Permit CITY O TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2002 -00318
'Y�y DEVELOPMENT SERVICES DATE ISSUED: 7/15/02
13125 SW Hall Blvd.. Tioard, OR 97223 (503) 639 -4171 PARCEL: 2S103CB -08500
SITE ADDRESS: 12401 SW QUAIL CREEK LN
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT : 034 JURISDICTION: TIG
Project Description: Wire AC unit.
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: 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:
TERESA STEBBINS HILLSBORO ELECTRIC
12401 SW QUAIL CREEK LANE 21185 NW EVERGREEN PARKWAY
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 524 -2662 Phone: 503 - 439 -9666
Reg #: ELE 34 -433C
LIC 134481
SUP 4240S
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 7/15/02 $46.85 2720020000( Elect'I Final
5PCT CTR 7/15/02 $3.75 2720020000(
Total $50.60
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 OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Permit Signature: (,� Issued By: /5 /�g
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: CZ921 " DATE:
LICENSE NO: `la - 'tOS
Call 639 -4175 by 7:00pm for an inspection the next business day
07/10/2002 09:00 5034399666 HILLBORO ELECTRIC PAGE 01
a — 00,D -7 c'
A Electrical Permit App
ED I3a terrr +elvad: '�(S -0 Y Petmitao.�LC . a0.'8
;•11��`' � i�: City of Tigard � GEN Project. appl.no.: Expire dam:
Address: 13125 SW Hall Blvd aid. OP. 97221 Dateiauea: By; j e►PLOe
Clry aJrigard one: (503) 639 - 4171
Fax: (503) 59B -1960 JUL 10 ntil case file no.: Payment
1
Land use approval: l • • _ a a � . _ '•..)
W ‘It
•
1 OF 1 11 I'
Iii 1 de 2 family dwelling or accossory 0 Commercial/industrial Ci Multi- family Q Tenant improvement . .
O New oonatructioe 0 Addition /alteration/replacement CI Other: _ ❑ Partial
JOB tiffl': 11\1'0101A' f111\
lob address; I .11111MiralliMMIll Bldg. no.: Suits no.; Tax map/tax lot/account no.:
Lot: Block S .division:— • .
Project name L 5 4 ,. r • • tioa turd location of work on pre t. ; - e. y
estimated dale of com . terion/ins. - .. :
t t) \ l'It.\t:I Ott Ai'1'1,1t"A7'1O\ • — ",. Il•:I. .%1 I.1
Job no: 10' , _ . FIFA Tea Ea
13usirleas name: , Newneitloltal- minstrel •• • ' oar
Address• a . f M dwalliagtardt indaaler
I$!lil F_1 Zip: a Si:Meer et*huh
Phone: j 4
T ,' li.ma : ' � ' 7 1000 •. A. 0 lase Poch addittm al 300 sq. tt. euryotdon thereof
CCB no.: Ir+i�t � GUM Stec. bus. Ile. no: VEMIZIP
-al Limited Nun;y, residential 2.
City/metro lie, no.' Limitedenegy. nop•residential 2
. . , _ lu
Each mama& red home or modular dwelling
I '-� ��� p D Servie a odic r fader 2
S urn .. electrician -•`L':! Des+
�� r gary(casorl+e/en— ItgWlatlaa
Sap, alert Dome (ptiM)c r �!!T �r�J• alteration or relocations •
I'ItOI'I.12T1' 011 \1' 200am•sor.ess 2
201 amps to • •00 amps 1
Name lnt): 401 apps to l.00 amps 2
Mailing a ddtesa: 601 amps to 000 amps 2
City: State: ZIP: Over 1000 al. tps or volts • 2
Phone: Pax: E -mail: Racmrneot or ly 1
Owner installation; The iobtallalion is being made on property 1 own Tempamry s ontwe or faadan -
which is not intended for sale, lease, rent, or exchange according to a snore 0R ' orralO44ti0ns
200 ampeor:us 2
ORS 447, 455, 479, 670, 701. 201 amps 10.100 amps 2
Own 'S s : • ,. Date: 401 to 600 al. ape 2
F:\'(I 1 \' L L'tt &sock dreg dta - nsw, altersrtlea,
• oroxlsesion parpaoelr
Name: A. Fee for b ench circuits with purchase at
Address: sonic. of feeder toe. each branch circuit 2
State: j7.1P: B. Feeforbtencltcircuiuwhlwttputehaae
City: of serou or f esdertee. Mt bt+aeh cirw - a
Phone: Fax: E-mail: each additional braru h e:itotit
1'l.-\iti III V11 (Plea Check mill that :ytpivI Mimic .(Servieeorfeedernettneludad):
O.Servies over 225ampa -tom tscial OHnlatrafefadlity Eachpamporisrtgatioocircle 2
O Sexvke over 320 artpe -Ming of 1 &2 O Mnordilae location Each aign or sudles lighting _ 2
family dwellings C1 Bulldieg over 10,000 square feet four or Signal eirtol (5) ore limited energy Pte• .
OSystemover600volts alum residentialluoits inone structure alteration, orexteasiona 2 •
O Bonding O Feeders. 400 amps to more o13aat:tiprion
O Oco+ptart bad over 99 peaeru ❑ Manufscr sad structures or R V pssY Each additk twi inspection aver the Miawalrle 1n say art he above+
O 6gi edigbdngplm 0 Odor: Periaspactioa I I l I
Sutbdt sets of plans wkh any of the above. tnveaegatior foe
The atbove ore act applicaUle to ttemporary conetructioa stroke. Other
fe
Not mitt J ens amps e+adlr m le. piaw eau Julius• rot MOM Inteasaman. Notice: W p ap ication Plan Permit It ew (al. Iii)
Cr $ $
q,, g 5
Q Vlaa CI Mast p� if a mit is not obtained'
edit mbar 111 a ti 'L:;= 'J, 1 within t s0 days atter it l les been State surcharge (8%) $
g 1 f °a accepted as complete. TOTAL $
t u Amount 4404613 (6a01COM)
• rnnfltt QlV0IJ. 40 A.LI3 0961 989 C09 %Vii pL :01 NOR to /[t /90
CITY OF TIGARD 24 -Hour
BUILDING • • Inspection Line: (503) 639 -4175
INSPECTION DI VISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / SAM PM BUP
Location / 1 4 6 " au-e & ODx, `R 1 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 4 /3 ' -- 6 6 (0 SWR p'
BUILDING Tenant/Owner ELC 3/ Q
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes:--- SIT
Post & Beam s= —�.B/� ✓WL�< < l.l.. - J
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall F-6 1 V 4. Q� Fire Sprinkler 6
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 C .
Low Voltage
Fire Alarm
SS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE U Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Date I � _ �i Ext
Approach/Sidewalk Inspector
Other:
Final DO NOT REMOVE this inspection record from t e job site.
PASS PART FAIL