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Permit CITY-OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2002 -00132 a I; DEVELOPMENT SERVICES DATE ISSUED: 3/26/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111BD -00312 SITE ADDRESS: 09940 SW PEMBROOK ST SUBDIVISION: PEMBROOK HEIGHTS ZONING: R -3.5 BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Installation of 7 branch circuits for basement rewiring. 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: 6 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: STEVE BROWN OWNER 9940 SW PEMBROOK ST. TIGARD, OR 97224 Phone: 503 - 639 -2562 Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 3/26/02 $86.75 2720020000( Wall Cover Elect'I Final 5PCT CTR 3/26/02 $6.94 2720020000( Total $93.69 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 -0080. You may obtain copies of these rules or direct questions to i 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: 0 DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • Eleetrical Permit Application - - oFFicr. 1;E (,N i:Y Date received/ p ay Permit no.;� 24(4)-' Ai /3 ' . t . 1 1 - 1 City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF I'1•:R ■l11 ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction JF ' Addition/alteration/replacement ❑ Other: ❑ Partial Job address: , e. , L .S7 Bldg. no.: Suite no.: Tax map /tax lot/account no.: 25//R12.-- 003/L. Lot: � Block: Z I Subdivision: /J,Gm/3g_00A. / 9 1 9673 Project name: [Description and location of work on premises: /j,4 /64.//,1Adr— Estimated date of completion /inspection: Job DO: OkA) E'R Fee Max Business name: Description ' Qty. (ea.) Total no. insp Address: New resldential- single or multi-family per dwelWrgutit .lncludesattachedgarage. City: I State: I ZIP: Serviceincluded: Phone: I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: 'Elec. bus. lie. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City/metro lie. 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: Services or Feeders- installation, alteration or relocation: 200 amps or less 2 Name (print): T 6� f t/ 201 amps to 400 amps 2 401 amps to 600 amps • 2 Mailing address: Ry r ' / 601 amps to 1000 amps. 2 �� City: D State: &;e1 ZIP: � 7�e7 Ov er 1000 amps or volts 2 Phone: 634 2562 'Fax: E-mail: I Reconnect.only.._ .. _._ -_ ___ ..._._.- _._. .. 1 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, alterat1oo,orrelocation: ORS 447, 455, 479, I :, 0 . / 200 amps or less 2 201 amps to 400 amps 2 i Owner's signature: �r... I Date: y # 2- 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, • or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: ' B. Fee for branch circuits without purchase Phone: Fax: E -mail: of service or feeder fee, first branch circuit: / 2 . Each additional branch circuit: b PL. N REVIEW (Please check all Ihal apply) Misc. (Service or feeder not Included): O Service over 225 amps-commercial 0 Health-care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 0 Hazardous location 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 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other: Per inspection I I I I ' Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ _ ❑ Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ State surcharge (8 %) $ / / w ithin 180 days after it has been Credir card number: TOTAL OTAL $ Name of cardholder as shown on credit card accepted as complete. $ 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 Z- AM PM BUP i Location w !J _ Suite MEC Contact Person Ph ( ) 4039 c3-.S7/2 7 PLM Contractor Ph ( ) 3 76 7 SWR BUILDING Tenant/Owner ELC Do /3A • Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT .kt Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Vlo v. / Drywall Nailing L� 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 •ASS PART FAIL E ► ECTRICAL Se icy ��►' ab Low • Itage e arm %' Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 0 � � Inspecto -/At-mg _ Ext Other: Final DO NOT REMOVE this inspection record from the b site. PASS PART FAIL CITY OF TIGARD 24 - Hour BUILDING Inspection Line: (503) 639 - 4175 V • • INSPECTION DIVISION Q'-- 1 Business Line: (503) 639 -4171 MST BUP Received Date Requested 3 / AM PM BUP Location 75 %€ lea--)72_6LA - _. Suite MEC Contact Person Ph ( ) PLM Contractor Ph ) SWR BUILDING Tenant/ ( Q.tX) 3 - 7c71 ELC Footing 07 6 3 7— 3 ELC 2669i i3 & Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear FPO 1 D Framing 1 - Insulation Drywall Nailing Q\11 l► Firewall - -GAZZM■ R`ilv. %cl 0N,I,Na Fire Sprinkler Fire Alarm Susp'd Ceiling Roof - S L \ ta. A : 11► • V . 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 Roug nh lI Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service cR6trunr-) s;■i■c cll■rDNL tetA6111Air4 covoi. UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FA SITE Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 3 -�g - Z inspect •-� Ext Other: Final DO NOT REMOVE this inspection record from e Job site. PASS PART FAIL