Permit A _ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00278
ll4, DEVELOPMENT SERVICES DATE ISSUED: 6/20/02
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -04600
SITE ADDRESS: 06707 SW PINE ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: 200amp service change with 12 branch circuits.
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: 1 W /SERVICE OR FEEDER: 12 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:
HETICK PORTLAND ELECTRICAL CONST INC
6707 SW PINE ST PO BOX 586
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: Phone: 655 -2281
Reg #: LIC 51764
SUP 3461S
ELE 3 -246C
FEES Required.Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 6/20/02 $160.10 2720020000( Wall Cover
Elect'I Service
5PCT CTR 6/20/02 $12.81 2720020000( Elect'I Final
Total $172.91
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
Permit Signatur 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: (P / . DATE:
LICENSE NO: (m I S
Call 639 -4175 by 7:00pm for an inspection the next business day
>� S KI Ziflg OFFICE USE ONLY
•
' Electrical Pe neanoin
U�Z 0 A'n Date receiver — ` .Q- ' Permit no.• y� yy, �p?f r r
r�J+ Z V IY
City of Tigard G ' I Project/appl. no.: Expire date:
City of Address: 13125 SW Hall Blvd Ti ard OR
h f Ti S and '7• Date issued: By: Receipt no.:
Phone: (503) 639 -4171 r'� I I:1
Fax: (503) 598 -1960 , Case file no.: Payment type:
Land use approval:
1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 Tenant improvement
0 New construction Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFOI i%IA'I'ION
Job address: 07 s1,/ p; ,..� r �
, Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: ' Block: I Subdivision:
Project name: I Description and location of work on premises: 5 Vtc._ e 4 .-t _./ d,)
Estimated date of completion /inspection: G ; rt s ..g.i re. -+ae, ,
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: gG I Fee Max
Description Qty. (en.) Total no. insp
Business na e: por.f4QKd Et/CG"h/1Ga ( Z / 7 New residential single or multi family per
Address: / q - 7 - 14., s+ 'ce t' dwellingunit .lncludesattachedgarage.
City: e a „ I State: pgj ZIP: 979 Serviceincluded:
Phone: 6$5 '2291 I Fay: 55-.734E -mail: ;D /0ad.t0:r, 1000 sq. ft. or less 4
CCB no.: 5"/ I Elec. bus. lic. no: y6 Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City/mctro lic. no.: 55/0 Limited energy, non - residential 2
°M:ifor60 , —/9 -dZ Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
7 Services or feeders— installation,
Sup. elect. name (print): r p _ , , � Licen no: , s
alteration or relocation:
PROPERTY OWNER 200 amps or less / &/,S5 ‘4,gS '2
' Name (print): ca,, L ,—(--) tc,k 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: 'Fax: I E -mail: Reconnect only I
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, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am.s 2
ENGINEER 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 6 44- 79 go • 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc .(Serviceorfeedernotincluded):
O Service over 225 amps-commercial ❑ 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 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan ❑ Other: Per inspection
Submit sets of plans with any of the above. Investigation fcc
The above are not applicable to temporary construction service. Other
Permit fee $ 60 - / O
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
❑ Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ /01..E/
Expires TOTAL $ —'
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440 -4615 (6 /00/La /
J" t g g o
C'' / b3
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
/ BUP
Received Date Requested - 7 / / -7 AM PM BUP
Location i1J 7 7 f -- �2� .2-1"" Suite MEC
Contact Person rn /l'/'1 Ph ( ) % 7 J 7S/ PLM .
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC •• — CZ a 7
Footing
Foundation ELC
Access: 1 _ Z 3 f � : LL � A S�
Ftg Drain -=6 � ELR
Crawl Drain
Slab Inspection Notes: ?piT SIT ,11)1
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ` I
Firewall ev Nk E NE Fire Sprinkler \
Fire Alarm C>LV�
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
C
Roug -In
UG/Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date � � 7 ^Q 7i Inspector �'`' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requeste ' t S AM PM BUP
Location (, 76 - 7 Suite MEC
Contact Perso Ph ) 4 1 4 ° 7 - 0 7 S� PLM
Contractor fas- A EG r'i� / CDrt h � ) �✓ / SWR
BUILDING Tenant/Owner ELC a — ? 7 d
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: 3 7 S SIT
Post & Beam
Shear Anchors / ,� 9
Ext Sheath/Shear �l flesh el L=l 01 ">' /.1,j/ rfifil•Sre- x79eY_
Int Sheath/Shear
Framing
Insulation
Drywall Nailing " 9 f C . ) I _
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
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
11 ,, PART FAIL
SI El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Date t> / A 7 /r �o 2 Inspecto • - ♦ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL