Permit CITY OF TIGARD ELECTRICAL PERMIT
1114 ' ' COMMUNITY DEVELOPMENT Permit#: ELC2015-00747
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/15/2015
Parcel: 2S103BB13600
Jurisdiction: Tigard
Site address: 12600 SW 124TH AVE
Project: Westwood Homes Subdivision: 2015-031 PARTITION PLAT Lot: 2
Project Description: (5)branch circuits for remodel.
Contractor: ROSS ELECTRIC INC Owner: WESTWOOD HOMES LLC
2870 SE 75TH AVE#203 12700 NW CORNELL RD
HILLSBORO, OR 97123 PORTLAND, OR 97229
PHONE: 503-642-2800 PHONE:
FAX: 503-642-5815
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 09/15/2015 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/15/2015 $10.30
Type of Use: SF Electrical
Class of Work: ALT 1 ea Investigation Fee 09/15/2015 $90.00
Type of Const:
1 ea Investigation 12%State 09/15/2015 $10.80
Surcharge
Occupancy Grp:
Total $196.96
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other applicable law. 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 the 180
days. ATTE - . e -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-6.10 through OAR • 2-0r '0 You may obtain a copy of the rules or direct questions to OUNC by calfing-5 1987 or 1.800.332.2344.
Issu d By: 62//11--/LA Permittee 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' , • A4 e. , 'r . Date: 2455--•
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Sep 15 2015 1 : 21PM ROSS ELECTRIC INC 5036425815 p. 1
1Iec rical Permit Application I ,,, i ,,. I. 0.a :,•`1 �. ..
City of rig rd 7aiwd �•A��
13125 SW Hall Blvd.,Tigard,OR 97223 ' a R Peefph No.; l� 7�
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Phone: 503.639.4171 Fax: 503.598.1960 ' .a Review.
1►r:nnn Inspeouonline: 503,639.4173 Disc ltaady/9y' og nkt— 1 Pate 2 Ihr
Internet: www.tigard•or,atw fad/h atttodr i S�� w5epoleatentel tnreme:ion
• ❑New constrjc:,:- a:t Adds:ion/alterutiorvreplacement ecM all t!►at apply inbred ter,o plena whp�a ,d bete.)
[2 DCmolllion ■ OthCr: DSmvlce«teak;400 amps ormon 0Buitdlnj over three florin.
wham the available Rah current ❑Midas nod trouyards,
,&.t Ii.'4., ,...aa'':u.s1:,m,.�'...t ..�:. areperla 10.000 amps at 130 rinser []PlQeuna buUetirtp.
I-and 2•famllydwelling ■ Commeroial/industrial Accessory building asitogamutorexceeds14,000 ❑Ca►amarolel_ apiculture,
IC Multl.farnil 8 Fires pump,
caw irradiation. buildings.
Y Master guilder ■ Other. 1❑Fire pwnp, ❑Init&adan or7J xvA
lose ' r e> rr ,+.•'. a '$r.+ ►; dMr r �..WV.,.`�°: •.. 4J�f11lrpncyl am.
�'_S� �6._.'+ E^^ a�s , ,-, Y� "A'er E 1 silly","'-
yi. ..ti n 100112•l oroaror a motor load of ❑ ^,„E� 'I-a^
Job no.: Job site address j4Q 0 . 1{ „pay.
t Y (�Slx or more tesidandal u►►ita, ❑Recreational vamp le part;•
Clry/Stek/ZIP: _ (�( c , ] 0tleakh•earefacilitiea. [3 Supply voltage for more than
Suite/bldg./Bpi.rw.; A` P`~•� m 600 von ec final,
Project name: location
Crass streot/dircotions to job site:
'ew residential single-or m u1 -nuttily dw cPI q unit.
- Includes attached garage.
3ubdivlaian: Lot no.: 1,000 •.ft.cr less
168.54
Tax map! arced no Ea add`I 500 ft,pr on 33.
C#(tnited energy,� ,,.,...• f��a'ar f: +`'E1 - ,ref Qrtial
., ... .k,
I- w4h snr,a aS.fI J 67.84 2
n 0 1 united enters.
ax,
1 d�UWK 1. ,..,,4. ._- �,rLc-�`�, �idY� i)'.4&� ld4n �•mf�. ily 67.84 2
' t
F r!? .► 1"Mi I 1.. non - ,ror(.location
” 1," ampa o .lets 100.70 2'111101M0.7.111. ,:;/..?.1e.!'`' ,•, � i_
,$ goer tp 41 r ,.e w 133.36 2
i Ntime; •1,1uit•dt,600 �1j3
- 20104 2
1 tidress: 601 turps,•10•►OM 1 a ll 301,04 7
-Over 1'in r,_,4,.0•r:o+..
Ciry/5tatc2lP: i'emporagae'K'•ea.r r ..ers estalla ••,alteration,awl
Phone:( ) Fax:( ) .. NE 59.36 ill
Owner installation: This Installation fa be ng in •e an rwop,wg that own •h i4 not . F i.a A31`w.u t,;''Wtlw 1•111 12508 r 2
intended far sale,lease,rent,or exchange,aocvrdIn$:'to ORS 447,449,670,and 701, PI
,zw
. `l.tr °rri
� ��lie1fI1i! 'T Ownerslpnature• :, -, .___ .. „ 1, e' 01 • tcwfN�, r . ,ar , , ; ..
, - vet"*atleellor Ace, i
Business name; - ills -K. t III 2
Contact name: b o mu
wllldpl tttt?tit a or er'fee,
Adgrt s;
.1..,...'b lies'of • 36.18 �.l�'
City/State/21P: — !ilLar5 '•171(ZT,7,,y',7171td: ?1 rRt� � 1
Phone:( ) Pax::( d elllmn&s, y . ,.v.. �.: � I!'C.CC}
E-mail
nest rd
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, Reconnect or ilk.�% 67.24 Ell
a 11s�st >a.. zc:< 2
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a t... 67.08 ��
Husincss name:Rata Electric.Inc 17-11b, ,,;.k.i ,
Address;2870 SE 7S' Ave,!1203 o Iiene•' 1on''or
extdntloa..Dig ribs: •
Giry/51atdz1P:Millsboro,Or 97123 °I`1Y T7I' Y i7t 3 r4'". 'f(C"
saL°Z". ► 3!'. a1bOVt
Phone:(503)642-28110 "^'
Fax:(3Q8)642,t161>f `,,• ::�: e m .•CCB Lic.: 157891 leotrica)Lie 34-4360 �li '0 '4 ', � 7 ��
,$Opp Llc,• 42323 P ENOM
Suprv.Electrician signature,•r uired: '
e
•
Print name; Stephen Ross Date: 2J8/3Q10 rt ...
Authorized signature:
State sun* (I2%ofpatriot fee): , r
Print Hams: P:,. t F
Date:
' 'ON 'I . I"°L t i;pllto 4 ilea•' leed wl .fa I80
> •IiiMeeptad Ai ebtk4141e.
u3 i:0,nyrsarmi,ttEI.0.PennM wv dot tool 09 • Musket of inaratioaa allowed poi ptietmit,
44046 13-1(l 1lOLCOMAVBn
_ 19 9�
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12600 SW 124TH AVE, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
FAIL
ELC2015-00747
Herb Stabenow
Not ready contractor will recall
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12600 SW 124TH AVE, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00747
Jeff Grove
Violation Summary:
Inspector Contractor