Permit ° L CITY OF TIGARD ELECTRICAL PERMIT
RMI :/L2
° COMMUNITY DEVELOPMENT DATE PE ISSU ED: #: 4
C /2009 2009 -00071
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 B D -01501
SITE ADDRESS: 09815 SW WALNUT PL BLDG A -1 -8 ZONING: R - 25
SUBDIVISION: FREWING ORCHARD TRACTS LOT : 001 JURISDICTION: TIG
PROJECT: WALNUT PLACE
Project Description: Install (2) branch circuits.
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: SIGNAUPANEL:
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: 1 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:
MARCIENE TERRACE ASSOCIATES JSM ELECTRIC
510 WAVERLY ST 7717 SW SKYHAR DR
PALO ALTO, CA 94301 PORTLAND, OR 97223
Phone: Contact #: PRI 503 - 866 - 7304
FAX 503 - 244 -4397
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 2/24/2009 $53.50 LIC 168451
[TAX] 12% State Surchar 2/24/2009 $6.42 SUP 5104 -5
Total $59.92 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 - 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 Ct i A Q c _L Q q p n Permittee Signature: 1 • ,�. "- 4/
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.
•
Electrical Permit Application ro li () I- r I . I: I s i : O \ I . \
RECEIVE r ^
City of Tigard Received d • a , p c} _4 Permit No.: - ' r a G . • r •
.7, • Phone: 503.639.4171 Fax 03.598 6 0 FEB 2 4 2009 Other Permit:
TIC A R I) Inspection Line: 503.639.4175 Date Ready/By: >urit• El See Page 2 for
Internet www.tigard or.gov CITY OF TIGARD Notified/Method: 61 I Supplemental Information
'WILDING TYPE OF WO ILDING DIVISION PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wTrrtems ehed:ed below):
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition
❑ O ther: 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 agncultural
12K- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
of Multi- family yes ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency oo system. ew motor larger s "E", "1 derived
JOB SITE INFORMATION AND LOCATION 1-3",
❑Addition of new motor load of ❑ "A", "E", "1 -2 °, "1 -3 °,
Job no.: Job site address: 9815 S.W. Walnut PI. IooliP or more. occupancy
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: Tigard / OR / 97224 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: I Project name: Dryer circuit I\ ❑ service or feeder 600 amps or more.
J FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 1 Tel I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft, or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Install dryer circuits ' Limited energy, multi family 75.00 2
residential (with above sq. ft.)
-- �� 6 ,A �� �/ - - Services or feeders installation, alteration, and/or relocation
LA - N `` i / v 200 amps or less 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: v V f i v et p I � Q�p m 401 amps to 600 amps 160.60 2
I r\ 601 amps to 1,000 amps 240.60 2
Address: 9815 S.W. Walnut PI.. Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Tigard / OR / 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503 )320 I Fax: ( ) 200 amps or less 66.85 1
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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ® CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: Maria without service or feeder fee, 1 46 85 46.85 2
first branch circuit
Address: Each add'I branch circuit f41 I 6.65 33.25 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular •
dwelling, service and/or feeder 90.90 2
Phone: (503) 320-4553 I 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: JSM Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 7717 S.W. Skyhar Dr. extension. Describe: Page 2 2
City/ State/ZIP: Portland / OR / 97223 Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 866 -7304 I Fax: (503 ) 244 -4397 Investigation per hour (t hr min) 62.50
CCB Lic.: 168451 I Electrical Lic.: C 217 I Suprv. Lic.: 5104S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 4 lei,,, ,, 1, Subtotal: 10:t9- 3.
Print name: Jeffrey S. McGinnis Date: 02-25 -2009 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 'TM (,- 4-z
Authorized signature: TOTAL PERMIT FEE: 897.9
Print name: I Date: This permit application expires if a permit is not obtained within 180 S . ' days after it has been accepted as complete. . q Z
CITY OF TIGARD
BALDING DIVISION PERMIT #:+ Ci(),y..lf)f)+ I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20)009
Phone: (503) 639- 4171a "1I+
Inspection Requests (24 Hrs.): (503) 639 -4175 .SW"
INSPECTION WORKSHEET FOR DATE: 2/7 &&0419 TIME: 7 :03AM PAGE: 13
SITE ADDRESS: 098 15 SW WALNUT PL BLDG A -143 CLASS OF WORK:
SUBDIVISION: .FREWING ORCHARD TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: WALNUT PLACE
DESCRIPTION: ln4tall (2) branch circuits.
OWNER: MARCIFNE TERRACE ASSOCIATES, PHONE #:
CONTRACTOR: JSM ELECTRIC PHONE #: 503-B66-7304
Inspection Request Scheduled For: Date: - 2/26/2009 Pour Time:
Code # Inspection Description C4o3)1 onf irm # Contact # Message
199 Electrical final 50 320-4553 N
Corrections /Comments /Instructions:
ti
►1 PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n IL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: .. ' N 66 LC/ Date: 246 l Phone #: (503) 718- of If 6
CITY OF TIGARD
A a .
B9hILDING DIVISION PERMIT #: Ei. 20ah•00071
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2124/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/25/2009 TIME: 7 :00AM PAGE: 17
SITE ADDRESS: 09815 SW WALNUT Pt G, 1 -f CLASS OF WORK:
SUBDIVISION: FRFVV1NG ORCHARD TRACTS LOT #: 001 • TYPE OF USE:
PROJECT NAME: WALNUT PLACE
DESCRIPTION: Inslall (2) branch circuits.
OWNER: MARCIENE TERRACE ASSOCIATES, PHONE #:
• CONTRACTOR: J ±M ELECTRIC PHONE #: 503-866-7304
Inspection Request Scheduled For: Date: 2/25/2009 Pour Time:
Code # Inspection Description ( Cof# \ Contact # Message
199 Electrical final 000824 -01 503. 320.4553 NY
Corrections /Comments /Instructions:
is U61 � E1t � -. - 14411 (O& 0 �(�► 9J �p ��
c tei:K.. s lAZS AO /t - 13 ( - 143SU
; e �. cx . Act. 1z . 3- ( ) -03)
rr Q--kA vnlb Ns (04--
\_4 C G-t » w i a, oN G ‘--vt\ 6N -�
i\Cq • 2s .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
y t FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1 \ 1 66 1 ---c - Date: 2:G-1 Phone #: (503) 718- ZTLK