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CITY OF TIOARD EL ECTRWAL PERMIT
PERMIT #: EL�2004-00159
DEVELOPMENT SERVICES
GATE ISSUED: 3129/04
13125 SW Hall Blvd., Ticlard, OR 97223 (503) 639-4171
SITE Al'1D►tE GS: 09970 SW KENT CT PARCEL: 2 S 114 B A-05500
SUBDIVISION: PICKS LANDING NO.2 ZONING: R-4.5
BLOCK: LOT : 085 JURISDICTION: Tlv
Project Description Install branch circuits
I N _RESIDENTIAL UNI', _ _ TEMP SRVC/F'-EDERS — MUCELLANEOUS
000 3F OR I ESE:
10 200 amp: FUMP/IRRIG'.TION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT t !'JE LTG:
LIMITED ENERGY. 401 - 600 amp: ;IGNAL/PANEL.:
MA04F HMI 5/C/FDR. a^; .b„ip, - ,6;3 volts: MIf`OR LABEL (10):
SERVICE/FEEDER —� _ BRANCH CIRCUITS ADU'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: ' r!: INSPECTION:
201 400 amp: 1s:W/O SRV(: ^R FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRN% H CIRC: 5 IN PLANT.
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: _ > .;00 VOLT NOMINAL.:
Rercnnect only: _ SVCIFDR>= 225 AMPS:__ '1SS AREA/SPEC OCC:
Owner: Coniractor: ---
GLORIA CRAIG L&K ELECTRIC
9970 SW KENT COURT 3540 SE KELLY STREE--
TIGARD,OR 972:.4 PORTLAND,OR 97202
Phone: 503-516-2524 ''h ane: 971-506-8351
Reg," 1 rC 15732h
FEES - _ -- ELL 26-11800
_ SUP 497;ti
Description Date Amount
Required Inspections
jIdJ'RM'Tj FIL( 14•rnut 3/2V n14 $8010 ---
nXj 8'!'o State Surcharge — 3/21) ',-4 _ $0.41 FRough-in
Elect'I Final
Total $L j.51
This Permit is issued subject :o the regulations contained in Ile Tigard Municipel Code,Statt of OR.Specialty Codes and all other applicable I jws. All
work will be done in accordance with approved plans. This pi rmit will expire if work is not started within 180 days of issuance,or if vmrk is,,u,-p snded
for more than 180 days. ATTENTION: Oregon law requires yup to follow rules adopted by the Oregon Utility Notification Center. Those rulu- are set
forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copi3s of these rules or direct questions to OUNC at(503)246.668)or
1-800-332-2344.
Issued By: , �Q�/1 — Permit Signature:—
OWNER INSTALLATION 0NLY
The installation is being made on property I own which is not intended for sale, lease, or rent. —
OWNER'S SIGNATURE:
CONTRACTOR INSIALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application ;=IV
City of Tigard Date/BReceivedy: Pennit No
e&ozaa 4- /6—f
13125 SW Hall Blvd,Tigard,OR 97223 Plan Review �saOther Pennit
Phone. 403.639.4171 Fax: 503.598.1960 Date/By
Inspection Line: 503.639.4175 Date Ready/B5- JuriS 0 See Page 2 fur
Internet: www.ci.tigard.or.tis NotifiediMethod Supplemental Inrarnontion
.............
❑
:
New construction PLAddidon/filteratioti/i-el)lacclllcllt Please Oicck all that applyE]Set vice over 225 amps,counin'l El I lazar lous location
❑ Deillolitioll 0 Other: OService over X20 amps-rating El Builting over 10,000 sq.fl.,
.... ..... ..
of 1-and 2-family dwell.ngs 4 or more new residential
..........---------- []System over 600 volts nominal units in one structureX I- -1-1;timh k\,,11mg ❑Cot ornerc i al/industrial Cl A,;:-.eisory buildmig [I Building over three storiea []Feeders,400 amps or more
L] %h[i, -killilk C3 Master bLilder C]Other: [10ccupan0 load over 99 persons F.]Manu factored structures or
EgrensAighting plan
RV park
EI Health-care facility []Other:
Job no.. Job site address: 9170 KA&& C-,r Submit 2 sets of plass with any oAic above.
'nic above are not ar-plicible to temoorary, construction service
C ity/State// al ic a ------
Suite(bidg./apt. Project name:
Description
A-
Cross otrcet/directions to job site: New residential Angle-or multi-fanilly!IweWng unit.
Includes attached garage.
1,000 sq.fl.or less 145.15 4
Subdivision: --ITOt7noi Ea.add'l 500 sq.ft.or portion 33.40 1
Limited energy,residential 75.00 2
Tax snap/parcel no.: Limited energy,non-residential 75.00 2
Fach manufactured or modular
dwelling,servioeand/or feeder 90.90 2
Services or feeder.,;Installation,alteration,and/or relocation
200 amps or less 80.30 2
P 401 amps to 600 amps 160.60 2
N) 201 amps to 400 amps 106.85 7
Name: GLO CIN LAALC, 601 amps to 1,000 amps 240.60
Over 1,000 amps or volts 454.65 2
Address: �Q Reconnect only 1 66.85 1 2
City/State/ZIP: Tiquvd (S ] r-1-7 72 Temporary services or feeders Installation,alteration,and/or
relocation
Phone:r- lax: — --
110 _ 200 amps or less 66.85 1
Owner installation: I'his installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for.,ale,lease,rent,or exchange,according to ORS 447,449,670,mid 701. 40'.amps to 600 amps 133.75 2
Owner signature: —Date: Branch circuits-new,alteration,or extension,per panel
A-Fee For brAnch circuits with
service or feeder fee,each
55 6.63 2
Business name: L 9-C L"t I C 13branch.Fee for bcircuit ranch circuits
Contact rArne: without service or feeder fee, 46.85
voch branch circuit
Address: Each add'I branch circuit .�65 3,Z
City/State/ZIP: Miscellanmus(service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: Sign oroutlinehoala" 53.40
F-mail T t Signal circuit(g)or limited- i
energy panel.alteration,or
2
............ ................ extension.Describe' Page 2
Business name: U�e -iL I �
Address: 9,540 ell Rach additional Inspection.ver allowable In any ofthe-above
6, ite inspection 62.50
City/State/ZIP: investigation per hour(I hr min) 62.50
Industrial plant per hour 73.75
Phone:(60.5 13
Fax:(!�
555'�
CCB Lic.:1573 ZJG Electrical Lic. Suprv.Lic.: Subtotal
Suprv.Electrician sigllbttirc,required: Plan ret itw(25%of permit fee)
State gurchni-ge(8%of permit fee)
Print name: Date:
ro'm,PER'dur Fp.v
L
Authorized signature This permit appoc;uZo ipir.,TrFrmitisnot obtalhed,�vithin 180
U
days alter It hu been accepted as complete
Print name: _C) Fee m,thodology set by Tri-Covoity Building lnduslry Service Board
dM 2M f�615 Number of inspections per permit allowed
j
i 10-4615VI(YOKOWWO
CITY OF TIGA►RD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
- BUN
Received __- Date Requested -____._ BUQ --
Location -_ Suite____ MEC _-
Contact Person — _ Ph(_____)
_ PLM __—
ontra - -- -- --- Ph(-- .;h �� S�G 8 SWR
BUILDING -_ TergV� n ' ELC 00 1-5-!
Footing -- 3L��J It 7 ELC
Foundation Access:
Fig Drain ELR —
Crawl Drain _-
Slab Inspection Notes: SIT _
Pus!&Beam _.
Shear Anchors --
Ext Sheath/Shear 1
Int Sheath/Sheet-
Framing - - --- - --
Insulation
nryv Al Nailing - --- - - - ----- -- --- _--_ �_..._ ----
Fire ivall
Fire Sprinkler - -
Fire Alarm
Susp'd Ceiling
Roof
Other:__ ---- - - -- - --
Final
PASS PART FAIL
PLU,dBING -
Post P. Beam
Under ',lab
-- --Y ---_ ----- -__ _ --- ---- .�-
Rough-inYo
Water Service
Sanitary Sewer ( �
Rain Drains ---�- ` �- ----- - -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: -
Final
PASS PA^7 tAlL ------_-__ _ .-..-- - - ----- --
MECHANICAL _ ___ - -------------------------------------- - _._ _
Post&Beam
Rough-In - ---
Gas Line
Smoke Dampers - -- -- ------ - ---- --
Final
PASS PART FAIL — -- - --- - ----J—�-P--
ELECT RICAL
Service -
Rough-In
UG/Slab
Low VoltageL.WaLAlarm
S PART F'lIL Reinspection fee of$_ _required before next inspection. P-ey at City Hall, 13,25 SW Hall Blvd.
F� Please call tar reinspectlun RE:- U:cable to Inspect-no access
Fire Supp_ly Line_- -
ADA
Approach/Sidewalk Data A,-Z -- Inspector Q Ext ---
Othei
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL