Permit CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
lk DEVELOPMENT Tigard, ) 639 -4171 DATE ISSUED: 4 -00081
13125 ED: 3/26/04
SITE ADDRESS: 06650 SW REDWOOD LN 200 PARCEL: 2S112DA-01400
SUBDIVISION: PP1996 -048 - ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Job No. 104076
Voice & Data
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:.
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DYNALECTRIC
15350 SW SEQUOIA PKWY #300 -WMI 2904 SW FIRST AVE.
PORTLAND, OR 97224 PORTLAND, OR 97201
Phone: Phone: 503 226 - 6771
Reg #: LIC 066793
SUP 4817S
ELE 26 -59C
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 3/26/04 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surchar€ 3/26/04 $6.00
[ELPRMT] ELR Permit 3/26/04 $75.00
Total $156.00
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 throuc
Issued by -D2i}111a —&— Permittee Signature ,11 /: /
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 7:00 P.M. for an inspection needed the next business day
MAR. 26. 2004 8: 51 AM NO. 981 P. 2/2
A. o ov S 7
Electri�ca1Perm itApplicataion
e r►atita o.
,r �, ,, . City Tigard � E L Datercceived: P
� �i,6a� a� gl
1 of Tig Project/appl_no.: Expire date:
Ciry ofYTgard Address: 13125 SW Hall BIVd, 1, `V '1!�'g , ORt97 4§11 bate B
Phone: (503) 639-4171 y: 1 Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case,fiile Payment type;
Land use approval: BUILDING DIVISION . �-
TYPE OF PERMIT
CI I & 2 family dwelling or accessory Or Commercial/industrial q Multi-family D Tenant improvement
❑ New construction CI Addition/altezationfteplacement Cl Other: a Partial
JOB SITE INFORMATION
Job address: : i j j tl/.%r/,MM Bldg. no.: Suitt; no 4l Tax map /tax lot/account no-:
Lot: BIock: Subdivision:
Project name: 0 . 4 /0 Description and location of work on premises: j i . try_ , J r
Estimated date o completionfinspection: - •
CONTRACTOR APPLICATION • FEE SCHEDULE
Job no; J f t 6 _ Fee lax
Business name: , I_ / 40 /I al / A�s criptioa Qty. (e3) Total mu, hasp
Address: :, . -� New tesldential- a�hgleorniulti- fanulyper
�� ��a,�� _ 11 Z IP: / J S re osin included:
IncludegattACliedgarage,
d ty' r +Jlf� {.�Q�" W Scr�iceinciudcd:
1
Phone'. �� , , /7-7 14 t 1000 sq. ft- or less 4
cta3 no.: /_ i„ Ecch additional 500 s9. ft or portion herrenf _�
- f � �i .);need energy, residential — M� 2
City /metro lie. no.:
- Limited energy, non - residential
..f..rC! . Each manufactured home or modular dwelling
Signature of supervising ele.- Ian (required) Date Service sncl/orfeeder 2
• Sup. elect name (pznt) : �� i Liceasetro; �r' Services or feeders— installation,
.
��� "�� rI- atterntionorrelocation:
. • PROPERTY OWNER :.. ,_ 200 ampa less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: !ZIP: ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1B-mail: Reconnect only I
Owner installation: The installation is being made on property I Own Temporary seh4c, or feeders -
which is notintended for sale, lease, rent, Or exchange according to • installahon,alteratian,orretocation:
ORS 447, 455, 479, 670, 701, 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 ampi 2
ENGINEER r ., Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with porch ; •f'
Address:
• service or feeder fee, each branch circuit 2
City: State: • ZIP: B, Fee for branch circuits without purchase
E- of service or feeder fcc, frrstbrench circuit
Phone: Fax: ��, 2
Each additional branch circuit.
I'AAN iREVIEW(Please Check iii that .ri IV ' ''," Misc . (Service or'feeder not included):
O Service over 225 amps - commercial ' Q Health -care facility Each pump or irrigation circle 2
El Service over 320 amps - rating of 1&2 ❑ hazardous location Each sign a r outline lighting 2
family dwellings Cl Building over 19,000 square feet foot or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or exteaston* 2
O Building °verthree stories C1 Feeders, 400 amps or mote *Description: _' _ 1 ! -
❑ Occupant load over 99 persons O Manufactured structures orltV park Each additional inspection over the allowable in any aftlte above:
O Egress/lightingplan ❑ Other: _ perins�ection ' I }
Submit sets ot'plans with any of the above, Investigation fee
The above are not applicable to temporary construction service, Other
Perm $ it fee
Not ell jurisdictions accept credit cards, please call juticdittiou for mom iefomtation• Notice. This permit application '
, expires ifs permit is not obtained Plan review (at _ %) S
within 180 days after it has been State surcharge (S%) .... $
accepted as complete. TOTAL $ [
•
440.4615 (6)00/c0tvf)
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 3 r �! -61 V AM PM BUP
Z / Date Request;;
Location t ' ' 50 e2-0D / / MEC
Contact Person '= �L_.. Ph ( ) 550' 2 / V PLM
Contractor f2/v{) g Ph ( ) SWR 1
BUILDING Tenant/Owner l .S '. - J a OO 215
Footing ELC
• Foundation Access: '
Ftg Drain ELR a 9 V d
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 C
Roof
•.h- •
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 • � .�C 1.�\L ��- _� � • V �V
ou -
UG /Slab -
al Voa•
MIO Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 111 Please call for einspect • n RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA D Ins actor A / � Ext
Approach /Sidewalk p
Other:
Final DO NOT REMOVE this inspection record .rom the jo , site.
PASS PART FAIL