13530 SW FERN STREET 13530 SW Fein Street
ELECTRICAL PERMIT
CITY OF TIGARD PERMIT#: EL.C2003-00120
DEVELOPMENT SERVICES DATE ISSUED. 3/11/03
13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104BD-02400
SITE ADDRESS: 13530 SW FERN ST ZONING: R-7
SUBDIVISION: VISTA LAKE JURISDICTION: TIG
BLOCK: LOT: 001
Project Description: Install 2 200amp/less panel and fe!-,ciur to existing load center.
r601+— — i TEMP SRVC/FEEDERS MISCELLANEOUS
_ RESIDEN'fIAL_UNIT - --- PUMPIIRRIGATION: "
1000 SF OR LESS 0 - 200 amp-
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OIIT LINE LTG:
4U1 - 600 amp: SICsNHL/PANEL:
LIMITED ENERGY: i%'NOR LABEL (10):
MANF HMI SVC/FOR:
amps 1000 volts:
SERVICE/FEEDER BRANCH CIRCUITS _ — >DD'L INSPECTIONS
_ W/SERVICE OR FEEDER: PER INSPECTION:
0 - 230 amp: 2 PER HOUR:
201 • 400 amp. 1st WIO SRVC OR FOR:
EA ADD'L BRNCH CIRC: IN PLANT.
401 • 600 amp: _''1-AN REVIEW SECTION
601 - 1000 amp: ____—.— ------ g00 VOLT NOMINAL ^�
1000+ amp/volt: >=4 RES UNIT S: j
Rocor ,ct only: SVC/FDR>1 225 AMPS: _ _ ,-CLASS AREA/SPEC OCC:
^� Contractor:
Owner: BOONES FERRY ELECTRIC INC
BUCKNAM,BRIAN +JULIE L PO BOX 628
13530 SW FERN ST WILSONVILLE,OR 97070
TIGARD,OR 37223
Phone: Phone: 682-4936
Reg #: SUI' 3170S
LIC 88482
FEES _ I:II: 1-2:3C
Description Date Amount RequiredInspections
I.I.I'RMl'� LC I'cnuit ; I I u� $133.70 ----- —�
I I ttt $10.70 Rough-.n
s; I
I AXE ,,Si ite Tux Elect Ser;icr
Total $144.40 Flect'I Final
This Permit is issued subject co the regulations contained in toe Tigard Municipal Code,State of OR Specialty Codes and all other applia7,ble laws.
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuan-r,or if work is
low
les
suspended
ule eaders set forth n AR 952 001-0010 hrougthan 180 days. OhNOA 19i0-001-01 0. Youn law requires tl to may olbtainucopes ofd by thesertuless Oregon
d�ectIldy questions tolon 0,UNCtat(03)se
246-6699 or 1$00-332-2344.
Z LlL �tc Permit Signature: L \ I +~
Issued By: , ,�i � __�
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: ___.-w-- --._ -------- --- �-
Call 62'94175 by 7:00pm for an inspection the next business day
Mar-05-03 O8: 27,A Boones Ferry Electric 503-682-7946 P -01
n Electrical Permit Application
Date rtccivrd:/ (I n Permit no.:E
LfSfri� _ i ..1 1 r
iGity of'Tigard -� PmjecUsplrl-no.: GupireQQdue:
Cir•nj7igard Address: I!I!5 SW hall Blvd,Tigard,OR 97227 Date Issued: Ry�•'V Receipt nn.: 7--
Phone: (503) 639-4171
Fax: (503) 598-1960 Caxe file nn.: Payment type:
Land use approval -
J I &2 family dwelling or accessory JCommercial/industrial J Multi-family ❑Tenant improvement
.7 New construction >iAdditinn/altrrettonlreplacement J I)thcr _-. _—O Partial
Job addresa: 13 S30 5w ¢rn 5 T,y ar d 1 F11dg rx+ tirnlr nr Tax map/tax Iot/account no. — - -
Lot: [clock: —
_----— . -- ie ri
Project name: 1*.a✓e _ _ ��t]escriphun and lactation of work un pnmises: /1/Cv purl• J ♦ tee •f
listitnated date of tom Iction/inspectinn: M;) _c 0 3 ——�O e>w r i n D^ cen'}e'"
W ELM
no: FW max'
Job!2L
lite name: ---- --------- (
— bexrtps►eo _ Qty ea.) Total so.laap
Hoor►es—r¢�F/�try'��rr lect�ric "Hal-d"fil.ormultE6dlyW
Address: •U• $oX ` 28 ��lll*YYN-IM IVdla rtdl�Qlrl�t.
City: Wilsonville state 08 ZIP: 97070 tl� ra•
Phone: 682-49.36 Fax: 682-79 �jma+l IIx11%y.N._ralesa A
IACII Additlorlal SIM)9 fl o pratrul thereof
C` 'I3no 8 -82 c.nlc ec.bua.li3-223C ; -- --- _._
-_ � Imfled cnitily, rerl�drnwl 7
('fly/ 0O2851ironed enem,. nm-reuda_aW _ 1
I Ach rrurrrrkurLd hone or modulu dwelling
Si c of upervisin electric al (rrquirod) -- -!'ale-- - Rervfce arlNrlr fecdrt _—_ _ 2
SupCIM. ; (print)' S d H e r r o n I-krne ran Serwkrs nrfreden-1111taallatlan,
T-- alterYtinnar rrlotaflerrs
n wnp<:rlesr. �j1� 2
Name(print): M dw I� �� V r f `I,I a,np%In 4410 amps _ 2
fiiailingadirlmsrF) _ _ nni amp.ln Ilton amp, 1
( ,ty; J State: zIP Over low AMP%01 vohs 2
P'onr - --- -- Fsx: E-mail: Reconnect and _ I
l)w'ner installation- TSe installation is being made on property I own Tese'orary%@Yomorfeeden-
which is not intended for sale,lease,rent,ar exchange according to Itaslallation,aNershol,orreloutJoa:
NMI LIMP%rr Ic%a z_
ORS 447,455,479,670,701, zM tun a14rx�un
O1wrn±r's si antic__ Date: 401 In(01 un 2
- lnnrh rlreolb•new,aloerftlon,
or extensive per pesel;
Nl;unr ---_---- A 4cr for hranch rireult w*prartlate of
Address. - - —� vMvler nr ttertrr fee.each Iuarrdl cin.ua 2 _
71P
I
f I•vC fis hranrh cucuav Wirru purchase
City 9wle'
_ _ of vuvice rr Itedet fa.rust branch circuit 2
Phone'- --✓-- Fax' I? gnarl iAr
sh NilxxuMan
l e+ cacuh:
Mlrr.(%rr v lr a or feeder sot lerheirrd)I
U tirrvice ova 115 an+p%,murwrtial IJ HrdM,ue fxctht> nch xury+1r tmµAUon circk - _ 2
2
U tirvl
eee oval 110 anglvrmlr,p 1i 1&7 U Ilaol�artim, kxitrInch+rµ1 kit ludine Iral+llryg - _
fimmil0 dWclBrngv U fluddnit aver 10.0110 vyuan•lirt i—te tilµral ciroonv)or a limned enerµy pawl.
U S%•oelrr ova MMI vnhv rxrrurud enter reaikmul unst in rine*nruav ahcnrtirM. 11 calen%trn'
U tlnddhnt over glue• .111x'% U F%rdety 4011 wkip;in more •Uc.rn tion - -
tJ(xrrywurl kud ova v)Petyro. 1.1 Marulfrrtteed vtrurlure%or Rv poi FichddlHunalInsfe flonover the alle"xibc In may stow Mom
J I U Met: -_ •--• -- g\r ul.ga num
Yabstila veta of plana with any of din obove.
The above ort%ant applkoble to temporary colnrdnacdoa seniee. t nhrr
Permit Ike .f
Nm all pknrull aunwlir unn Hr mrxe nairttnau.m Ncktieo' Thio prnitit ;tppll%allnn J --
J VI%4 J Mavrwt At If expires it's pemtif Iv tint ohutincd Plan review(at °/i) S _.
/ / witin xyv ua hIµ11 dflet he.Irc'en State vurchatpe(8%) S 7 n__
r'rrda+ant numh r � ---
I rprrr, ;lccel+trd ter%:omplr•lr TOTAL
\amt tel�udMr4lrr a%hewn rrn neAa card
S
1 iidhnlAer alglnala h' —_._tonmrn 4404611INnf4l'UMI
.._—.�_.�. _ --- I /Q t'r S F V S � U► S'O� rl f'�n.o
CITN I 116AHL) 24-Hour
U
BUILDING �� Inspection Line: (503) 639.4175
INSPECTION DIVISION Business Line: (503) 639-4171
MST _
PUP -
Received -_ _Date Requested 3 -13 ANI---_--_ -- PM - -- Bt;P
Location - -3,5 34) _ ./ — Suite -- ---- - MSC
Contact Person • _!C( ---- Ph(— ) -` � � - PLn� _- -- - -
Contractor - Ph(---- - ) --_-_-_ SWR _
891111-DING Tenant/Owner _- _ _ _ ELC 3 �p O /-;1-0
Footing
Foundation Access: --� ELC
Ftg Drain ELR
Crawl Drain _
Slab Inspection Notes- - SIT
Post& Geam
Shea,-Anchors
_-- --
Ext c:heath/Shear
Int Shee!h/Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinklar - - -------- - - -- - - - - - --- - _
Fire Alarm
Susp'd Ceiling - -- --
Roof `
7 1
Other -
Final
PASS PART FAIL -
PLUMBING
----- --
Post&Beam
Under Slab
Rough-In
Water Service _
Sanitary Sewer
Rain Drains - - -- -"- -- ---- - - -----
Catch Basin/Nanhole
Storm Drain ---•
Shower Pan
Other: --
Final
PASS FART FAIL —
MECHANIP^'AL
Post&Beam ------- -- —
Rough-In
Gas Line
Smoke Dampers -------- --___.._-_------ _
Final
_� P;�ASS.._P-A�FAIL' - -_—
'T LECTRICAL
Rough-fin
UG/Slab
Low Voltage ---_----- - _ —
Fire Alarm
Ft Reinspection fee of$_.__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
KIRPART_ FAIL
SITE Please call for reinspection RE: --_ _ _ C Unable to inspect-no access
Fire Supply Line
ACOA r ?'.•, -
Approach/Sidewalk Daus _� � ."-- Inspet _—__-.._-- _ — —. _Ext
Other:
Final DO NOT REMOVE this Inspection revvird from th6job site.
PASS PART FAIL
J•
CITY _ TIGARD 2.4-Hour
E .ILI NG Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BLIP
Received Date Requested- 'lam AM_____- PM — _ BLIP
Location -..�'-�.z�Q— � Suite---- MEC
- --- -
Contact Person _ Ph( ) PLM
Contractor_ _ -..- Ph( } � ��_��'F32 SWR
BUILDING Tenant/Owner _- ELC �
Footing -- _ --
Foundation / ELC
Ftg Drain Fc�eG /,,,� ---
Crawl Dain ELR
Slab on NotPost$Beam --- - ���--`J O ��•�� -- -
Shear Anchors — -
Ext Sheatt:'Shear
Int Sheath/Shear _
Framing
Insulation - --
Drywall Nailing
Firewall
- -- ..---
FireSprinkler
Fire Alarm - -
Susp'd Ceiling --- --- -- .
Roof -- - --
Other: -
Final - - - -
_PASS PART FAIL -- _
Post& Boam --
Under Slab
Rough-In ----
Water Service _
Sanitary Sewer ---� -- --- --
Rain Drains
Catch Basin/Manhole -
Storm Drain - - --------_�__�— �`
Shower Pan -- ----
Other: -
Final �----- --
_PASS PART FALL --- - - --
MECHANICAL
- -
Post&Beam --
Rough-In
Gas Line ----
Smoke Dampers -
Final - -
_PASS PART FAIL -- -- - -
ELECTRICAL
ough-In
UG/Slab - -- - - - --
Low Voltage
- - -
i 'arm -
r 7 n Reinspection fee of$ required before next inspection. Pa��spect
125 SW Hail Blvd.
PAS! PART FAIL
SITE j Please call for reinspection RE. -no access
Fire Supply Line
ADA
Approach/Sidewalk Date 3�� (� ;nspeatOr__ ..__. _,.- Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL