Permit A'. CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00511
hhil i e Ve/1 DEVELOPMENT SERVICES DATE ISSUED: 10/16/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111AD -11600
SITE ADDRESS: 08880 SW REILING ST
SUBDIVISION: SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK: LOT : 043 JURISDICTION: TIG
Project Description: Installation of (2) branch circuits for a/c and furnace.
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:
MICHELLE BRASHEAR GRF ELECTRIC
8880 SW REILING 15460 SE PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: 503 - 684 -7047 Phone: 503 - 829 -4146
Reg #: LIC 76751
SUP 1655S
ELE 3-484C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 10/16/01 $53.50 2720010000( Elect'I Final
5PCT CTR 10/16/01 $4.28 2720010000(
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 m = • . - opies of these rules or direct questions to
Permit Signature: Aj Issued y:
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 ..A7Q19 DATE:
LICENSE NO: /l 56
Call 639 -4175 by 7:00pm for an inspection the next business day
Oct 12 01 02 :13p GRF Electric 5038295747 p.1
Electrical Permit Application
� , . Datereceived: /� / Permit Et.e ', a ,/ -eas
'..1 II City of Tigard Project/appl.no,: Expire date:
City nfTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
>4_1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family O Tenant improvement
❑ New construction ❑ Addition/alteration/replacement O Other. O Partial
JOB SITE INFORMATION
Job address: Fire, SW /� !� h e , r Bldg. no.: Suite no.: Tax map /tax lot/account no.: .
Lot: Block: ISubdivision: a t, ,4.rL Ct 72
Project name: 13 trrt q /, e et I ,- I Description *rid location of work oil premises:
Ea imated date of completiorJins :tie _
.if
CONTRA Obit A rlitiTIO, '-' -t -•&` :- : : : ., = - s I Sal Ell f C_r- , . .,,=_= ---- - ;
Job no: • Fee Max
Business name: G R_F e.) Ccsf-fri U Description Qty. (en.) Total no. insp
New residential - single or multi-family per
Address: i G Lf- to O S. Pat ea. !/t Ice is L et to a dwelling unit Includes attached garage. •
City: M I t I/ et D S t fL State: ZIP: --1 'i O tf-L Service included:
93Phone• K?u�t{..`t-/e Fax: $2_q -57 LA E -mail: - 1000 sq. ft. or less 4
7 ( e I I Elec, bus. lic. no: 3 - � k q . n Each additional 500 sq. fL or portion thereof
CCB no.: S C.
Limited energy, residential 2
City /metro lic. no.: 3 Z Limited energy. nonresidential 2
/
����•
, w . ' ID I // / ! Z f b 1 Each manufactured home or modular dwelling ,
Signature of supervising eel ician (required) Date Service and/or feeder 2
Sup. elect. name (print): A ) - • A ,..„ License no: / & s 5-,5 Services or feeders — installation,
PROPERTY OWNER alteration or relocation:
200 amps or less 2
Name (print): Ai r cp. e g - 201 amps to 400 amps 2
address:
/ 401 amps to 600 amps 2
Mailing r s L, l r 9 t'l q 601 amps to 1000 amps 2
City: T.; 4 _ I State: J I ZIP: C 7.2-2. Over 1000 amps or volts 2
Phone (� ft." — 7 p 'f Fax: 1E-mail: Reconnect only 1 •
Owner installation: The installation is being made on property I own r Temporary services or feede -
which is not intended for sale, lease, rent, or exchange according to tfattoo , alteration, orrelocation:
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
•
En G1N EEIt Branch circuits - new, alteration,
•
or extension per panel:
Name: A. Fee for branch circuits with purchase of tti7 se S-
Address: service or feeder fee, each branch circuit I 2
B . Fee for branch circuits without purchase &.
City: 'State: 'ZIP: p ! • of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apple) misc. (Service or feeder not included):
O Service over V.5 amps- commercial 0 Health- carefacility Each pump or irrigation circle 2
O 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,
0 System over 600 volts nominal more residential units io one structure alteration, or extension* 2
0 Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park
Each additional inspection over the allowable In any of the above:
0 Egress/lightingplan 0 Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other ^ _ a Not all jadsdicdons accept anent cards. please call jurisdiction for mote information. Notice: This permit application Pe[miL fee $ i
Cl Visa 0 MasterCard expires if a permit is not obtained' Plan review (at — %) $ Lt. Z g /
Credit card number. / / within 180 days after it has been State surcharge (8%) $
Expires accepted as complete. TOTAL $ c/
None of cardholder as shown on credit card / b
Cardholder signature Amount ( u
$ Amomrt 7 c 1 " C- (0-/- a 2-- fiAWC01.0
• (4 55 5 /o- / -6'`'
037,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested // AM PM - BLb
Location q R 3 d Suite MEC °( 0. 3.57
Contact Person Ph PLM
Contractor Ph 2 S 7- 7 x o SWR
BUILDING Tenant/Owner ELV D--c)/ v 0 Sl 1
Retaining Wall ELR
Footing Access:
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PA ART AIL
( MELFTA NICA
Post & Beam
Rough In
Gas Line
Smoke Dampers
Fi
e�. PART FAIL
TRICA
- '«
Rough In
UG /Slab
Low Voltage
Fire Alarm
931$0 PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date /�� �Q Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.