Permit �� 7 �,�j eftee -05) E
" PERMIT j L
~� 6I �F I�
COMMUNITY DEVELOPMENT PERMIT #: ELC2 00836
DATE ISSUED: 12/12/20/20 07
.TIG■RD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 02 DC -00800
SITE ADDRESS: 08870 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 009 JURISDICTION: TIG
PROJECT: LALLY
Project Description: Replace existing service panel. 12/17/2007 Add (5) circuits. • RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 40 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
LALLY, DONALD P + BRENDA J NELSON ELECTRIC LLC
8870 SW O'MARA ST 1745 4TH AVE
TIGARD, OR 97223 WEST LINN, OR 97068
Phone: Contact #: PRI 503 - 267 -8529
FAX 503 - 237 -6472
FEES
Description Date Amount Reg #: ELE C 123
[ELPRMTJ ELC Permit 12/12/200' $80.30 LIC 168080
[TAXI 8% State Surcharge 12/12/200' $6.43 SUP 3506S
[ELPRM'1'J ELC Permit 12/17/200' $33.25
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $122.64
This Permit is issued subject to the regulations contained 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 issuance, 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 1.800.332.2344.
Issued By: / A..1, ./.b 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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
/�.11 - , � 5) ELE PERMIT
C IIG ' (ISIS
�� PERMIT #: ELC2007 -00836
" ° COMMUNITY DEVELOPMENT DATE ISSUED: 12/12/2007
�M \
PTa 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102 DC -00800
SITE ADDRESS: 08870 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 009 JURISDICTION: TIG
PROJECT: LALLY
Project Description: Replace existing service panel. 12/17/2007 Add (5) circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
LALLY, DONALD P + BRENDA J NELSON ELECTRIC LLC
8870 SW O'MARA ST 1745 4TH AVE
TIGARD, OR 97223 WEST LINN, OR 97068
Phone: Contact #: PRI 503 267 - 8529
• FAX 503 - 237 -6472
FEES
Description Date Amount Reg #: ELE C 123
[ELPRMT] ELC rmit 12/12/200' $80.30 LIC 168080
[TAX] 8% State Surcharge 12/12/200' $6.43
SUP 3506S
[ELPRMT] ELC Permit 12/17/200' $33.25
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $122.64
This Permit is issued subject to the regulations contained 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 issuance, 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 1.800.332.2344.
Issued By: o A.A.1 ✓ �h 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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
.. _
DEC-17-2007 : c'BA FR Jf9 t r� f` C) f� U ecoE‘ 1 Tr :186 lEri'7� P.1 1
MP /a
Electrical Permit Application h, u1t (II I If 1 -' \ I i � ;;
( ..� ,. ...
5 v° , C it, of Tigard � � °—
\t� 7/3!3 k"" k"" \'L� L 'I- ��,
' 1.112 n 51t f 6 1 0 417 i l'aN , qg 19 0 GP Lt:WA' Cnta natal
6 _ Phone 50i61Q4t "i 17s ^035�8ty 1 ^ LVd _..j..- .____ —
tIOn 1 tar 5q
. 3 639 41 p� • ' e �� I�171 +e aced, 11a !! Sr P0, 7 far
�: 1C7
,f 11, n I Inc C
sis Snpp0tncntnl Information
Worm Hitt. ttgard nr gm, \ M 1
- T \PF (I4 "(IRK PLA'\ REVIEW
I ^' �•-'" 1 low east. c11 tba apply +30/111f 3 cm of piacs , items chaktd nein, l
Q Zeu construction 4 ion replacement 0 Cienri.d at feeder 1r.0 trans or mar, 0 Bw,Idme o i1•ace ntmcs j
0 Demolition ❑ Other what Jhe a I.b'e fault currant 0 Merin: end bwnards I
C OF (O\STRI CIAO e+,ttde 1 vr p., n, 1 {a snttc a, Q Flmnn; budder
�. — . _.._ l 4,5 to cram! ,, r tuce 1 0';0 ❑ C. : mmcrelol -us apri.uh
and 2- family d „clltng ❑ (ommercial I nJu44nai ❑ \ci:e,4on h ulldin f a•.n,r n r 111 -u o +aouannn: buadmaa
Multi -famd2
❑ •faslar builder OSlier C 1:0 r an.o ❑ In
sfeil_uun of '' h:\'•\ 11
i -- - _--- ' - Q F a:erren: ,,stem larg, 9:v.:Ruth do,cd v.xttm
SOB SITE l \FOR\LATIO\ t \1) LOCATION [] •dd■nn or non mace le.-1:1 of 0 A . f 1.2 . I., I
_.
IfrdHP riccupain,
Joh no Job Silt address- 0 5 , (Il : r ;�( d t m t;l 111104 Q R<- r „;nontl , eh :cle parks
.... - � — `1. '1 -'rc f chain 0 5apph , al;af.e for nwre !nar
( U) State YIP' Cl ynri,o)1; nnrn ne4
i _ I ■ 0 flu _re... i,xmmm
1 Suite bldg apt no Prolecl name 1 , 0 true nr taint-4.'1 ampr nnnato
_. ____ __-- FEE SCH I)t LF.
C ro;, str2et din:ortons In Joh VIC __ 1 (24s i tees I Taul ■ ~
- - - - - -- - — — , Ness residential single - a multf•famil} dn. ellIng unit. l
loeludes attached garage. !
1
Subtly, i<ion: —�— I 1 of an � 100n w 1 or less 1 Ids 15 4
________1______ i 13 add 1 : sq R or portion 1 1 33 40 1 ! i '
l a1 , . parcel nn \ add gage: residential 1
't --- L sc co, 2
DES RIPTIO\ OF \10RK t 1 , .,hzt .e,c1 ft t 1
q ! llrmlt cas ^, multr farad,
� � ! / { A _ r.^strsnllnt 1,nh 144 t? abate s 1 'S Gar i 2
! r ' c tO� a Q ' u - 4en • .5 or feeders installation, alteration, endear relocation
-
amps or less ttl i t - 1 i
is PROPERTY OWNER ❑ 11%St\3 , 2101,anpsto400amps • 1Ubli4 1 2
......- ._____., _________ _ .. - -- - . -.. - _ f
vattte `**4 4 491 amps n Gael a mp, ( win(' � 2 • I. !ice - _ _ - — 601 amps to f.000 amps 24(16L1 ' 2
4ddeess: f t, cr I nnn imps nr , tilt I 4S j 5 j ' 2
C its silt: /IP lem Se rsltes or feeders installation, alteration, and r or
Phone I 1 , I a\ t ; n.l� ; ,r less L j 66 6.5 1 i t ,
1 1)n1 to 4(01 nl s Ri 30 I i?
(�ener installation: I his m,talGat h ,rte made os pro�m rhea I curl a h,wh is nut ? t
intended for sale. Masi:, rent, or c\change, according to UR$ 4 446 (`n. and "tt I 1 amps 1. sata amp.. 133 15 1 2 I
j (h , nrr , t nature. I)xc ■ ' ( 3ranchcircuits - nos, alteration, oreslenston. tvtr ianel 1
1 ----•- ... -- - - - - -- - - - - -- -- - - - - - s 1 ce r,.r hrench eircuns a rib T - --
I ❑ APPLICA \T ❑ (O \T t(I PF IV-41s i 2Dotc ,tares t cadre Ice J h 6 : /� ..., - I , 3. ` ' 3
Lath nn)hb llr ill i,
: Ruvm°,. name It i cc tar hronth.ireait:
�.. - -- - cr feeder fee j u:a1 en I r i � i
! Canted nrmc r1 4C, $S I 1 ' i
firs, hruneh wean I
' \ddre4, L ash add i b140 ch ereuti # ! 6 65 �. j /g11 -'
,-_ -- __ __.. —._ miscellaneous (sen ice orfe . r-ern nel tided
i C in State /IP 1 uc m Of modular
_ 904q; 12
— __ ________._____;_____L__.._ i
Rhone. 1 f I as _ Rut l sers ilnnec nnl, 4 and or (cider n68 f '
Pump or mpaston uri
1 i
1 •mail 1 53 40
-
( \IRA( FOR annrn ut lrn111 lino aiJti
/ !LC S,pnal irc,rnt,lurllmned-
Ilu>ine„ name i
'. �/ i
cner ?i P.Itlel 1IICIVian II
1 11 Slate �' / .. � � � 1 fi n ch od i ection o'er allowable in o'
ro of (he chos
j 1 �° I t: onpuuon 62 4(1 i
P ! In s rulgauan per hour 1 h- mini _ 62 i0 1
� - - '5 ' } i
C(131_ Ic. t , 1# h le 1 Li i S 1.1c Indusmal plant per hour '3 '�
�r E i _ l(IRIC Jl PF.R 'SIFT FEES
SUN
n [lc'Clrlelan CIE nature. raa r r._ Jp � { 7 � �
Print name ' /ate Plan rat,les, i2cc'oorpennit for - I
_� a .• —_.. -- - A— -__ -1 "lmc surcharge I' a'1 p-omm feet - e& - Cr Z-ta
i ,1uthorirCd signature.
1 fUl\L PER\IITfEt ' � i
Print music: 1 ibis ptrmn applintton e, if a permit b no t obta nf I:R q
[1 8tt_ ----- ___..___ J dais after n has been accepted as eomplrte. $3 S.
1 \unhcr n} mar.:<nnn, slinw pc* ptnmt
ex-4.Le_e_0 e 4 ---- 0 9. it *' �., Y OF TIGARD E TRICAL PERMIT
' " PERMIT #: ELC2007 - 00836
°, COMMUNITY DEVELOPMENT DATE ISSUED: 12/12/2007
?Tt 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102DC 00800
SITE ADDRESS: 08870 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 009 JURISDICTION: TIG
PROJECT: LALLY
Project Description: Replace existing service panel.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
LALLY, DONALD P + BRENDA J NELSON ELECTRIC LLC
8870 SW O'MARA ST 1745 4TH AVE
TIGARD, OR 97223 WEST LINN, OR 97068
Phone: Contact #: PRI 503 - 267 -8529
FAX 503 - 237 -6472
FEES
Description Date Amount Reg #: ELE C 123
[ELPRMT] ELC Permit 12/12/200' $80.30 LIC 168080
[TAX] 8% State Surcharge 12/12/200' $6.43 SUP 3506S
Total $86.73 , REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained 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 issuance, or if work is
suspend or more • 180 days •TTENTION: Oregon law requires you to follow rules adopted b • = Oregon Utility Notification Center.
Thos ules are set forth in •A; • 52 -••1 -0010 through OAR 952 -001 -0100. You may obtain cop' of these rules or direct questions to OUNC at
503 46.6699 ' r 1.800.332. :44.
Is ued By: 4 ,/ / Permittee Sign /.�
, `J % '
/ ,/ -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, o rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
v CITY OF TIGARD ELECTRICAL PERMIT
ih
y CO MMUNITY DEVELOPMENT PERMIT #: ELC2 00836
D ATE ISSUED: 12/12/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 DC -00800
SITE ADDRESS: 08870 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 009 JURISDICTION: TIG
PROJECT: LALLY
Project Description: Replace existing service panel.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
LALLY, DONALD P + BRENDA J NELSON ELECTRIC LLC
8870 SW O'MARA ST 1745 4TH AVE
TIGARD, OR 97223 WEST LINN, OR 97068
Phone: Contact #: PRI 503 - 267 - 8529
FAX 503 - 237 -6472
FEES
Description Date Amount Reg #: ELE C123
IELPRM"h] ELC Permit 12/12/200' $80.30 LIC 168080
[FAX] 8% State Surcharge 12/12/200' $6.43 SUP 3506S
Total $86.73 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained 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 issuance, 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 -00 :::: hrough OAR 952 - 001 -01:1. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued r• yy zez, /t/ / / Permittee Signature: de ' , ii I, / 4 fir
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
RECEIVED
t)li.fn ilf'1 �-)3Rra
Eleetrical Permit Applicati 1 `v 2007 x ;r ' _ ;.3 , x¢ '4 r '''.>"e;;:' ` - p
s n �r Received
City of Tigard k ,Ur l IUHMU DateBy: /?/ / 1�`5/ Permit No. �1.-� 20a?7'e:615 jii
' a 13121 S \4 Hall Blvd.. Tigard, O p� �y Plan Review
' - 'R!� , 8 Phone: 503.639.4171 Fax: Lt. ! G1 DIVIS� Date /Bv: Other Permit:
y v
Inspection Line: 503.639.4175 Date Ready /By: )edS' / el See Page 2 for
T1G'AKI] Internet: www.tigard- or.gov Notified /Method: .776-- Y Supplemental lnformation
TYPE OF WORK PLAN REVIEW
❑ New construction ddition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 salts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
.JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑' A". "E ", "1 - ? ", °I - 5 ",
oAO C� I OOHP or more. R cc r ea ti o n
Job no.: Job site address: Orkitr D / `J /' F(lti1 ❑ Six or more residential dential units. 0 vehicle parks.
9 City /State /ZIP: ❑ Health -care facilities ❑ Supply voltage for more than
�j //� / �/ ` � � � J ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: '✓/ Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtr. 1 Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 4
Ea. addl 500 sq. 6. or portion 33.40 I
Tax map /parcel no.: Limited energy. residential
DESCRIPTION OF WORK ( s ) 73.00 2
wit above ft.
` l J � I Limited energy. multi - family 75.00
.o ry er. / A�,^ - residential feeders above sq. fi.)
vv 6/ `� �/ Services or feeders installation, alteration, and /or relocat n l
200 amps or less / 80.30 e .1(/ 2
Q]" PROPERTY OWNER ❑ TENANT' 201 amps to 400 amps 106.85 2
1 / _ 401 amps to 600 amps 160.60 2
Name: " �O� n, O�l�l��J 601 amps to 1.000 amps 240.60 2
.Address: / VG!"\ J Over 1.000 amps or volts 454.65 2
l Temporary services or feeders installation. alteration, and /or
City /State /Z1 P:
- relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease. rent. or exchange. according to ORS 447. 449. 670. and 701. 401 amps to 599 amps 133.75 2
Branch circuits- new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
13usiness natnc: B. Fee for branch circuits
Contact name: without service or feeder tee. 46.85 2
first branch circuit
Address: Each addl branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: I Each manufactured or modular 90.90 2
dwelling. service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuits) or limited -
Business name: A ,/,ega/ ��' l Gee- energy panel, alteration. or
Address: /70 i- CCC Ape, '" /� extension. Describe: Page 2 2
City /State /ZIP
%inn AP, 97 '4c) Each additional inspection over allowable in any of the above
Phone `
`) NNN���� Fax: �� � ���
� Per inspection I 62.50
v h `C � j / J
Investigation per hour t I hr min) 6_ >0
CC13 Lie.: / D Electrical.- l.ic_: e -z g i Supra. ' :;.350(0 S Industrial plant per hour 73.75
` n
Supry. Electriciansignature. required ) _ (i /
35—.C10 ELECTRICAL PERMIT FEES Subtotal: N. )
Print name: I 6N[ a / / / Date: a f cj Plan review (25% of permit fee): �(/
C 2 ! State surcharge (8% of permit fee): o. 1"
Authorized signature: TOTAL PERMIT FEE: l( . 75
Print name: Dale: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pertoits\ELC- PermitApp.doc 05/23/06 440- 1615T(11,05 /CO \UWEB
CITY OF TIGARD
A .
1 BUILDING DIVISION PERMIT #: ELC2007 -00836
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 "I-
INSPECTION WORKSHEET FOR DATE: 12/18/2007 TIME: 7 :01AM PAGE: 71
SITE ADDRESS: 08870 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: (lfg TYPE OF USE:
PROJECT NAME: LALLY
DESCRIPTION: Replace existing service panel. 12!17/2007 Add (5) circuits.
OWNER: LALLY, DONALD P + BRENDA J, PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503 -2.67 -6529
Inspection Request Scheduled For: Date: 12/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 061677 -01 503.267 -8529 N
Corrections/Comments/Instructions:
aU kl q . ‘, ( 1,Nd ale ---- PPr‘75
C/
p PASS El PARTIAL APPROVAL ❑ CANCEL III NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
;
Inspector: Date: E Phone #: (503) 718-
' 1
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELC2007 -00836
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007 Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �'� '
INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: 65
SITE ADDRESS: 08970 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: Q09 TYPE OF USE:
PROJECT NAME: L.ALLY
DESCRIPTION: Replace existing service panel.
OWNER: LALLY, DONALD P + BRENDA J, PHONE #:
CONTRACTOR: NELSON ELECTRIC L.LC PHONE #: 503- 267 -8573
Inspection Request Scheduled For: Date: 12//4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 06480 -01 503 - 980-8505 Y V
Corrections/Comments/Instructions:
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❑ PASS ,PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
l � j Vg Inspector: r I Date: ( ( V Phone #: (503) 718 -