Permit ,r
Jf
CITY OF T
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC2003 -00507
I DATE ISSUED: 8/14/03
1 I I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S103DC -03200
SITE ADDRESS: 11250 SW VIEWMOUNT CT
SUBDIVISION: VIEWMOUNT ZONING: R
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Relocate panel box and add 1 branch circuit.
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: 1 W /SERVICE OR FEEDER: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WILKISON, SARA OWNER
11250 SW VIEWMOUNT CT
TIGARD, OR 97223
Phone: 503 620 - 1622 Phone:
Reg #:
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/14/03 $86.95
[TAX] 8% State Tax 8/14/03 $6.96 Rough -in
Elect'l Service
Total $93.91 Elect'l Final
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. I
Issued By:
I 4 4 / of / _`. '� , Permit Signature:) '
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
/ 4- .' ._
, , OFFICE' USE ONLY
Electrical _ -' : �, ,� 7 ' ration •
• Date received: / Q• Permit no.
1 3 — Go ill 7
A City of Tigard pp„ ri 1 4 003 Project/appl. no.: Expire date:
Cnv of Tigard Address: 13125 SW Hall 1311W T igard, O R 97223 Date issued: ff Receipt no.
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 CITY O TIGARD Case file no.: 4 . Payment type:
Land use approval:
• BUILDING DIVIS
TYPE OF PERMIT '
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial • ❑ Multi - family ❑ Tenant improvement
❑ New construction ,Addition /alteration /replacement___ ❑ Other. ❑ Partial
JOB SITE INFORMATION
Job address- 11'251) SW VI vuu YY O JYt* (J1 Bldg. no.: Suite no.: Tax map /lax lot /account no..
Lot: I Block I Subdivision:
Project name: I Description and location of work on premises'
Estimated date of completion/inspection
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: I Fee Max
Business name:
Description Qty. (ca.) Total no. insp
New residential - single or multi-family per
Address: dwellingimit. Indudesattadied garage.
City: I State: I ZIP: Serviceiududed:
Phone: I Fax: I E -mail: 1000 sq ft or less 4
CCB no.: E1CC bus. he. n0. Each additional 500 sq. 0. or portion thereof
Limited energy, residential 2
City /metro lie. no.' Limited energy. non - residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print) License no: Services or feeders—installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): SR le,ri t 1f.l..zSoi(� 201 amps to 400 amps 2
Mailing address 110 5 - t ti M
i .c,t),yrno 1� C°T 401 amps to 600 amps 2
25
601 amps to 1000 amps 2
City: 1 dot rd State: G ig I ZIP: ccrZZ3 Over 1000 amps or volts 2
Phon(;(rA i io_liaZ . I Fax: — 1E-mail: 7 gap lyi 1K iso /cyt[teconnect only 1
Owner installation: The installation is being made on property I own Temporaryservicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, '0, 701 200 amps or less I V•) 2
1 201 amps to 400 amps 2
Owner's signature: l' • Date: • I 6 401 to 600 amps 2
ENGINEER - Branch circuits- new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of {{ /'�L
Address. service or feeder fee, each branch circuit / (p. (6 2
City I State: I ZIP: B Fee for branch circuits without purchase
of service or feeder fee, first branch circuit. 2
Phone: Fax: E - mail:
Each additional branch circuit
' PLAN REVIEW (Please check all that. apply) • Misc. (Service or feedernot included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irngation circle 2
❑ Service over 320 amps -rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders. 400 amps or more *Description
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the ahlomable iii ally of the above:
❑ Egress/lighting plan ❑ Other Per inspection
Submit sets of plans with any of the above. Investigation fee
The abos a are not applicable to temporary construction service. Other cg
la fee .$ b(D CL 5
Not all pinsdictrons accept credit cards, please call Jurisdiction for more mformation Notice: This permit application
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $
Credo card number / / within 180 days after it has been State surcharge (8 %) .....5 & . –( rJ
10
Expires TOTAL ... .. 5 93.
accepted as complete.
Name of cardholder as shown on credo crud
S
Cardholder signature Amount 441)-4615 (6 /u0 /COMI
CITY OF TIGARD 24 -Hour ,
BUILDING Inspection'Lihe: 1503) 639 -4175
INSPECTION V SION Business Line: (503) 639 -4171 MST
( BUP
Received `� 1 6 P"'1 Date Re9uupsted (.01 AM PM BUP
Location d / 2_ 50 vi ew 44 ouv +Ci'- Suite MEC
Contact Person C /kA U 1 I Ph (_ 6 2 -0 — /(9 2Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner . e g — On 5?) 7
Footing (' cA mi'∎i) c<G e ELC
Foundation 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 1 , CC NIs) T i t-- Y'''l.) v 1/-0 .$ V ) Y r .
Fire Sprinkler V
Fire Alarm t-
Susp'd Ceiling L_ l7 vA Q t U Roof
Other:
Final
PASS PART FAIL I
PLUMBING
ID
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 V
Servi - —
•
ough -In
.i - _ .
Low Voltage .
Fire Alarm
PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for rei spection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date V .� 1 b Inspector i 14 - Ext
Other: -
Final DO NOT REMOVE this Inspection record rom the Jo ' site.
PASS PART FAIL