew, alteration, or extension, per panel
- -" - _ . .. 777_ ) :. . - -�_ _- . r,;[ _ -
� -` -7
;.. '',7:-..,' - -- - `;'� _'- : '-7--.77..- - �; �- . � A Fee for branch Cit4ttitt with
. :air`' - . b�
BCHS Lam.. / service or feeds fee, each
G C 1 G� __ r Z C branch circuit 6.65 2
K� 8. Fee for branch circuits • .
Contact mane` /�,/� Coov4' 5 without service or feeder fee,
Address: • , VI 2214 ► e each branch circuit 46.85 2
Each add'l branch circuit • 6.65 , 2
City /Stattral: VAS (a DO- 6 111 Z 3 Miseellaueous (service or fader not minded)
Phone: ( 5 0 3 ) Sell - ■ PI Fax:: (Se 5) 5q1 - 83 . k 53.40 2 •
I Sign or outline li : ins "D ( 53.40 53Ab 2
E-mail: : _ _ _ - 1 --- in a or invited - • In - __ -i i d1_ , " ' 7 `,7�; -.S; L , 7 . .•" i , 7 A antra panel. alteration. Cr
extension. Describe: Page 2 2
Business name: CAI \ G : PG ■ L _
Adams VI 6 5 S 2._f _ Each additional inspection over ailowabte in any of the above
-
ity /State/Zip: Per inspection 62.50
C
� , k,e, i Q n it till 2 3 Investigatlan per hour (t Iv min) 62.50
I I, Phone: •3) S w. , : Fax 470 )591 -B3 ST _ Industrial plant • : hour 73.75
CCB : \7.0 Electrical lie.: 31.1. -4167t Suprv. Lic.: tic/ S S 5�1�v
Subtotal
•
Strprv. Electrician signature, required: 41 moo .C2 4. Plan review (25% of permit fee)
Print name: groat , i. lc Daze: 6 LI /eg State stachage (856 of permit fee) y s Z,
�f/�� leg PERMIT F 11 1 s ` h
Authorized I� Thee parodt appaeasoa expires Ifs permit is not obtained within 110
v darn after It au been accepted as complete
Print nemm tLe,A,A (, , , ► J Date: 6 /MOO 14 : . N logy set by Tri Building Industry Service nec d .
inspections per permit
e doe 17101 440451,IRIW07iC014,Wsa
CITY OF TIGARD 24- Hour
BUILDING Inspection Line: `(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date equested 6) — 2 AM PM BUP
Location /3SDa Suite MEC
Contact Person Ph ( ) 10 8-08 PLM
Contractor Ph ( ) SWR 1
BUILDING Tenant/Owner / %'-Q Y _ ELC �d O 7 - o C7 3=a 7
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
- Alarm
�! r 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
, PART FAIL
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / Z (p Approach/Sidewatk Date Inspector ( - A L�g� ( Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL