Permit .CITY' OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004- 00766.
ply D SERVICES DATE ISSUED: 12/2/2004
l l� 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S135DA-01000
SITE ADDRESS: 08530 SW PFAFFLE ST
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -P
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Wire convection oven.
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:
DALTON, DAVE T & T ELECTRIC
8530 SE PFAFFLE ST. 4120 SE INTERNATIONAL WAY
TIGARD, OR 97223 SUITE A-105
MILWAUKIE, OR 97222
Phone: 503 - 267 4419 Phone: 503 - 652 -7610
Reg #: LIC 150973
ELE 26 -1105C
FEES SUP 2184S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/2/2004 $53.50
[TAX] 8% State Surcharge 12/2/2004 $4.28 Rough -
Elect'l 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- 2 -2344.
Issued By: / 4:16-vat/4-- Permit Signature: a9-7
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
03/06/2013 14:38 FAX 002/002
w IVED Electrical Permit Ap BJ ►, ' „s- FOR OFFICE USE ONLY
City of-T DEC 0 2 2004 t1 "`I
nlr'r\» 8... ° j ,,
i !25 tiW Flull I11rJ • I'1gaId.OR 9722,1
Permit Nn / /� ��'���
Alf 0 1 5111 (19 4171 Fa\ 503.575 1 000 /, I'lau Rc\ 1a\\ •— - ..
11� f)d1c•11y. Other I'Lrnnl
Intipectiun I ins 501 039 4175 CITY OF TIGAR "! I -, Uarc ttaady;lsy J t1„ •�
Internet ww\v a ligunl or us Nouliadi�tt:plud• Et tier i ' 2 fur 1 I
BUILDING DIVISION `T �up n•ntul 'nI r Onllalilln
_....
TYPE OP WORK PLAN REVIEW
--1
❑ New construction RAdditron /alteration /replacement Please check all that apply
['Service over 225 amps, comm'I ❑I lururdoUS lucatiun
❑ Demolition 0 Other:
-
' CATEGORY OF CONSTRUCTION ❑Service over 320 (Imps - rating ❑I4udting mere 10,000 .q. t'l .
ni• 1• and 2- family dwellings 4 or mitre new 1es kleuli
❑ I - and 2-family dwelling—Commercial/industrial ❑ Accessory building ❑System over 0(10 volts hOminal units In one structure
❑ MuIU Flmlly ❑ M25ter bu ilder ❑ Other. DI over Ihr(c starts. ❑i ecd, ti, 400 ailing nr mule
JOB SITE INFORMATION AND LOCATION ❑occupant load u\ cr 99 persons OM V pti iactt n 'e(I strimores or
hh ❑f Egress/lighting R
ss /IlghtinY plan R V park
Job no : 9b4 . lL I .J ,fob efts address: - ❑Health -c; ❑
u facility Other . •-- .. ,_•. - -
`�l P5 �C, Sr< P�;�f1e �t . Submit 2 seta of plans with any of the above,
' City/State/ZIP: 'T9a.rd b 1722 J • I' hcabovearenotapplicableto temporary can ,uuc'llanscrelcc
Stitt: /bldg /apt. no. Project name: FEE* SCHEDULE
Dcsciip inn I Q1). I Ft( I 7 eol4i T—
Cross street /directions to site: New residential single - or multi- family dwelling unit.
Includes attached garage.
_ - 1,000 xj 11. or Ics. I S 15 4
Subdivision Lot no : l:a. add'[ 500 so fl or portion 11 40 �
TaK nmp/parecl no : ^ Limited energy, residcntial 75.00 - - 2
DESCRIPTION OF WORK Limited energy, non-residential 75 00 - - - - 2
/, I •
Each manufactured modular
IAA / OnVp�i[Q/1 0 Ven dwt tin.,5Cl'vlcc /tit Netter 9(1.9(1 2
tr Services or feeders installation, alteration. and /or relocation
,. 200 amps or less 80.10 r
❑ PROPERTY OWNER I 0 TENANT
401 amps to 600 amps 201 amps w 400 amps I06,s5 2
Name: T X 160 60 2
.� 17C�'I/r l a I ion 601 amps to 1,000 amps 240 60
Addicss' Over L000 amps or volts 454 05
City/State/ZIP Reconnect only (;).85 ,
Tontpornry services or feeders installation. alteration. and /or
Phmic. (605) 2 • 21 t-/ IQ j Fax: ( ) relocation -
•
Owner installation: This installation is being made un property that I own which is not - 200 amps Or less
...
66.35 I
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 201 amps In 0 0 0 amps 100.10 2
401 amps to 600 amps 133.75
Owner signature; Datc: _
Branch circuits - new, a11cfaiiun, or extension. per panel
❑ APPLICANT ..._ 0 CONTACT PERSON A. Fee 1hr branch circuits with - — —
l3usmcss name • - service Or feeder ice, cacti
• branch circuit 6 (15 1
Contact [faille:
13 Fee rm. Munch eu'CUtts `
ivitho,rl service ul feeder I'c'e, �
Address. each branch circuit 4(' i5 0 G 2
Gash add'[ branch circuit Q 6.65 , 106 2
C'tly /Stoic /7.IP Miscellaneous (service or feeder not included)
Phone: ( ) — F T x; ( ) Pump or irrigation circle 53.4(1 2
E-mail Sign or outline lighting 51,4(1 �_
Signal circuit(s) or limited
CONTRACTOR energy panel. alteration, or
Business name: T & T Electrical, LLC extension Describe: Page 2 2
Address- 4120 SE International Way, Suite A105
Each add illapection over allowable in any al 111e above
Pei inspection 62 50
i City/State/ZIP. Milwaukie, OR. 97222 Investigation per hair (1 hi .,mu 62 50 '
Plume: (503) 652.7610 I Fax: (503) 652 -7612 Industrial plant per hour 73,75
C'C'l3l.lc.: 161167 Electrical ic.: �•- ELECTRICAL PERMIT FEES*
� -6,D, Supry Lie 473
g, , i `� ,�
Suprv. Electrician signature, required: Subtotal G.J✓•
� y �' j L D iu. / Plan review (2$' %, VI permit fee) r Prim name' - 1> M I R({ U IVl�Y I^ Dote U; r State surchars (;t orpei,, Ice) � -.—
TOTAL PERMIT FEE g1, q67
Authorized signal es' • • _
Tats permit i g 1plicalinn sunless if a grant: It nil uhudard „ilhin Ikp
Print name: T20Y . � to days alYcr it has brit: accepted as Cumptctf
/TG DiltL': / ��, //�� T
' Fcc IIYIItedeln �y set Its
k/ 1. 1 n- (aunty:lauding hithenry tiun ice Itaard •
n ,,, l•1 ,,, „ "• N un l6 er o p geni a ll owe d
4 Nunn,. 1.11. •PeonmAi1, do[ 1_ a.1 44d.aDl ?111Wn,2'COMAVI :a
I.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Liner - (504639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / — 13 AM PM BUP
Location g Sad f • Suite MEC
Contact Person I ' / (UJ Ph ( ) / / - PLM
Contractor • Ph ( )2 6 �0 7 - / ? SWR r
BUILDING Tenant/Owner ELC ?' .06 ! 60 76 ,
Footing
ELC
Foundation
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
C7
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
P, ART FAIL
Service y�
Rough -In �� ,c)v / — a 6 7 /.z‘
UG/Slab
Low Voltage /l/ d • . 0
Fire Alarm I
ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S E LI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line � - /
ADA
Approach/Sidewalk Date J� I — Ext
•
Other:
Final DO NOT REMOVE this Inspection record om the jo ' site.
PASS PART FAIL