Permit 4 CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
x a�Ilj� DEVELOPMENT H BMENQ Tigard, OR 97223 -00146
(503) 639 -4171 DATE ISSUED: 6/3/2004
SITE ADDRESS: 11355 SW TIGARD ST PARCEL: 1S134DC -00600
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Irrigation control
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: X
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ANDERSON, LARRY R AND BIZON LANDSCAPE (IRRIGATION CONTROL
CYNTHIA M 25935 SW GRAHAMS FERRY RD
11355 SW TIGARD ST SHERWWOD, OR 97140
TIGARD, OR 97223
Phone: Phone: 503 682 - 2424
Reg #:
FEES Required Inspections
Description Date Amount Elect'l Final
[ELPRMT] ELR Permit 6/3/2004 $75.00
[TAX] 8% State Surchart 6/3/2004 $6.00
Total $81.00
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
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by / 4a� E Permittee Signature cry) c _
c.�-�� -y(
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
FROM '.0N LANDSCAPE CO. (TUE)JUN 1 2004 10:42/ST. 10:42/NO. 6336807779 P 2
mectrIt a>i rermit elppucauon
�I p
CI� Tigard '0. _
r ; �i c�� `r R jx u� e y Pem...No • �j,/ ,Z 2(90y- OO/LI
13,', 25 SW,E 11 Blvd., Tigard, OR 97 Plan Review Iv`-
Phone: 503.639.4171 Fax: 503.598.1960 'too4 , ,. , Date/By: e` Permit
Line: ne: 503.639.4175 11, N . i . ' i
Data Reedy /lay. 1 DI See Page 2 rut
Internet www.ci.tigard.or.ua J C � k ca AR>t REVIEW Notified/Method: supplemental Information
TYa D &Q litlC `v� r jl oN PLAN REVIEW
[ 'Pew construction ❑ Ad® Lion/ Please cheek all drat apply:
' N
❑Service over 225 amps, comm'I ❑ Haz/1rdays locution
❑ Demolition 0 Other
.. . _ Q Service over 320 amps - rating ❑ [3uildag over 10,000 sq. R.,
CATEGORY OF CONSTRUCTION of 1• and 2- family dwellings 4 or more new residential
❑ 1- and 2-family dwelling I Commercial/industrial ❑ Accessory building 0 Sy over 600 volts nominal units in one structure
❑ Multi-family ❑ Master builder ❑ Other. ❑ Building over three stones ❑ Feeders, 400 amps or more
❑occupant load over 99 persons 0 Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egressgigitingplan RV park
Job no.: I Job site address: it 355 _) 17.„j 5 1- ❑ HealthKSre facility 00thC•
Submit 2 sets of plans with any of the above.
`�''�
City /State/ZiP: I (1 6,14 6 . q M a4-3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: Qe ," v,t
�, - (,J We /1W FF SCHEDULE
mammon I Q9• I Fe• I ToPJ I '
Cross street/directions to J ob site: Z t New residential single- or multi - family dwelling unit.
ril'� I �' tL '-`" includes attached garage. LA 444 b 0,
.se _ _ �;_ A 4- 1.000 sy. ft. or less 145.15 4 •
Su... ision: P Lot no.: Ea. add'l 500 sq. R or portion 13.40 1
.. Limited energy, residential 75.00 2
Tax map/parcel no.:
_ _ ._ Limited anew, nmarrsidential 75.00 2
DESCRIPTION OF WORK Each mamufaclured or modular
dwelling, service and/or feeder _ 90.90 2
Services or feeder. Installation. alteratlun, and/or relocation
200 snitsi or less 50.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
€10. 401 amps to 600 amps 160.60 2
Name: v •eAA "2'40 t < 601 amps to 1,000 amps 240,60 2
V 4� Ova 1,000 amps or volts 454.65 2
o
Address: 5 (....0 � � [ Z ��� y
Reconnect only 66.83 2
City/State/ZIP; +4 vt G "1 a3 O Temporary services or feed Installation, alteration, and/or
Phone: (S CIO g 3 13Lk I Fax: (e)3 Cl 3k-I -C( 2relocation 00 amps or less 66 .85 I
Owner installation: This Instill +Lion 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: _Dale: Branch circuits - now, alteration, ur extension, per panel
❑ APPLICANT I_ ❑ CONTACT PERSON A Fee for branch circuits with
,, service or feeder fee, each
Business name; ' 1" \Q � � f � - branch circuit 6.65 2
G/
B. Pee for branch circuits
Contact name: without service or feeder tee, 46.85 2
Address: each branch circuit
Each add') branch circuit 6.65 2
Ci ry /State/' /.I P: Miscellaneous (service or feeder not Included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
�
, r l ` r
extension. Describe: Page 2 2
Business name: 1l!'� f f�
Address: D. 5 1 C -..� (..11 ut r C, Rash additional inspection over allowable in any of the above
o G Per inspection 62.50 _
City /State/ZIP UUt 6 L- I T 1 `� 0 Investigation per hour (l hr nun) 62.50
Phone: ( 5 ) .6% t-0-4 I Fax: ( s'n3) 6g - 3q- °I Industrial plant per hour 73.75
RI.F.CTRICAi. PERMIT FEES•
CCB Lie.: 6 13 I Electrical Lic.. I Suprv. Lie.: Subtotal y S 0
Suprv. Electrician signature, r ;wed: Plan review (25% of permit fee)
Print name: / 1 Date:
State surcharge (8% of peri4iit fee) d, op
TOTAL PERMIT FEE / O D
Authorized signature' N, . % Tl nb p cnmtt applkaUon esplrea If p pemnit N not obtain within , 180
days after It has been accepted as complete
Print name: a • ^! ec. I Date 6// /c) • Fee melhndnIney set by Tri- C:nunty Raiding Industry Service Wined
•• Number of m. paction% per permit allowed
is \Ruilding\Penmts\F.LC•P • .doc 12/03 440.46I57(I0/02/t•.OM/WP,g
. mow 0
CITY OF TIGARD 24 -Hour
BUILDING Inspection I.ine:.,(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 6 -no AM PM BUP
Location • / _ Suite MEC
•
Contact Person 40/!.! / Ph ( ) C• god — 4143 Lf PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: /
Ftg Drain ELR 2 ,,
P)D 7 / ‘::7
Crawl Drain
Slab Inspection Notes: J SIT
Post & Beam ..l.11 . (/ '
Shear Anchors _ /. .�
Ext Sheath/Shear a -f _.1J1_!1 i..
Int Sheath/Shear
Framing - — �i �' _�1- i. I ��
Insulation � _/ (
Drywall Nailing `¢'AQ/iQ
Firewall Ad-
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 -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
47'� �"� PART FAIL
El Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA lb - fl I r - i• i ,
Approach/Sidewalk Date �J In spector _ .� u j d +� i Ext
Other:
Final DO -NOT REMOVE this Inspection record from the Job site. - "
PASS PART FAIL