Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00257
COMMUNITY DEVELOPMENT DATE ISSUED: 5/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104AD -04500
SITE ADDRESS: 12617 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: TVF &R FIRE STATION LOT : JURISDICTION: TIG
PROJECT: TUALATIN VALLEY FIRE AND RESCU
Project Description: Foundation grounding wire.
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: 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:
TUALATIN VALLEY FIRE & RESCUE B &C NORTHWEST ELECTRIC INC
20665 SW BLANTON ST DBA HORIZON ELECTRIC
ALOHA, OR 97007 1818 16TH ST
WEST LINN, OR 97068
Phone: 503 - 649 -8577 Contact #: PRI 503 - 650 -6540
FAX 503- 650 -6562
FEES
Description Date Amount Reg #: ELE C343
[ELPRMT] ELC Permit 5/6/2008 $46.85 LIC 178708
[TAX] 12% State Surchar 5/6/2008 $5.63 SUP 4445S
Total $52.48 REQUIRED ITEMS AND REPORTS
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 181 •. s. ATTENTION* Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 0.1 -0010 t roug • • • 952 - 001 -0100. You may obtain copies of these rules or direct questions OUNC at 503.246.6699 or 1.800 332 2344.
Iss d By: k I / • , / Permittee Si.
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:
CTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
ciir;' May 08 08 01 Sap William Postles 503-850 -8582 131
Application— - r .- w t -= • ' F ® L 1 1 :011 t'll 1 ti 1 I `i (', t 1
Electrical Permit A piQ py�°a " //�/
T y f Dale/R . 08 0 / ?nd N° - ` ;�'�"�1 .25
City of Tigard ld (,{ `^ . '� oa,�R •
13125 SW Hall Blvd., •Cigard, OR 97223 Plan Review t7tncr Per toil.
e Phurte: 503.639.4171 Fax: 503.598.197 0 6 2008 °sr11"
I)'ait Ready /Les Jura Ill Sec Rust Z for
l.L A;i I7 I 111Cn 1 t m 1.Ip . SQ1.639. 1 Norillod'Method; - -- I Supplemtapl L.roratarinn
IMem WwwGg�d- or.Brn _� 1
,1 • PLAN RIME* OF IV AN. , 4 •-a• e , kk i I O. _
_ "• I�tt laAC cal'•J all IIFJl •tPPIY N,abrel a v.t of vl' wA,lrta cl,w Iw low)
New construction 0 AddiGon/a ion/rcplaccm a own three stoney.
0 Service or t.rriaf tu u t ❑ Hui w/In
Cl Demolition El Other: ,..hare the aomluNc fault cuncnt „^ M"a tin and boaFynrde-
pct)erd7 111.11K10 alum 8l I50 ands, or ❑ !Noting b,ul,LuEi
CATEGORY Or CONSTRUCTION less to ground. or ex 14.0[x) Li < . -- mental -l1w grreulturaI
O I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building /imps for AIL attlm .netalLnose, Nuldinin
QFircpttntp, ,r2, lnfitnlla[wa nf7S KYA
M u l t i - family ❑ M a s t e r builder ❑ CI E trpcl,cy Clara-, -Barer xeprairefely tlerimod system].
J08 SITE INFORMATI AND LOCATION ID Addmnn of nrw motor load of C `A', "1""l 2" ' I
_ min. a. more oceup,m,:,.
lob no.: Job site address: C ree.emltu,.rAl vehicle pads
7585 Wa]nfIt Rat_ ❑ more
flunhr ntatwhim
CI H�uttha•nrc r,r,r.d.•4 G Suwty vdtal2 cur more than
C;ity/3ta- eJZIP• 77? ❑1 xtdaui kxat u' tI( IL, manual
Tigarr� pE 9 3 �
l Q:3arYltt or I�tiUCr ;�tTO mnp6 mart.
Or
Suite/bldg./apt. /apt no.: Project name: _ F h :b; SC ILD1'1,H:
n.... a- "' in Y ! I IoW T •
Cross slYeet/direet1oas to lob sloe: New residential wnglo- or multrtaloay dwelling unit.
Includes attached mirage.
145.15 4
Lot n0.. 1.000 sq. It- or less , 5.15 I 1
Subdivision: _ Ea. add'L 500 sq.:t. or po tiun I 1
Tax map/parcel no. _• Limited energy. TcsulunGul 75 00 2
RESORPTION Oil WORK w Il n c •ni = -,
Limited enCrn, mar-family I 75 DO , 2
residential rsnur shove A I
�117r1 prat Ifl[l1I Ir� WIrP Services or feeder. inittallatirn, allcrattul. and/or relocation
200 amp. nr lcs>• xn 1(1 7
--_, 0 TENANT 201 amp.. to 00:arms - - - - r - 106.55 2
PKOIERTY OWNER - ;._1_, 2
401 amps to 600 ar:mi 16U 60 2
>yante: Tualatin VaIIev Fire $ Rescue �. 60l ntnms,o,.cllu> _� 240 2
Address- Over 1.000 anti or volts , 4S4 (5 -y 2
29665 s - • t 'Temporary service. or feeder. installation. AI1rratanU, and /or
CitY /Ststcl'CIP' relocation - - - -,_
�4laha 9700 7 Fox :( ) 200 amps or IN, I
Phones ( ) (,6.35 , 1 1
--� 20] amps to 400 amps -T 10030
Owner installation: This installation is being made on property that I own which is not u y I 1 2 2
__- _
W OILS 447 449 6711, moat 701- 401 amps to ' ` amps _ , 1,37.75
intended for wale, lease, ny►y or exchange, according Branch circuits new, alteration esteneioaji panel
Owner signature; Date: -- , A_ FCC SIVY Mn+ach cac h
uits With
--
— tlbove : ervrrc or :coder Ice. ❑ APPLICANT — - 1 ❑ CONTACT PERSON us 2
each Oerv, nnwr
B usiness name: i4- Tee for brfuleh :trcutt_C — � .
wr(hour AIN. ice or [ceder ter, I ar , KS 4 6.85 2
Contact name: first brunch cLrcurt 1 V 85
Each add branch circuit - I
6 tin L
Address: Miscdtancrrua erviCC or tender not meladrrll
City /Statc/ZIP: Each tannin nen, or modular 9C.90 2
dwetli • sem... and/OK f cd. r 2
Phone: ( ) Fox :( )
Reconnect onh• —, I . 66-35
Pump or rmgatn)n circle � — - 53.40 2
F. - mail: - 2
Stan nr n,Al,w• :, ^.hl log � ' ' 40
• CONTRACT--[ • _ f
— Signal cin�lrnl ,; or h
Business name: g c NorthWest.Elect ar _ energy panel, a;tr'ralrnn, Or
e,rpension, Des( rifle- Page 2 2
Addrew 1818 16th St _ - - __ _
Fall additional imps-chefs mar a in any or the above
CitylSr:uclL� :WeS Linen O.: , : Perin apectitut — 6250
Phone: (593 , t Fax: (503)650 -6562 Invev'tq-alicmner hour (Ilrnun) 1 • 4: 5o
r p IndusmLJ plant T �-'T hour r 73 75 C
CCB Lie.: 17870: _ Electrical l,ic.: C34 Suprv. Lie.: 44455 1.1 ECI R 1. -sIRM r- FEES
/D s-.0 *r�4 / u► ' . , �'j/ -� !o / / G
Suprv- $teetricran -t — _ � tiafKOtnl 46.85 _
ablft� -Bird
P lans Yt•YLCw(25 " • 0 pan JEL l et l -
Print narno: Terille Stavi i Date: 05 -06 -08 Slaw .nrchargc ( :' ,t permit tee)- 5.63
��� TOTd \i.1'I:RMI 57 48
audto.'iJed signature: / /� - r! —+ - - -
ms permit appli[,fnan eaptrka ,( a ptrroN u not ublaincd width) tau
p ale: 05 -0 6 -08 [fart after it h,,. been p erpretl r,• complete.
Prim n1U71e : Wily • M..77 VV -- - Number 01 II,. colon rdlowoj pm' ntnn :tt.
11Du, td'a41∎Perme,ayte 050..006 440461ST(11XXI /COh111wk7a
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI4se0041° 0026
13125 SW Hall Blvd., Tigard, OR 97223. DATE ISSUED: OS
Phone: (503) 639 - 4171' •• r 'I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5 - 0e) TIME: PAGE:
SITE ADDRESS: \2611 S Lk) wAL0 tea' CLASS OF WORK:
•
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: I c—i[Lr3 QS 6 W
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
nest
Corrections/Comments/Instructions
t �6 dpti — 6 • N 5 6A11 "1
•
•
/ ►j PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �.6Q-: Date: S E1 0t Phone #: (503) 718- /'-1AiN