9460 SW TIGARD STREET 1
9460 SW Tigard Street
�\ ���� ®� �IV/"1�® ELECTRICAL PERMIT
PERMIT#: ELC2002-00647
DEVELOPMENT SERVICES) DATE ISSUED: 12/19/02
13125 SW Hall Blvd.. Tiaard, OR 97223 (503) 639-4171 PARCEL: 2S102AB-01800
SITE ADDRESS: 09460 SW TIGARD ST ZONING: I-P
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND.
BLOCK: LOT: 056 JURISDICI ION: TIG
Project Description: Installation of(1)200 amp or less service and(12)branch circuits.
_—R_ESIUENTIAL UNIT TEMP SRVC/FEEDERS _— _MISCELLANEOUS
1000 SF OR LESS: 0 200 arTrp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 arnp: SlGN101J7 LINE :
LIMI•I ED ENERGY: 401 600 amp: SIGNAL/PANEL:
MAN' HM/SVC/FUR: 601+amps • 1000 volts. MINOR LABEL (10):
_ SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: 12 PER INSPECTION:
201 - 400 amp: 1st W/o SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
_PLAN REVIEW SECTION
601 - 1000 amp: _ ----- –
1000+ amp/volt: v >=4 RES UNITS: > 600 VOLI NOMINAL:
Reco_nnect only: SVC/FDR>=225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
GREEN VALLEY DEVELOPMENT LLC ALLEN JOHNSON ELECTRIC
BY GARY HELMER P O BOX 411
10585 SW WALNUT ST AURORA,OR 97002
1 IGARD,OR 97223
Phone: Phone: 651-3101
Reg M LIC 34879
St1P 2602s
_ FEES ELE 24-142c
Description Date Amount_ Required Inspections _
I LI'It",1 f� E:LC'frim, i' I'i $160.10 Elect'I Service
"I AXE 8%Statc Tu\ $12.80 Rough-In
Total $172.90 Elect'I Final
This Permit is Issued subject to the regulations contained in the Tigard Municipal Code,Stale 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 H 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-,001-0 You may obta in copies of these rules or direct questions to OUNC at(503)246-6699 or
1-800-332.2344. "
Issued By: t_ Permit Signeture: �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATUPE: _ DATE:
CONTRACTOR INSTALLATION ONLY
— LC(.ZL-v ; —
SIGNATURE OF SUP Id) ELEG'N: DATE:
----
LICENSE NO: _— `` ��12�) ---- ------ ----- ---
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date received - Permit no.: ({f•
City of Tigard Project/appl.no.: hxpiredate:
City ofrigard Address: 13125 SW Hall Blvd,Tigard,OR 97221 Date issued: By:X,.AReceipt no.:
Phone: (503) 639-4171 —
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
'I ITE OF 11"FAMI'll
U I &2 family dwelling or accessory J-Cunumcicral/tntiu�tn,rl 0 Multi-family &Icnant improvement
U New construction LeAddition/altcrntion/replacement U Other: U Partial
1 ORMATION
Jot,address: a( 5 r' Bldg.no.: Suite no.:/p- Tax snap/tax lot/account no ..
-- - — --
Lot: 61 Subdivision:
Project nano, -ii Description and location of work on premises: 1�,,,,�.►/ J�,v, �,,. ,,.
Estimated door rrf completionhnspection:
1 1 ON t
Job no: Pre nlax
-��-- r Ti4 - -- -- --
Business name: Q .�f`�i"1CCf/ Ihwcription Qty• lea.) ictal nn imp
New mIdential-single orinrdti-family per
Address: -C-1,30X Includesatlachedgarnge.
City: A;Mo, R State:4 1,L Service Included:
Phone: 000 sq.n.or less 4
_ �Q3 �Y-Arai Fax: E-mail:E-mull:
CCB no.: y Elec,bus.tic,no: i t-/- i y> Each additional SW s .It.kit p rutin therrof
Limited energy,residential 2
City/metro lic. no,: !/� - 1.imitedenergy,non•retridemiat 2
/_ v�N �� _ Each manufactured home or modular dwelling
Sign-nt-are-sof supervising a ctrician(required) Date --�� Service and/or feeder 2
Sup elect.mmne(print): (J License no. Services orfeeders-Installation,
alteratlon or relocation:
200 amps or less _ _ �v ��•�� 2
_Name(print): q,.r y � �h yid 201 amps to 4W amps _ 2
401 amps to 600 amps 2
Mailing Hadnss: 601 limps to 1000an,ps - — 2
City: / i+>( —_ Stale: 44&1 ZIP: OF/I t je Over 1000 amps or volts __ 2
Phone: J-/& --/7 Fax: E-mail: Reconnectonly —_ l
Owner installation:The installation is being made on property I own Tempornry services or feeders-
which is not intended for sale,lease,rent,or exchange according,to Installation,alteration.or relocation:
URS 447,455,479,670,701. 200 anitms or less -- — — 2
201 amps to 400 amps 2
Owner's si nature: _ Date: E4011-600 amps 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of `� flFill
Address: service or feeder fee,each branch circuit
City: Slate: zip: B. Fee for branch circuits without purchase
Phone: FAX: E-mail:
Ifservice or feeder fee,first branch circuit:
— --
limch additional hr,rnch circuit— _
misc.(service or feeder not Included)-
L,
nc luded)
U Service over 225 amps-commercial U Hcahb-c•ac ta. w, Each pump,rr irrigation circle _ _ 2
UServiceover320nmps-rating of 1X2 UHavardouslocaorm Hach sign or outline lighting 2
fan,ilydwellings U Building over 10.000 square feet four or Signal circuits)or a limited energy panel.
U System over 6(x1 volts nominal more residential units in tine structure Ateration,or extension* — 2
U Building over three stories U Feeden,400 amps or mora 'I kscri tion: _
U occupant load over 99 persons U Manufactured structures or RV park I ash addillonal Inspection over the atIowa ble In an of the ahave:
Cl Egress/tightingplan U Other _ __- {'rrinspection r�— _
Submit___sets of plans with any of the above. Invests ation fee
l _ The above are not applicable to temporary construction service. Other
Nor all;ormictions accept credit cants,please call iuri^diction for nage inkxmmtlon. Notice:This permit application Permit fee.....................$ _/k d
U visa U MasterCard expires if a permit is not obtained Plan review(at _ 96) $ "----
Credit crud numhef: - ____ I - within 190 days ailer it has been State surcharge(8%)....$ 'a, X!�f
Cxpiretr /7�A�
accepted as complete. TOTAL .......................$
Ne of— older u shown on crsxrir c
-- Cardholder tripartite --- - fit)4611 ISAX cOM)
CITY OF '"IGArW 24-Hour
BI'ILDIi'G Inspection Line: (503)639-4175 MST "
INSPECTION DIVISION Business Line: (503)639-4171
BUP _
Received — __ --Date Reuested —1 AM-- .__PM _ BUP
Location _� --�:. _ ulte - MEC
Contact Person — r!h ) PLMContractor—'��__, L?�2Sr �(L ) SWR --
BUILDING _ Terant/Owner —_ _ ELC 0
Footing
ELC
Foundation Access:
Ftg Drain ELR —
Crawl Drain _
Slab Inspection Notes: -�� SIT
Post&Beam _
Shear Anchors --- - -� —
Ext Sheath/Shear
Int Sheath/Shear �.
Framing
Insulation
Drywall Nailing —--
Firewall
Fire Sprinkler --- - - - - - - —
Fire Alarm
Susp'd Ceiling —
Roof
Other. - -
Final ------_ ----------
- - —
PASS PART FAIL -- �PLUMBING
Post
Post&Beam
Under Slab ---- - - --- -- --- -- --
Ruugh-In
Water Service — --- - -- ---
Sanitary Sewer
Rain Drains --- - — -----
Catch Basin/Manhole
Storm Drain --� --- - _ —
Shower Pan
Other: - ---- -- ----
Final
PASS PART FAIL ----- -- -- - - - -
MECHANICAL
Post& Beau, -- - ---------
Rough-In — -- — ------- - ----------- -----------
Gas Line
Smoke Dampers ----- --- - - ----- ----- --- -------
Final
PASS PART FAIL - — - ------ —__—_
ELEC ICAL
ervic
ough-In -- -— ---- — ----------
UG/Slah
Low Voltage
Fire Alarm
Final
PART FAIL Reinspection fee of$-_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinsrection RE:— —____ _ Unable to inspect- no access
Fire Supply Line
ADA ..� �
Approach/Sldewalk pat* a p��f C�v'L lesp�etor--�"'�,f? Ext
Other:— _— - `� ^
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line- (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
SUP — _—
Received —.—Date Requested_—� �_ AM____ PM — BUP
Location ---- Ll�o U ��C.l� --- Suite K, e MEC - ------
Contact Person Ph( ) S -3 ls� PLM __----^—
Contractor e _h n svr, _ Z1FC'ffiC Ph( ) SWR
BUILDING Tenant/Owner _ _ ��-�'"� � ELC'),2
Footing --
Foundation ELC
Access'
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 1 SIT
Post&Beamr'�
Shear Anchors C L .- .,.rrt c� �.(,-fi'C �
Ext Sheath/Shear r _
Int Sheath/Shear
Framing _ ---
Insulation
Drywall Nailing - -- --_
Firewall
Fire Sprinkl ar -- — - -- — —
Fire Alarm
Susp'd Ceiling --
Roof
Other: -
Fir,al
PASS PART FAIL
_PLUMBING
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other.
Final
PASS PARS FAIL
MECHANICAL
Post& Beam
Hough-In ---- -- --
Gas Line -
Smoke Dampers - - - - - ------------- -_ _ - --- -
Final
PASS PART FAIL ---
ELECTRI AL
Service — _..-----------.._.._ ---------
Rough-In
UG/Slab ----- --- - --_ _.
Low Voltage
Fire Alarm
t n- ❑PART FAIL Reinspection fee of$-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE _ _ _ Please call for reinspection RE: _ _ Unable to inspect--no access
Fire Supply Line
ADA '
Approach/Sidewalk �� - - InspectorExt
Other:
Fina: DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL