12130 SW 92ND AVENUE-1 12130 SW 92"d Avenue
CITY OF TIGAIRD ELECTRICAL PERMIT
DEVELOPMENT SERVICESPERMIT#: ELC2002-00658
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 635-4171 DATE ISSUED: 12/23/02
SITE ADDRESS: 12130 SW 92ND AVE PARCEL: 2S 102AB-00918
SUBDIVISION: KIMBERLY ADDITION ZONING: R-7
BLOCK: LOT: 018 JURISDICTION: TIG
Project Description: Job No.73610
Service change
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: I WiSERVICE OR FEEDER, PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR IDP: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
LINDSAY,BRUCE D OREGON ELECTRIC CONST/GROUP
12130 SW 92ND 1010 SE 11TH AVE
TIGARD,OR 97223 PORTLAND,OR 97214
Phone: Phone:
Reg #: LIC 203
-- �— SUN 44600
FEES ELL
Description Date Amount
11PRMT] ELC Permit 12 2; n' $80.30 -- Required Inspections
TAX)8%State'Tax 12 '; u' $6,42 Elect'I Service
Elect'I Final
Total $86,72
This Permit is Issued subject to the regulations cnntained 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 is,4:.ance,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
1.800-3& 2344.
Issued By: ��'/6�L r_ —_.._ _ Permit Signature: J (t,.�, Cc�.�1r
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
Electrical Permit Application
- _ Dacc reuxivcd; JErxpirc
emit no4�• Z2� -q��St
City of Tigard RECEIVED Pro ecVPp a i,na_Address: 13125 SW Hall Blvd,Tigard,OR 97223Cigr ojTfgand date:
Phone., (503) 639-4171 Date issued• y: Receipt no.:
Fax: (303) 598.1960 DEC 2 3 1001 Case talc no.. ayment type:
Land use approval: ;CITY OF TIGARD
rt
r
W I &2 family dwclling or accessory ❑Commereial/industnal ❑Multi-family 0 Tonant improvement
❑New construction Q Addition/alteration/replacement ❑Other;
D Partial
Job address:
D°t' Suite no.; 'tax map/tax lot/account no.:
Block: Subdlvlsion:
Project IDescription and location of work onremises:
Estimated date ofcomplction/inspection. p Service change
Job no:
Business name: pregori Electric 1-i U_( Description pry. Foe Max
(ey Total no.iary
Address; — Newr asidentlal•vinglc or ntullidrpamlly per
dwelllssa unit.Inc lodes anach ed rage.
Cary: State.-'OR ZIP; 972 4 Seniceinclnded:
Phonc: Fax: _1 Q 1114-Mail: 1001-xq,A.or luv,
4
CCP no- Elec.bus, lic.no; Uch odd,uional 500R.or rtlon thereof
is ro I' .no . Urniled crerey rcsidcnrinl 2
Limited energy. nun•msidcntiul 1
Each manufactured home or modul;tr dwelling
uir
si lure of su in octridan rc 12/,Z 3/(,?
( Date Service snNor fader 2
9 .elect name q: k License no: 44 S Servicesorheden-In talld{on,
nitentlnn or relacollont
200 ams or lure 1 80. 02
Name( riot)._ 201 snips to 400 ores 2
Mailingaddress: 401 ores to 600 unp, 2
CI 601 ;turps to 1000 ore 2.
ry _ 541tet ZIP, Over 1000 um s or veils
Phone; IFax: E-mail; Reconnect only 2
Owner installation; The installation is being made on property I owls Temporary servicer or feeders-
I
which is not intended for sale,lease,rent,or exchange according to Installation,all°sullon,orrelocation:
ORS 447,455,479,670, 701. 200 amps or less 2
Owner's signature:
201 a s to 400 tum
Date; 401 to 600 am s ,
Breach circuits•now,alleral n,
Narnc: or exlenslon lour panel:
Address: — A. Ree for branch circuits wm purchase or
xorvlce m(ceder fee�cuch branch circuit 2
City _ _a—tate: liP B. fc: for branch circuits wuhotu purchase
Phone; Fax: Email: of service or radar then Gtr brturch circuit; 2
Each uddltional brunch circuit:
Mise.(Smite or recder nul Included):
d
So ice over 225 arnre
pommemurl O Health•enrc facility lath pump or Irrt Linn circle 2
G S°Mee over 320 rope-mting of 1402 C3Huunrdous locution Encl,sign or outline fi htin 2
family dwellln{(s ❑Building over 10,000 squire feet four or 516mal c:n unl(s)or a llmdcd caul ti ,rel.
0 System over Nn volts nominal Inure residential units in onr structure Alteration, or extension'
O Building over c stories Cl Feeders,AIM amps(if mom —
❑Occup3111 lona ver 99 persom ❑Manufbchued structures or RV park 'Deacripuon: —r __
O Egress9ighung plot, ❑Other Each addll{oeal lnrpectlon over the allowable in any o'rhe sbovet
Submit`sen of plans with anv of the above. Per inxpcc --
10vt.n� •alien fur --
The above are not applicable to temporary Construction service. Ocher
-80 Nul all Iurirrlleduns accgtt uvdit rardx,Pietist;citll lurirdicuon Om30
x arc mlbrmxeun Notrt.-e. This permit application Permit fee...,,,..... �
a _
❑Vire O MuxlerCard e:rplres it a permit i5 not obtained Plan review(at
Credit 911(d number —.`- � Within 180 days afie. tt has been State surcharge B°ib �
,purr C ( ).....S
Pm�e uTCan�fin rr as, own un ct h eaN accepted as complete TOTAL . . ...................S
GWho at ci route ` f
muum
AA1461`i6.tr,C0M)
ZIN 100/100 d 11N -011 12:11 20-IM30
CITY OF TIGARD 24-Hour
BUILDING Insk ction Line: (503) 639-4175 MST -
INSPECTION DIVISION Business Line: (503) 639-4171 BLIP -
--
Received _ ___ — Date Requested AM---- PM 13UP - - -
Location __ __ > C; 61 r���-y' --Suite----_ - - - MEC
PLM
Contact Person . -t.�''c�L" Ph --- --
G _ Ph( ) -- _
Contractor S W R
_ C> n
BUILDING Tenant/Owner ELC _
Footing E L -
Foundation ACC9SS: �� ELR
Ftg Drain 11
Crawl Drain Y SIT -
Slab Inspection Notes:
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&Bearn
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 - ----- `--- --�---
E RICAL --.—
'ervice
ough-In - —�_— ----------- - _
UG/Slab
Low Voltage
Fire Alarm
ART FAIL
L] Reinspection fee of$ -______.__required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
*SE ^--- [] Please call for reinspection RE:. Unable to Inspect-no access
Fire Supply Line l
ADA h � _BXt
Approach/Sidewalk Date ��1. j , r-----� Inspector _
Other: - ..__._
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL