Permit •
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00127
i� DEVELOPMENT SERVICES DATE ISSUED: 3/13/03
1,L ..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134CD-08900
SITE ADDRESS: 11825 SW SUMMER CREST DR
SUBDIVISION: BURLWOOD NO.4 ZONING: R -4.5
BLOCK: LOT : 031 JURISDICTION: TIG
Project Description: Electrical reconnect.
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
GRESHAM, JERVEA L EAGLE ELECTRIC LLC
11825 SW SUMMERCREST DR 4840 MOSS ST
TIGARD, OR 97223 PORTLAND, OR 97219
Phone: Phone: 452 - 8026
Reg #: LIC 124834
SUP 3565S
FEES ELE 26 -968C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/13/03 $66.85
[TAX] 8% State Tax . 3/13/03 $5.35 Elect'I Final
Total $72.20
This Permit is issued subjed to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more tha : i •a -. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in O • - 952 - 001 -001 c through OAR 952 - 001 -0100. You may obtain copies of these rules or directquestions to OUNC at (503) 246-6699 or
1 -800 -3 -2344.
Issue. By: ✓ _ ;�1'1 Permit Signature: r
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
•
CONTRACTOR INSTALL . TION ONLY
SIGNATURE OF SUPR. ELEC'N: 4 Q ' ' % ��' � - ' 'D — cam DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
11 1111111 ? 2003 2:30PM EAGLE ELECTRIC LLC 503 452 -0121 p.1
9/12.2003 13:53 FAX 5035981980 CITY OF TIGARD VI 002
. . FOR OFFICi': USE ONLY Permit Application Received a Electrioa,
Date/ay; , / 0 0 A _ Permit No.: ie,cloog -40 1)-7
City of Tigard RECEIVED Planning Approval S P i ar�rrtit No.:
13125 SW Hall Blvd Plan Review Other
Tigard, Oregon 97223 en 'M Detr/By: N
permit
Phone: 503 -639 -4171 Fa 3 -4921 }O3 Post•Review Land the
1 ' n',r �,� 1 1: I.. ;. Da�19v: Case NiD.:
Internet: www.eitigard.or�.l¢ a•i-' 1 Contact ` �I Poke 2 [or
24 -hour Inspection Requede T4�9 RD.r� "" , xamdMelhod 11�� 19nppleineatalInformation.
BUILDING DI SIGN
E ; a.o...? : ,: j . v.q :pNt: : ti, 0 , :1! .. ! '.',. . :f'"Wil i 'xd }tWiL : r. ..)';
• New construction I. Demolition r Service over 225 amps • • Health facility .
commercial • • hazardous location
O Additio , .1 erab , _, r_ _ • lncement IL Other: 0 Sewioe over 320 amps-rating of ID Building over 1 0,000 square feet,
;a !'li1 t9id°'!�ti$ �a i = �'% :1Y.. l:ef�np,(o5 : :.' :',a:� ;•. :i :` '•I . i& 2 family dwelling; four or nu residential uaimin •
9 1 & 2- Family dwelli _ IN' Commereial/lndustrial ❑ spars over 600 versa nominal one ao,teture
0 Building over three stories ❑ Foulest, 400 amps or more
• Accessory Building IiII Mum- Family D occupant load over 99persons ❑ Muwtlsetured structures or RV park
Ill: Master Builder Ir Other: 0 Emett/lightingplan ❑ Other:
wi) LID , , ; . ; s , : •. Submit gets of Plans with uey of the above.
4 1.f.:;: .•.":!{ :-., ' rs,$J _2 •d,:l: 1L r �••1� I' '1!'� <t i a • {' :�: Ileable t to
' The above are not e • e. ra construction aervtee�
X Job site address: / /8 .2S" 5 W gv Crag be, ^ :ii.. " >r ; ' , 4 . 3 1 ' F?�''17Z,i ;.v e5 1_ii� ik! := .r`' A -:
Suite #: 1 Bldg. /Apt. #: Number efiuspaction0 per Permit allowed
Description Qry Pee (ea.) Total
Project Name: Neer nsldndakiagle or multi- fate1ly per, i
Cross street/Directions to job site: damning unit. Includes attached garage.
Service included:
_ 1000 say. ft or lees 145.15 • 4
$lish additloZ$00 pal ft. or portion dreamt 33,40 I
Limited energy. residential 75.00 2
Subdivision: ( Lot #: Limited energy, non resift/1.01 75,00 2
ma •/, aI #: Each reanufactaad home or modular dwelling
Tax n.e t � . ., L . •, S., service sndrot feeder 90.90 2
• _1 ,r y�,u L LAVIS%D tE1 ti .f�iA : o a , r • ., s,.,...:: ' 5grrleaa ar feeders - iasaallarloo,
X I Ef o /VJJ N alteration or 'elm-edam
200 amts or lets iWO 2
201 amps to ciao arise )06.55 2
40) amp imps 160.60 2 `
s to 60
:A> � M.. 5F+ .1. • t � 601 amps m WOO _ ato.60 _ z
I��' °_ ytT t;f �_� i :.''� a' T 6 lj i r r,. �_L . �S w.;L' ,'' 454.65 2
- Over 1000 a to
Name: Reeormect GO I 6&85 ,6,175 2 ,
Addre • . Temporary acrrives or.teedcre - lastelledon,
alteration, er relocation: � 1
City /State/Z1p: _ 200 amps or less
201 401:1 mass I 'two 2
Phone: Fax: ' ��-� rp � 401 pol)6amps J 133.75 1
r " tl '' . 1k fo.i ' ' ,.. ta... t6�� 1® 1�,i 1 f t � R• ' .E lxtl3?31tia71:r Braaeh
: 1 !r,�.�Y� �� :[icev, :lt.)��:.:
..rFr . .r •�rYY x:.,..a`! d►cufta- sew, alkntlon.or
Name: extension per panel
A. Fee for branch checks with purchase of �� 2
Address: rcrvice ar Mi fee. agar itfraneh d ,
City /State/Zip: B. Fee for t�rsnch circuits wi thout purchase of _
service or feeder fee, S braft tet branch circuit 46,85 2
Phone: I Fax: Each additional tomb circuit 665 2
.
Mirc.(Scrvlee or ceder not included): 2
E-mail: : a c h rump orini circle 53.40
.1° r1f�}i w !i'� Rr� ��' 1 ° f : � i i 19] [ i9tLWYi�.A. � . "...� i �.. "(� ��.P. E sign or oy�(pine i R 53.10 r. . 2
.
Job No: 1 Signal ciren0(s) or a limited energy penal,
alteration, or extension Pi$e 2 2
Business Name: gall_ ,le,c,� -v 1,...1., C. _ Daeriplen:
Address: 4115S)___ { � i W _mass ST Ert en additietml Impaction over the allowable In any_of the above:
Ci /State/Zipi c ...F-la.• O�a- ci 7 a..1 4 nor inspection par hour (ruin. I hoer) O
Phone: t2 432 -170zb r ax: (5D f-52 - -0 f a l lnvenia donfee;_ •
Other:
CCB Lie. #: I24134 Lis.#: a 4. - `Rv ' C :L :':ilk,,L;r': •,yg . < v, .' .it:, `;r61 _ -rl . .i.:.-':
.. 7'
Supervising electrician ';( / Subtotal S. 1» tl r . .
i. i . ` < , Plan Review (25% of Permit Pee) S
li albutt; nays d: -t �- - )
5 5 Slate Surcharge (8% of Permit Fee S 4 a_ —
Print Name: L�1� ~$r�'T� TOTAL rERNIrr FEE , a rjQZ -old
Authon2ed — ,' Notice: This permit application expires Ira permit 4 not obtained within
r � 280 days after it km bison accepted w complete.
X., SignaturE: - - - =' . �� �—�— *Pee methodology aa.by Tri -County Bundled Industry Se/a'lee Board.
'
Li ALe y "'
Am rANTObJ
(P1esse print name)
i ;\Dsts\Permit Forrn\i lcPemaitApp.doc 01/03
CITY OF TIGARD 24 -Hour T �
BUILDING- Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ "' �F 1.3 BUP
Received Date Requested 3 -- t AM ' P BUP
Location ga .- — /A ■4L_' Suite ' v MEC
Contact Person Ph ( ) 41t 8O -14, PLM
Contractor Ph ( ) /1--4(-.3 T SWR 3 BUILDING Tenant/Owner ELC J -oo /a 7
Footing
ELC
Foundation Access: L / _ /
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ( }'�
D ywal Insulation ( ��y �J ' J
Drywall Nailing �
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 7
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
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• SS PART FAIL
SITE Please call for reinspection RE Unable to inspect — no access
Fire Supply Line
ADA _ /
Approach/Sidewalk Date ✓ ' Inspector l Est
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL