Permit d 4 a ® Y OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELC2008 00170
`� DATE ISSUED: 3/25/2008
T IGARD ' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S110BA -05000
SITE ADDRESS: 14535 SW MCFARLAND BLVD ZONING: R -
SUBDIVISION: SHADOW HILLS LOT : 015 JURISDICTION: TIG
PROJECT: WOOD
Project Description: (10) branch circuits. All encompassing low voltage(HVAC & Audio /Stereo).
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: 2
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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:
WOOD, HOWARD & KATHY OWNER
14535 SW MCFARLAND BLVD
TIGARD, OR 97223
Phone: 503 - 516 - 5388 Contact #:
FEES
Description Date Amount Reg #:
ILL,PRMTI ELC Permit 3/25/2008 $106.70
[TAX 112% State Surchar 3/25/2008 $12.80
I EI,PRMTI ELC Permit 3/25/2008 $75.00
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $203.50
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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 1 -0010 through OAR 95 r 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issu d By: ci . I/ Permittee Signature:. _ i / ` „w�
OWNER INSTALLATION ONLY
The installation is being made on propert I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: (` DATE: g/
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.
Electric dr -- , y w,� � '1 V ..
:.,it Ap plication b ,� F OR';OFFICE USEtONLY 0 x .;
D acei B ed / G ( •70
City of Tigard � pPe Permit No.: i(,b
Date/By:
;" 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
l t7 t._ Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
f""''' }, Inspection Line: 503.639.4175 Date Ready /By: luris: ® See Page 2 for
T ; IGA1i• D :
^rk' :ka Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
El New construction [Addition /alteration /replacement
❑ 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 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
[g1- 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
JOB SITE' INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: h y — l h 7 � I 6 100HP or more. occupancy.
I `t 7 J� IYti TL4vlDL w it YJ (/� S ix or more residential units. ❑ Recreational vehicle parks.
Cit /State /ZIP: 1 Health -care facilities. ❑ Supply voltage for more than
y �� ^^ Q � � � z' Z 0 Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: 4.41 t ( ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 6 t1 , z_ iiK 4,„ Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
1,,,„44,,,,., II 1,000 sq. ft. or less 145.15 4
Subdivision: S V � �, Lot no.:
, l Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF 'WORK IP (with above sq. ft.) 75.00 2
1 '' ((�� (� Limited energy, multi - family
W (v- (,-.l -I-2.)„-- J {q� T1 t c _ / t[>`.o.z..k .,' residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
X PROPERTY OWNER . ❑ TENANT - 201 amps to 400 amps 106.85 2
Name: 1.0 wrt ui as 401 amps to 600 amps 160.60 2
'� 601 amps to 1,000 amps 240.60 2
Address: 1 - S te („ a 6/(),A. Over 1,000 amps or volts . 454.65 2
Ci /State /ZIP: //�� " "-� 6/(),A. Temporary services or feeders installation, alteration, and/or
ty T� .4,...d vv` f 7.ZZQ relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I 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
g ,) 7 r1 Branch circuits — new, alteration, or extension, per panel
Owner si nature: ,,,. .x� ",/ L Date: F / 4 6 A. Fee for branch circuits with
. . . ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name:
without service or feeder fee, / 46.85 4 .. vs 2
first branch circuit
Address: Each add'I branch circuit 1 6.65 .5 9, 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
. CONTRACTOR Sign or outline lighting 53.40 2
•
Business name: Signal circuit(s) or limited-
W In e„ — energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT. FEES .
Suprv. Electrician signature, required: Subtotal: /elf , 76
Print name: Date:
Plan review (25% of permit fee): 1.1,
State surcharge (12% of permit fee): / O(• R()
Authorized signature: TOTAL PERMIT FEE: / / 9 . 5z)
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: \Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
IR
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
FRESIDENTIAL WORK - ONLY: r �` ^i
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems* n
Other: t -, 4SS/ K.
' COMMERCIAL WORK ONLY:. . .
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting* •
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION 4 PERMIT #: El 02006- 00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/24008
Phone: (503) 639 -4171 , �����,
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,_ ' J
INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:OOAM PAGE: 20
SITE ADDRESS: 14635 SW MCFARLAND BLVD CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 015 TYPE OF USE:
PROJECT NAME: WOOD
. DESCRIPTION: (10) branch circu All encompassing k33w voItagc(HVAC & Au dio/ Stereo).
OWNER: WOOD, HOWARD & KATHY, PHONE #: 503-516 -6388
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 EIec.tiical rough-in 067362 -01 503516- 388 Y iy& it' -
VI' UAW >
Corrections /Comments /Instructions:
A A i� O aid ol<
ck,6 ( c bk 0 1 D k. AM . ......_ .shas■al
tO � C
1'1 {lii!•r t t lull.. 4. . re- 1[) A% p.) , I �_ . -i/ -i .4+4 pms, f
.• . - aixt ,.. jai
,eg /nd„,,, ,,,,,, ,,,,,,
aiel Ky dc- • 4 5ra�,or; od/ 9 a
a mita iiii :u.Z; 0( At 1 A 54 4
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ' 3"I thl Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION w PERMIT #: ELC2008. 00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3125/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 67 I L
INSPECTION WORKSHEET FOR DATE: 3/26 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 14535 SW MCFARLAND BLVD CLASS OF WORK:
SUBDIVISION: SHADOW FiIL.L.S LOT #: 015 TYPE OF USE:
PROJECT NAME: WOOD
DESCRIPTION: (10) branch circuits. Alt encompassing low voltage(HVAC & Audio/Stereo).
OWNER: WOOD, HOWARD & KATHY, PHONE #: 503-516-5388
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3/2672008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 067362 -02 503.516.5388 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
" ❑ \ \\ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: P
Date: z /11 Phone #: (503) 718-
1
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14535 SW MCFARLAND BLVD, US
Building/Res/Electrical/NA
199 Electrical final
PASS - No C of O
ELC2008-00170
Jeff Grove
Violation Summary:
Inspector Contractor