Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00448
, DEVELOPMENT SERVICES DATE ISSUED: 07/24/2003
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2 S 113 B 0 -00300
SITE ADDRESS: 08048 SW SHAFFER LN NEW DURHAM
SUBDIVISION: BORQUA ELEMENTARY SCHOOL ZONING: R-12
BLOCK: LOT : JURISDICTION: TIG
Project Description: JOB NO. 924067
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: 14 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:
SCHOOL DISTRICT NO 23J CHERRY CITY ELECTRIC
13137 SW PACIFIC HWY 8100 NE ST JOHNS ROAD D -104
TIGARD, OR 97123 VANCOUVER, WA 98665
Phone: Phone: 360 - 571 -4411
Reg #: ELE 37 -620C
FEES LIC 91668
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SUP 3486S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 07/24/200 $139.95
[TAX] 8% State Tax 07/24/200 $11.20 Ceiling Cover
Wall Cover
Total $151.15 Elect'l Final
•
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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: /� „� D�� Permit Signature: ��
6 '�"' 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 7:00pm for an inspection the next business day
.C-CE SERVICE ; S;,LE ' 5035408147 04/20 '01 12:00 NO.214 03/03
•' .., . :. c..1Ly oI '1135 (7i nn2
)r 1(1 /•
A Electrical {' J 'cation
r
Date received: I Y=[itfCno_e/6am3. /106
A'`•' qi City of Tigard >� �f,ei a 05 aa,j
t: L no.:
ciryafrcgard Address: 13125 SW Hall )31Y Ti hi}.. : 17223 Dare Br _ Recei
Phone: (503) 639 -41ITY OF TIGARD file to.: Payment n
Fax: (soy) ass- 195�UILDING
DIVISI
Land use approval: •
•
o 1 & 2 family dwelling or accessory 3 Comm1/industral Cl Multi- family 0 Tenant improvement
0 New construction 0 Additloll/?ltscalionheplacement 0 Olher.. D Partial
•
Job address:3 Ogg SW Sh a A h Bldg no.: Suite no.: Tax niapf ix lotlaccount. no.:
Lot: Block: 1 Subdivision:
Project name_ (A, I h A- 1 Description and location of work on prcmiser
Estimated dare of co • .leti,onrins. .
CO1'7RACTIOR ,� r°" t` __. >y _.. l=St7it0, ^t _ t .
Job no: o: ��%�.�f9 / l r\ i roe Naz
Business Warne: Gerry tV Electric 1C
Description . Qty. (a�) Total] no. rase
1Vewrte - fie or unit-fondly per
Address: 81C0 NE St Johns Road ate D-1C4 d milingeat e.
' Ow: Vancouver .. sue: WA =a: 98665 s :mew: aa.& .
' Phone: ..161}- 411 Fm -5/1 -441 Erman: iv7o sq. fter1=: 4
CCB no.: 91668 Ele - btts. lie. no: 37 -621JC r b addsD 4apl sy_ tti or pardon ih"raof i
LSailederargy.trsidcotal 2
jv Metr'o /lie. nO' , Unitdtintnl.acm- tesidartiol Z
121,1 1101 l Seek menafaaorad horeeor nodular d - eli"ms
Sift • o• eaprisircg c cici n (required) D:ae Seri= andlarfoicr • 2
Sup, elect, nome(priritk John (moll Lit nserta: 3486 5 atiou rr lonotl eGalbr6oq
- , � a1t�sEiaa
y for klX, 3i , . _ ... . - 200 gaps ar I :a 2
Name (print): r ?Dl strops to 400 aspt Z
Mailing adds 401 naps
GOO amps 2
601 sows m 1000 amps _. 2
City: Stye: MP: Over lox amps ar verbs 2
Pfaonc: I Fax: 1 gm°il• pe.._...-.t • V 1
Owner installation: The installation is being made on g qty I oven TemPatausery5ceo °r .
Which is not intended for sale, le. c; rent, or ezthange ae�rdmg to �� 0n ' °rtnionoriQjf°
2
ORS 4 201 47.455. 479, 670, 701. l 2
amps to m 400 oo amps 2
Owner's signature: Dal= 401 so WO • • 2
n n Y a�iIt r g , . r - __:;_.: 7 ' L • Brock dsclats - Ere clteraV
of extension lQpooel: .
Name: r A F= far brorth circuits with port:ha:e of
Address: Grim or feeder fee, au* brooch nitwit 2
City Stater - ZIP: B, F_ for brooch circuits venom putrh• -s /, 1, • � qq
of Enrol= orf=1-m . first brandi crmai.• I . 2 , 3 r. 15
Phone. Fax. E
Each additiooabiraadteircme �. • Y(o
' 3.10 Il •
7 LP 7 R 1 al . ::1 1) 1 X11 11ri1 i p7 . 1 !7 .; ; Afaa (Service arfiedernot6Kiotad):
0 Scrvim ova225 orspc' d
msra al 0 H efsdblty Each Farm oriaigsiocr ci: cie Z I
sl -
O Sri - over320 amps- cas�rg or Ib2 0 Hszardasrs location , Eft signor outline lighting 2 ,
tt<railydwcIliat; O Baitdlrso+e1o,t7ro slum re,_ four Signal oixcaids)or ■ride encrg7pearl.
O Sync:tt over GOO vans noralrgl Inc= =id =aid balls la arse :.u;, -,,,.. eh:ra ion,oreaetis;on _ _ I 7,.O ' /,• l v 2
0 Building aver three =lies 0 Fades. 403sulpaormoat *gsztipdoce
❑ Ocupant hard over 99 per•ons 0 M.inuramreEd na . cams or kY prat FyIdr addinortal ioeprrcirott ova- the alla.ralrbe In any of the save
0 E,gsrmsliighang plan • 0 abet. _ Peicapastion i 1 I 1
Submit srtte of plan wttfr any of t'bebe alibve.. Iaaescipstion
•E1re above are ttret applicable to temporary eo tactioa oath=: alhs 1 J /�
' erneanpuie6ictia +c sereo :-tZs
ec5t � rillltainilniao cureenEa=a IJGt7C: Ilanper itarppliCaiion P'etlllit S 11 - I. �+/
O Vlsa O Mssretard spires if a pwarit is not obtailrev Flan a:+riow (ar — 5o) S
tier t =e antra= l f • ...lain 1;0 days after it has 6..'ee State surcharge f %) .._. S ri • ;- 0
- : ,, • anted as complete . TOTAL S a .
]errs tf aretcdoer at &own on =in card
S _ •
r...,...�_ °�°•-se I+a�' 6434615 (6rxeCoM)
; tt
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 634171 MST 0\ :, t
Received Date R qu sted I o' l b �} AM BUP PM BUP
Location g I . Suite MEC
ll
Contact Person '1v l2 Ph (1121.) (0 0r ) - Siy TL PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 09 - D D 4 L A
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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P ASS PART FAIL C (
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
FART FAIL
' Se =�
Rough -In
UG /Slab
Low Voltage
Fire Alarm
AS 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
r PART FAIL
0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ///2 In spector ' �.. i / Ext
Other:
Final DO NOT REMOVE this inspection record from the ' b site.
PASS PART FAIL