Permit C ITY OF TIGARD ELECTRICAL PERMIT
- X" ` PEROT #: ELC2003 -00128
41,1) DEVELOPMENT SERVICES DATE ISSUED: 3/13/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BB -01400
SITE ADDRESS: 10265 SW SERENA WAY
ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1
BLOCK: LOT : 028 JURISDICTION: TIG
Project Description: Move 2 circuits in kitchen remodel.
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+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
THOMAS ADAMS ELECTRUM INC
21019 SW ERIN TERRACE DBA SPECTRUM ELECTRIC
BEAVERTON, OR 97006 2050 VISTA AVE #100
SALEM, OR 97302
Phone: 503- 259 -0459 Phone: 503 - 361 -1256
Reg #: LIC 116453
SUP 2919S
FEES ELE 24 -353C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/13/03 $53.50
[TAX] 8% State Tax 3/13/03 $4 Rough -in
Elect'l Final
Total $57.78
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: ,�,ca, Permit Signature: , , : Jv /
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: l M
Call 639 -4175 by 7:00pm for an inspection the next business day
ti
03/10/2003 14:08 5667503 TM PAGE 01102
03/06/2003 15:7 Fla 5035981960 REc51VEIIGARD
,�.�-_� FOR � r °>✓ >r�..E
• Electrical Permit Ap 11ca 0 2003 Received 3 —� ry -0 3 ` � .: C , 14 w , S(
maiming A pproval Sign
City
CITY OF TIG ARD Sig nrlxN°
13125 S W H Blvd. BUILDIN' •'VISION l Ma
W Hall Blvd. Ds• ; - Permit No.:
Tigard, Oregon ! 7223 Poet-Review per t N
Phone: 503- 639 -4171 Fax: 5O-598-196O ,- „,o ,+, , ;, r +i ^' i Date1B : N0'
f luris.: See Page 2 for
► S
Internet wvl�w.ci.ti�gat�l -onus r' r.l Contact So� e�ental Information. Inspection Request: 503-639-4175 Name/Method
'44 fi t, - ry, �_, :; .� :, :.. !; ..
s�►•
' :e. - sir” -1.4' ?i: i ' �1.1 i�'1LY' ' I' A t- ia. � N..�.. s • Health-care facility
t,:t. 0 Service over 22s
II New construction I ■ pemoIit commercial 0 Hazardous location
O ther: 0 S ervice over 320 amps - rating of 0 Building over 10,000 square feet,
E / r 'Placement '� four or more residential units in
90 " 'jii r` s 152 2 Vanity dwellings
'," i 1 � '..;1 ' ! , ° ' �` II ' - I. ` y System over 600 volts nominal vtle structure
i ' ;' 2-Family : commercial/ y p Feeders, ure amps or more
r I & dwellin _ 1■ Sys ng over three V t8 i of
Di [l Occupant load over 99 persons 0 Manufactured structures or RV park
Access() Buildln _ 1 D Egres6llighdng plan 0 Other DI Master Builder IR Other: Submit sots of plans with any of the above.
L �7 a - i X11 �) ' .. m : The above are p ot a i livable to tent • r : contraction service.
' .i1, '. i i- �' a '1 1 C""Rh
1 1. ��1�
Job site address_ ] o 2 514 Number of ins • talons • er 1 ermit allowed
Suite #: _ � Bid • JApt. # : « Iles (ea.) Total 11 peacri • don
• 'ect Name: New realdeutleksingto or molth ramify per
Cross street/Directions to job site: dweilinlf unit. Includes attached garage.
L.. Service Waded: 145 -15
\ % L. � Each ad. ft.
banal 5 33.40
66 1000 sd• t.ona150115•. ft 0 ;an thereof �
united ere , 4 tesidearial 75.OD
L o t #: 75.00
NEM
Tax I' division: I.
Each manufactured home or modular dwelling
Tax ma +! • arcs] #: _ r . 1 Y, : p, 41 :44.1. service andlor d eee r
90.90
teMi; It'ii,,, tai '. •`' : °' 4�_t, 1 L • F :e.ar : :'i :i', a' . S cesor enders - lostalladOo, ■
ie C 1 ea 1 S to T .n alteration or relocation:
700 - • • s or less 80.30
W-SJ0- ibeke -� 201 am.: to 400 :,• • EN 106.8 2
11 ,: ■ 600 am MI 160_ 2
6 01 : 1 to 1000 240.60 2
--
;I.%lR3a9 li'i0��f: ii�i'ttii `pVbr Over 1000 , . orvolts 66.85 2
.t ,
Name: Zb•10M�AS ' DAMS Reconnect on
7 gi NJ -- ' A Temporary Sarvlees or feeders . installatlofb
Address: �1 `� alteration, or relocation: 66 -85 1
A 200 ant.: or teas 2
r i 4 = � "1;.r d7 ' • 10030
201atn•- to40 ••- ■�- 2
Phone: r U 4 A Fax: m 600: • .:
1 : i t ,7 1 '' -. _r, :e, I ' P ME o;a 1 Branch circuits -new, alteration, or
extension per panel:
Add Name: - A. Pee for branch circuits with Pie of 2
. each branch circuit 6.65
Ci /State/Zip: A B. for branch service or f -+ _ - is without o A M 2
service circuit
St
service or feeder' fee Gust branch h circuit uit
�� 6,65 2
i • t - • Fax: - Each :. ditianal branch circuit
E -mail: :.1. • or ini Misc. (Service or feeder not included): 111 53.40 2
`....',0 ?1�J':W� :iM;tAi. C j . . t ; j } �, j ?, . :M1
; �1 ; s 1 y . i . E h 1 . or maim , ■ t ' . lion circle • , MO 53.+10 2
Job No: _WrO Si g nal circui w a l energy patrol. 2
M alteration, or extension MIEN
Business Name: r A I' neac riptioa . MIN
Address: 2050 V i 5TA• �ItE Z. an —
(mil /StAtelZl • :
A t CR ® Each additional inspection over the allowable in an of the above:
Per ins • - ;on , - hour Loin. 1 ourIIIIMIM 62.50
• Phone: 03 • : , . , IffiffiEMPEW . l 0 If hwesti: • r�
CCB Lie. #: t v Lic. #: - 3 C, I ' Other: 3 t, , t. E44 , MIMI
, ., : :.: E; m
SUPerVising electricx ' , p Su btotal $ a
Si ature required: f -- • Review % of Permit Fee S e
Print Name: •- us'� Lic A : ` .A. 4- 4 ,1 Plan Review
ti -T, : 'to o • - ee 111131•1111E4.=
AudAuthorized 01" TOTAL PERMIT FEE &
ce: This permit application expires if a permit Is not obtained within
Signature: A t �1 - ► at . 07 .0 days after l e 41 t accepted tut
sni d ty l Indust service Board.
i , Fee methodology act by
IF (Please pri g
c- rtL. ...n.,. -..1* G.,.w,el RlrParwatAnO.doe 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (60316n-4171 MST
,)
BUP
Received Date Requested - � � M PM BUP
Location / U '14 s Q �t/ Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( .77i ) a-3 S 3 4")--- SWR 3 ado a
BUILDING Tenant/Owner j (1� ELC Ce
Footing 025- l — D T [[,, sq ELC
Foundation Access:
Ftg Drain \D \�AVI _ G� 6 1-4 �-/ ELR
Crawl Drain I
Slab Inspection Notes: I I SIT
Post & Beam C I Yv V IC )4 V»
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
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-1n
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage Lt3 j i - 1 Y 'C S C IY. 1,
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Ell Please call for reinspection RE: El Unable to inspect _ no access
Fire Supply Line
ADA
Approach /Sidewalk Date 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: (50 639 -4171 MST
BUP
Received Date Requested __ AM PM BUP
Lo ' n /a n� �P S pp . /4 Suite MEC
C c e Ph � � 7� / -c23.5 3?4'2
Co tractor Ph ( ) SWR
BUILDING Tenant/Owner ELC J — 00 /
Footing
•
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes:_ _ - SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear `
Int Sheath/Shear
Framing
Insulation Aar 4-0>,
Drywall Nailing r
Firewall I _ C 1/.(1
Fire Sprinkler
Fire Alarm /_ Kd /2ve .,L _ . cilLget
Susp'd Ceiling (� mil' �v
Roof
Other:
Final i/O Co-riter(79-
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
Low Voltage
Fire e Al
10 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 ins ct — no access
Fire Supply Line
ADA
Approach /Sidewalk O 3 Inspector frE �( d G/
Other: �/
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL