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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00061 e DEVELOPMENT SERVICES DATE ISSUED: 01/29/2001 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110BA -06800 SITE ADDRESS: 12036 SW WILDWOOD ST SUBDIVISION: SHADOW HILLS NO.2 ZONING: R -2 . BLOCK: LOT : 051 JURISDICTION: TIG Project Description: Kitchen remodel. Job #8170 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: 6 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: SMITH, S CHARLES BRIDGETOWN ELECTRIC PO BOX 230831 STEENSLID + CO PORTLAND, OR 97223 2230 NE THOMPSON PORTLAND, OR 97212 Phone: Phone: 281 -9397 Reg #: LIC 103824 SUP 4177S ELE 26 -887C • FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 01/29/2001 $86.75 2720010000( Elect'l Final 5PCT CTR 01/29/2001 $6.94 2720010000( Total $93.69 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE \- 11), Oaej ISSUED BY: 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 • £ cg Ar-m-eri( 1 _� Electrical Permit Application "'``Fl`'. `' °'' -= -- -- Date received: Permit no.: City of P _ A 1900 SW 4th, Ste 5000, PO Box 8110, Portland, OR 97201 Phone: (503) 823 -7363, Fax: (503) 823 -3018 COMMUNITY 0EVELOPMEN) dastis TOD: (503) 823 -6868, Website: www.opdr.ci.portland.or.us TYPE: OF PERMIT & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family 0 Tenant improvement 0 New construction 0 Addition/alteration/replacement ❑ Other: 0 Partial _1013 SITE INFORMATION Job address: 1 �(O S W bui)lclurcrobt St, Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: I Project name: 13)4(,u so i'I Description and location of work on premises: - f - C. '` Estimated date of completion/inspection: I I / 2b"1 d ( Will ou call for ins r ction within 24 hours? Yes ✓No _ CONTRACTOR APPLICATION FEE SCIIEDUL.F Fee Max Job no: ell Description Qty. , (ea.) I Total no. insp Business name: 3rideterown E I ec tr i 4- New residential - single or multi- family per Address: )..2.1 3 4. N w i + II t hart IAoS- dwelling unit. Includes attached garage. City: IbI't1 and I State: OR. I ZIP: 972.3( - Ie03 Service included: Y 1000 sq. ft. or less S 163 4 Phone:50 b11' 7131 I Fax: S/3 -mail: btet?i,ilerIdSFar,t o(A Each additional 500 sq. ft. or portion thereof S 37 CCB no.: 103 $24- lElec. bus. lic. no: 2(P – 881 C. Limited energy. residential $ 37 2 City/met Le. no.: 4-23 Q 0 I — 00003(040 Limited energy, non - residential S 37 2 Each manufactured home or modular dwelling i.. W 4- 40--a-.0et -olei Da "O Service and/or feeder $ 99 2 S' n upervising electrician (required) te �� Services or feeders - installation, Sup. elect name (pent): 1<el th Site ti s I iC License no: 4111 S alteration or relocation: PROPERTY OWNER 200 amps or less S 88 2 201 amps to 400 amps S III 2 Name (print): 401 amps to 600 amps S 167 2 Mailing address: 601 amps to 1000 amps $ 251 2 City: `State: I ZIP: Over 1000 amps or volts $ 470 2 Reconnect only S 63 I Phone: Fax: E-mail: Temporary services or feeders - Owner installation: The installation is being made on property I own installation, alteration, or relocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less S 69 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps S 103 2 Owner's signature: Date: 401 to 600 amps S 139 2 E N (i I N I.'. l: R Branch circuits - new, alteration, or extension per panel: Name: _ A Fee for branch circuits with purchase of 4 Address: — service or feeder fee, each branch circuit S X 2 R. Fee for branch circuits without purchase t[Jrr � , G Q City: State: I ZIP: of service or feeder fee, first branch circuit: / $.4s3 • � a 22 Phone: Fax: E -mail: Each additional branch circuit S ,, , (/ I PLAN REVIEW (Please check all that apply) Misc. (Service or feeder notincluded): Each pump or irrigation circle S 63 2 O Service over 225 amps - commercial O Health -care facility Each sign or outline Sighting S 63 2 U Service over 320 amps - rating of 1 &2 0 Hazardous location circuit(s) or a limited energy panel. family dwellings 0 Building over Signal circ 10,000 square feet four or S Cir ui extension* S 63 2 O System over 600 volts nominal more residenual units in one structure O Building over three stories 0 Feeders, 400 amps or more •Descnpuon: O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/lighting plan 0 Other: Per inspection I I $ 75 I I Submit 2 sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. �+/ 1 Notice: This permitapplication Permit fee $ if ` ' 1 C expires ifa permit is not obtained Plan review ( 25 %) $ G within 180 days afterit has been State surcharge (8 %) $ 7 accepted as complete. TOTAL $ 44 0.461 5 (6/00.00M I CITY OF TIGARD BUILDING INSPECTION DIVISION fp, 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested o AM PM BO? Location / ZG 3 G Sw ',,14 woo d 5" Suite MEC Contact Person Ph C0.2/ — 7/ Z Z PLM Contractor j7td e- / ] L �� SWR BUILDING Tenant/Owner ELC 2iv / —" ' ' Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain U�.F-0 �2 L= a, (� f Qvs �1`� n 4- 37Ar.i � �SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam • Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL Service Co v ,A . Rough In UG /Slab Low Voltage Fire Alarm C ' E Ati0 PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ ' required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk Other Date 2/7/ Inspector E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 3zy CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7 - Z y AM PM BLD Location / i G 3w Gv / r6 /• -vei S �— Suite : • ME • Contact Person Ph 6U- it Z z-- PLM , Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ('a, S r Susp'd Ceiling C_ Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains • Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELEC Rough In UG /Slab Low Voltage Fir- •larm tar- ,( - PART FAIL ` BackfillGrading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspect'•n RE: [ ] Unable to inspect - no access ADA / • Approach/Sidewalk Other / Inspector Other Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.