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Permit A i! ,- ELECTRICAL PERMIT CITY OF TIGARD PERMIT #: ELC2003 -00700 DEVELOPMENT SERVICES DATE ISSUED: 12/4/03 1‘ l l l 13125 SW Hall B lvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133DD-05500 SITE ADDRESS: 12769 SW WINTERLAKE DR SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 ZONING: R -4.5 BLOCK: LOT : 094 JURISDICTION: TIG Project Description: Add and /or relocate (5) branch - circuits. 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: 4 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: - • . f Owner: Contractor: GREENWOOD, ROBERT A + SHIRLEY J SYMMETRY CONSTRUCTION ' 12769 SW'WINTERLAKE DR 19468 NW CORNELL RD . TIGARD, OR 97223 HILLSBORO, OR 97148 Phone: Phone: 503 - 533 - 2200 Reg #: LIC 155339 ELE 34 -650C • FEES ' SUP 4588S Description Date Amount Required Inspections [ELPRMT] ELC Permit 12/4/03 $73.45 . [TAX] 8% State Surcharge 12/4/03 $5.88 Rough - Elect'l Final Total $79.33 This Permit is issued subject to the regulations contained in the Tigard Munid pal 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: Zbk Permit Signature: �?/ /9p/ 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 INSTALLATIO ONLY SIGNATURE OF SUPR. ELEC'N: 0,17 /9'/ DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day DEC -03 -2003 01 :02 PM GENCO MECHANIAL 503 722 4389 P.02 12/00,4000 19:02 Fa S� 36881800 4 CITY OF TIGABD 001 ll -�'1! ' i U , -> ,,,, 1 . ,,1 t , 1I1'101 . 1 ~1' 1 e "a 9 . Q . J#� p tdo • g City of Tigard E�6jy Qt_ j �� • ,� • •. 13125 Sw HO Blvd. G rd � Pion t tsv , ocher Tigsrd, Oregon 97223 ���9G��� o� ^ l pert- lieYlav/ Phone: 503-639-4171 1ax' 803.598 -1960 - 1 1 1 \ _• San rasa l for lhtc net www.ci.tigarri.ar.un LI,` Can= 8 , . ; mllnbrmaelo •,. 24 - hour Inspection Request 503 - a .1vtmoo �.° - .-74, - .;:,' • • ' N . ; =• - - • •, • ! 1• : woke over :25 amps- Health-tax facility . III New construction (� Demolition commercial Ha:araoua location Vclid onlalterationh - • l a e e m c n t t o Other: ©Servao over 320 amps - rating o!' ' Buit&na over 10,000 a9 h feet. - 1 & 2 family dwetlInga four or man residudle units in mu 600 v nominal one unmet re L :, ■ C0t»a►etciaUlndusttial te 40 or more . !�. " LIiL.�F �(..__ Bmldin6 over aunt stories amQa IN Accessory Buildin : I M Multi.FamilL Occupant load over 99 persona Other wed structures or RV perk Master Builder IN Other: i Sabina soot of plane will any of the shore. - '-:....:':•!;(??, 1011' TE� .t • '•' ;'n7 ' 4tre M re Tittabovear ,- s s onhvetonserriot. _ - ' �^ �� • Usable W temperer/ „ . _•'44-15.7., • .:' Job site address: 12. (P J . . . :v t - * -r ' t� r `:: :f 8 l J t # Number of In • anima ' er pro t Doe •too Qty ( T od IS �CO C0t Alame: _ Nen/ raldgtlakinsle er ntokl- ' • • ', Per Crass street/Directions to job site: dwelling alt. Wades Medial sense. Service indnded: 040 Atertem Es. 503 it or ..non . • tli♦1so1.11&:lm■ S11bdiVISiOII: - -- I,O 0): = _ Tax ma..ineeI #: _ _ R I 'r ,� A J. ROVINLI 0• / " •.err .400 r ONEMPRIAMII El ��yypl� �1l ��11�'ZT:.' um ,.. MIIIIMMI:II MI Lita/Cas ►1 • ' .� • v`J �� �1 • -• ' ��1 -1 • :9`' _e •:1 �7� � `,�,• '� • 1- I I `� � Miirr'Pll kg Name: - ... • ar.d 81-. r - � ltifi owirra am Address: w ■ - ' r ' etaratior Or Meadow 66.e5 re Phone: • - y L. 7i� t...., 4,. ....LX ■ ' ° N U h1 :c 1 Name: N 5 A N 6.6s Ilo, oath bripleb circle Ci /S tate/Zip: B. Po for c ut poniard. of n in nrg - Phone' • •- . 0- •) _ Fax 112_717 IL S - — re 10/11111W-1: c - acs . '.7t :,J .o ll Job No: � I�; ; ' r NI N Address: ` ,i r , s ..' JJ.� . r s i ■ d1.: � � DV hou (min. 1 howl tt M • MI Phone. -WON/6W .. • • (•, EIE Supervising eleetriei: 1 �i - y L9 os /0 a' 0 S brad si • utr'cd; . : . Plan Rovicwl25 % of Parnit Fa$) Print Name• o.. _' 1iS.ti Lie. #: °W. i . - sty 5 ',. A% of PeVIttIT Fee .f+. to 0 TOTAL PERMCP FEL I Authorized Notice This pordil appii . i espires f s welt V not obtain - dd. Signattu'e: Oats' 1 • J3 1SC d ays a lte r is boa b ete acoapted es mmpl.u. Fee matbodoloe is by TrI ounty Building Industry Belvieu Board. ease input name) I:\Dan'Pemit Foerrs\ecPerrmltApp doe 01/03 CITY OF TIGARD 24 -Hour • BUILDING Inspection Lime:. (50:3) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST ,,�� BUP Received V2 3 / 4 : 2 7 1�ate Requested —210 ._ PM BUP Location / Z7 ( C (.( ,.0 ��JL ah Suite MEC Contact Person Ph ( 5 )3) -3 3— 2 2_0 PLM Contractor 0/LI.Q,Z Ph SWR BUILDING \--) Tenant/Owner —A.%• i 4 4.1/. .1_ C $ — (7C) 7Q Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: / SIT Post & Beam d --t- 0)l V ' Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Drywall on Drywall Nailing Firewall 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 O _ & 2- t<, - ,m in, Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 4jX PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA _ Q Approach/Sidewalk Date y Inspector G Ext Other: Final DO NOT REMOVE this Inspection record from the Jo site. PASS PART FAIL