Permit • • h "w CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00038
�ln DEVELOPMENT SERVICES. DATE ISSUED: 1/26/2005 '
"I �! 13125 SW Hall Blvd., Tigard; OR 97223 (503) 639 -4171
PARCEL: 2S112AD -00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY .
• SUBDIVISION: ZONING: I -P ,
BLOCK: LOT : JURISDICTION: TIG
Project Description:. Extension of (8) existing circuits, replacement of 380 fixtures. .
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:. 1 '
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 1
401 - 600 amp: EA ADD'L BRNCH CIRC: 7 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:
HOME DEPOT USA INC IDEAL SERVICES INC .
BY MARSHALL + STEVENS INC 3525 S ALDER '
ATTN: MELISSA SHAPIRO TACOMA, OR 98409
PHILADELPHIA, PA 19103
Phone: Phone: 253 671 - 2160
Reg #:• LIC 154353
ELE 37 -988C • FEES - SUP 1551S .
Description Date Amount .
. Required Inspections
[ ELPRMT] ELC Permit 1/26/2005 • $155.90
[TAX] 8% State Surcharge 1/26/2005 $12.47 Rough -
[ELPRMT] Investigation 1/26/2005 $93.40 Elect'I Final
Total $261.77
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- 332 -2344.
Issued By: �Q�� Permit Signature: Sj ,,L 5;
• 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. ELECN: , . DATE:
LICENSE NO: '
Call 639 -4175 by 7:00pm for an inspection the next business day
Jan 26 2005 11:49F1M HP LASERJET 3330 p.2
EIeC CII''ical Permit Applica I` � eD FOR OFFICE USE ONLY
City of Tigard RE �F ED ..
,�j� � Perm No.:1 �� q�
13125 SR' Hall Blvd., Tigard, OR 97223 Date /By. l � Q�� `/i` D6Q ? �
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JAN N 2 6 200 R _ i4ifiti Date/By: Other Permit: lu
inspection Line: 503.639.4175 i.w -a.� Dale Ready /By: rir. See Page 2 for
Internet: www.ci.tigard,or.us • ^ pD Notified/Method: -1- ) G 6d Supplemental Information
:'t '�::::� , ali-rr ,: i i '-'�� � ( � � r_ � 5 L; •. , y _c cs 11 lc . _.! ffR ! 4.E+?rsw �1E'�ai
;r -FlaEl l 1 t J3r3t.r . , Ix i is r °,I i ., ; Ill�lIll ' � > S l'' 1,..ItwilF�`- 1 1 1 n - i .. 9 . f .. I 1.,_._.... , 1 1. 1'
.,•_ .... ...r. ,.11l,nh.--. tl,a. t.: m .rn. .�_.% 1 , 1 , -p,,. Il Ilrsm 7 a;na-� «''r�Jiiis'4 U�' �:
0 New construction ri A. • • i ion alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, contm'I El Hazardous location
y t ,a ._ ... ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. �1[� w� �I , e � I ; w'^ niCLRI' I,e ��z:�a� fx it 't l of
. - ,J I 1 1, xr',r., 1 c,,, i 'ti_.,t ,hl°i�iQ - & ,, 1 ;, I IiMIi>iu�art;.Fc # `•L''' w ;;�iil ,; 1- and 2- family dwellings 4 or more new residential
❑ l - and 2 family dwelling E Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- famil ❑Master builder ❑ Other: ❑Building over three stories ❑ Feeders, 400 amps or more
i.n I j lul , g w "_erg ,�_ i ❑Occupant load over 99 persons ❑ Manufactured structures or
1
i x kr',T�'l1 U � '
�`� o.Ai!Yn . pt g IU7[6 4 ( 0 _-l'S. Nl :fin , ❑ Egress/lighting plan RV park
Job no.: Job site address: Q / ��
❑ Health -care facility El Other:
UG�(J c..., ; f 1 � Lt! Submit 2 sets of plans with any of the above.
City /State/ZIP: + The above are not applicable to temporary construction service. aid �5i�fif , •_x=s`i� �y� � il(IiIU �. „ = ;";:_:s''•trnll,!
Suite/bldg./apt. no.: Project name: ila -r � a'ss` - , I,'P'O� ., & 9 i , iin . ..'iL.J• J,E
__ dr r.r_.o, r_ i', r __.....nw sii },�li �I ._. rs,
IL * 'E` i s Dracnpllon i Qty. I Fee. I Total ,
Cross street/directions to job site: c...--. 7 (cc . Ity,4 at , (, M .` New residential single- or multi - family dwelling unit.
Includes attached garage.
Or\ :91/4/0, - grck 4 e - . 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no
Limited energy, residential 75.00 2
(t
7r •, � L`'a ''t , p .lnt t , _ p, 1 Limited energy, non- residential 75.00 2
''', oat 1, ,' 4 tip l itG�i'6 t i , $ a 4 t l it Q 6 T* 9 �1 1, �I - n ?n !! s I
- �w- -- ss Each manufactured or modular
dwelling, service and /or feeder 90.90 2
' • [' ` ■ Il Iiii ) 'l Services or feeders Installation, alteration, and/or relocation
' •' ; • r L f j • '`�? b - 200 amps or less 80.30 2
Ji ; i it �� , e • � r: .,.: t �� I i 1 aui a Ilia 201 amps to 400 amps 106.85 2
e ... >:- ., ., u .,,.. ut .. I. Lc ... ._ J11 E i . �, dfi n i 11� .1
401 amps to 600 amps 160.60 2
Name: ..koc \e ,.,� ± % 601 amps to 1,000 amps 240.60 m 2
g r) 1 Over 1,000 amps or volts 454.65 2
Address:
1 i l 4�C� , `C PC] ( )�j> �� � (�fA Reconnect only 66.85 2
City /State/ZIP Tl (1 0 1 ,---A t 0 e _ q.-- '' Temporary services or feeders installation, alteration, and/or
`+i U' I < relocation
Phone: (9 3) •• ; ;; �q _ r , - 00 Fax: (5 G Q,L4 -3,s--/
lS} c 200 amps or less 66.85 1
Owner installation; This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
e� (f� ,�,,,, :, I A . ,,r,s..�,.. -., a u . 11' p � i ..._. -_•; P IB i
I m. .� F, •i1',fISSC i.. , , / A t m aid ';�,'' =�e`;� F ,, ,. z . ' 1 - , ' . ' A� ` A. Fce for branch circuits with r ''
n .... -• Lr r,i.:�: ":y -s I...F.,, � -• ,.,�..., .s ,$i, . - -:..x . 1 � - °�4•,�
service or feeder fee, each
6.65 2
Business name: - =c.) � �
� �p � c f„..) c .... _ branch circuit
Contact name: - 'r' C. B. Fee for branch circuits /� y� •
Ck:di�k0.d?'h� - n , without service or feeder fee, 46.85 7� 8 y 2
AddiCSS: 'a., each branch circuit
- a L_ . s r Each add 'I branch circuit `7 6.65 L•i/(p. 55' 2
City /State /ZIP: ` C ^ �o t A_. a9 Q C
r Miscellaneous (service or feeder not included)
(� ^� f / fd Al Pump or irrigation circle 53.40 2
3) (
Phone: ( 7�...' L (' ) Fax .. US ) 1- '
c_ . 70 Sign or outline lighting 53.40 2
E -mail li •
�' <! i � � � Signal circuit(s) or limited -
IIII ... " s " °i , �'s ttrt�t _-�°'" l,
j� '� lax i -9, ,'..� T,ie4i iI �, a .�i ; r '�t� t_ Clt J , �.-��� jh �_'�� ..al �G ener �� l�ffris. • i-� gY P
extensi Describalteration, or
e: Page 2 2
Business name:
�6 AL f' 4 C sS = c
Address: �- 7,- �.
__ Each additional inspection over allowable in any of the above
it,,, -, ` Per inspection _ I 62.50 6.. 5O
City /5tate:ZlP: -�'�+ ?(1� j j ' g per (1 a 4 Yalu
Investigation er hour 1 hr min) 62.50
Phone: (Xi) �,j7i ,a) i' C.) (a5 ) 67 f --- .• A - industrial plant per hour 73.75
Vft
GCB Lic.: !f3 l _ r;; d . 311 v. � , ,. X 1 1 ` t,11! ' .. ' 1 :__'-' 0j L°' li iili; ,:u;
j5- 1 E lectrical Lic i:l 11 " "
� S �Z } j ' I Suprv. Lic.: �.�.�j Subtotal
14
Suprv. Electri,ciarpsignature , required: • /1 tt - Plan review (25% of permit fee)
Print name: p �r State surcha ( % of permit f ee) ( Ci
r e t. i .: 47 . / Date: . t
TOTAL PERMIT FEF._. _ _ .
Authorized signature I � t
This permit application expires if a permit is not of obtai wit hin 18
days after it has been accepted as complete
,
Print name: L ' `� ( - • Fee methodology set by Tri- County Building Industry Service Board i
V ` ' Date: - � '" _ Number of inspections per pem,it allowed. Z
is BuildinglPeamia \ELC- PemmApp.doe 12/03 440- 4615T(INO2 /COM/WEB / `
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00038
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/26/2005
Phone: (503) 639 -4171 A �� I
Inspection Requests (24 Hrs.): (503) 639 -4175 ' " I I ..
INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7:14AM PAGE: 121
SITE ADDRESS: 14800 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOME DEPOT
DESCRIPTION: Extension of (8) existing circuits, replacement of 380 fixtures.
OWNER: HOME DEPOT USA INC, PHONE #:
CONTRACTOR: IDEAL SERVICES INC PHONE #: 253- 671 -2160
Inspection Request Scheduled For: Date: 4/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 003810-03 253- 671 -2160 Y
Corrections/Comments/Instructions:
Y/1
),
gi PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - 14 . Date: ," ' c7 Phone #: (503) 718-
CITY OF TIGARD 24 -Hour _
BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
f BUP
Received Date Requested 4 -- I I`f' S AM PM BUP
Location 1 --kBo(i) S VNI SV 1 Po. ? \4 h' , Suite MEC
Contact Person -', MC=\ IV(' 11) La I h ) -- dcA PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 0 0 3 0 e
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 6.141\._ W K6 } SIT
Post & Beam +—
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation � O� �N UM14
Drywall Nailing -
Firewall S
Fire Sprinkler
Fire Alarm A NcLD L'2JY" t o V1i \ ‘ 1 � 1 s 'At t' 1 )-
Susp'd Ceiling
Roof W ` kt \ 0 War t_ 1 j\_ 0 ?6 I]
Other: -
Final
PASS PART FAIL
PLUMBING Rs \ t,v •)0 Q:t L,lq� 1 S 1k C \o
Post r laam � 1�1 \ ‘^06'M s l CL\ //..__ \ S ln1 Y`n�� (jP
Under Slab �,7- � 1
Rough -In
Water Service
Nsn
Sanitary Sewer 1 P■Zsi\sFy 9 pim..
Rain Drains
Catch Basin% Manhole
Storm Drain
Shower Pan
Other: (r
Final
PASS PART FAIL -
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Q Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA ,_ 1 ``
D Inspector 111S -\ aVie. Ent
Approach/Sidewalk P
Other:
Final - DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL