Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00307
�i��► DEVELOPMENT SERVICES DATE ISSUED: 5/29/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134DC-09200
SITE ADDRESS: 11498 SW TWIN PARK PL
SUBDIVISION: TIGARD PARK ZONING: R-4.5
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Installation of (2) branch circuits for NC unit.
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+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JUSTIN KRISNODI BOONES FERRY ELECTRIC INC
11498 SW TWIN PARK PL PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 443 - 1583 Phone: 682 - 4936
Reg #: SUP 3170S
LIC 88482
FEES ELE 3 -223C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/29/03 $53.50
[TAX] 8% State Tax 5/29/03 $4.28 Rough -in
Elect'I 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: Permit Signature: erA/ fj°AG / 69-770
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 - by7:00pm - for - an - inspection - the - next day
May -28 -03 07:44A __ z _P.01
Electrical Permit Application
- Da croueiwnd: s .2,f,/ 0 3 Pataitno.: SZCo200.5 -de& A
,:4_"' x. City of Tigard l ojectrappl -no-= Baphe :
\---.• Address: 1312S SW Hall Blvd, add, 3 :- I
City a/Stara .h ��� Due usual - .! -1 `
Phony: (503) 639.4174061101
Fall: (503) 5984960 c ji : roKj11 0 1113 Case filono.: Pannent om:
g p, • .-
Land use approval: - i 1 Z $ Z. �b
TYPE OF P1•1011T
Cl I & 2 family dwelling or aoccssory • 1, s y ., „ ” t Cl Multi - family 0 Tenant improvement
0 New construction ' L ' , . raIierar o Other 0 Partial
.1Uii SITE INFORMATION
_lob address: / / ' • .n..• 'ikri,, PA.. k PL Bldg. no-: Suite no.: Taut mapltaa lot/account no.:
Lot. [ Block: ISubdivisioti:
' _ Projr:ct name: ICJ! n 1 Description and tocation of work on premises: A c I/ el; -1 ` .
Estimated dale of co npluioa /inspection: v n e 0 •
CON112ACTOR .APPI.l( .af1ON 11 :L Sc•ri LE
lyb no: i lj rz 0 - Fa Alaoc
Y Ne �rt•+•+4k [r�r tea) Petal on ids}
Business name: 8a an of.,. Felt �l r r ;
Addncss. C So 'i 6.2 P, v _ ,, dwaln[grhbda6mwdwdVra
Sly 1.i c l so n v i l l C State: of? ZIP: 910 7 6 Saetteeh rholet
Phone: 6 82 - 9 4 Fax: 68t - 5k E-mail: ,H Q bd0,1•y 1000 sOt. orlox
.---,--- 4
East. aeduioea1500 [e. or portion thaftof
Cal no• • fe7. Elec. bud. tic. no: 3 - s_ c
City /macro li rL s
— - --- —� Li n�rtentdenal _ _ _ 2
• ..
Limited totra_rennontlal
' S • J� j07 Eseh reendkerwen borne m roodnIre ehvelli oil
Si ' r"' i . electrician re4eire/) D Services ardor fonder 2
S det. name (priot): - 1-- on e ✓0 Luanda: % /e S ° eesor[.. -•:... barb
......„„..4.,..i..
PRI:lf l.ItT\ O NF :I2 200 drops or loss 2
Name (print): S /i/ 1<R a/UBl) / 201 pogo to 400 ears 2 -
401 am m rifl
ps e maps
Mailing adskas: S) rid, Lr 60 maps a laa..pa 2
6 ry: /GeR. Stan- ate: 9 9 over I00 amp tie yoke - - 2
Phone: ' J Fax: 1E-m211: RODOS Oeeeokx . I
Amor installation: The Installation to brief made on property I own Temporary lawless arDap a -
which is not Intended for sale. lease, re, or exchange acootding to iwa�lloa. dterstiian,°r' `
rem,
20 of 2
ORS 447.455, 479, 670, 701. V
201 amps w 400 veils 2
,Owoc signature: Dale: 401 10600 2
circuit.. stem, altreatme%
orexaeaetoa rer wel
Name: _ A_ Foe for bra eirwns with purchase of
Addends: aorwioc of reek: fro. web broach ogreish ( 2
air Ste:. ` B. Fes tar hooch dewing waisted pt¢rhuc ' g s .
of service* e feeder fee. fuu 'Nina gram[ 'i6 , 1
Phone: - - Fax: E - mail: news edditional branch cuwic I d, .
PEN 111:VI : 11'1PIe:, ' e cluck all rlt:,t :eppI)1 (Ser+keorlMirwolreeelod4q'
❑ service otner 225 eenp»eeuaiaasial 0 Naltbeere tbo'u'y Each pump or inigred4a elide _ 2
O Service ewe 720 wing or l ea 0 Rarrdow leaden Eseb alp or ceding h ear
family dwellings O &srlderrs war 10.000 ,0,,,, feet f our or Signal dewit(r) W awn' limited m panel.
O Syvno over 600 wars nominal More residential wits in one structure dteewion a cercesloa
O Building oter three stories Cl Feeder& 400 wort er dunce •Oescriotion: —
q oe rDern load over 99 persons ❑ Maeufaemrod ■endear or RV part[ Lath addidosel t�edlm ewer the allowable la say of dm sbe• �
O EgrecrAigreing Oen U Other- - Perleepecwo i 1
Sorban seta of plena with say of the ahem. Inveaa Rauoe trc ___,
-
_ above are not ap plicahl a to tswp n
e ry eoaetruction eerce OdK' ' -
The a _
' Me ail ladicS maw creed nod. pNacs me ioax'�Oa to am tdaosdoa" Notion: This permit appliation
Pamir fez ........-- ._.. -.. S r. • r
o visa 0 Mastercard expires If a permit is not obtained Plan review (at _ %) $
ex
e care far.oer _ .. - Li within 180 days .Act tt has h State surcharge (8%) -- .. S ': '- e
"1Q
accepted VJ _1 TOTAL �r •� 7 S
N-0 •f �• u Js Arden a r e id !i complete. 11 oT� -. _.•- s r ( ,
'— $ .
Ordoweer *pea= - Honor r *Curets tecOvore0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ' ' ' AM PM BUP
Location / / q 1 710-e;r7 M ft_ Suite MEC
Contact Person Ph ( ) PLM
• Contractor + • L f .e c Ph ( ) ‘oSa— (193,6 SWR
BUILDING Tenant/Owner ELC 3 — 00 30
7
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 POprte
Fire Sprinkler(i)n \l/k\
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 Ac ,
Low Voltage
Fir: Alarm
,t� -'±��„ - ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S T' ❑ Please call for reinspection RE: --iv- . , U - • inspect - no access
/l ilt ,'
Fire Supply Line ri/ ,
ADA
Approach/Sidewalk Date g • Inspect _ ♦ � • i s
Other: V
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
— /i