Permit CITY OF TIGARD ELECTRICAL PERMIT
31111
" PERMIT #: ELC2008 -00384
COMMUNITY DEVELOPMENT DATE ISSUED: 7/7/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BB -18900
SITE ADDRESS: 16145 SW 103RD AVE ZONING: R -7
SUBDIVISION: RIVERVIEW ESTATES LOT : 035 JURISDICTION: TIG
PROJECT: REILLY
Project Description: Installing (5) branch circuits for kitchen remodel.
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: 4 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:
MARK & AMY REILLY JSM ELECTRIC
16145 S. 103RD AVE 7717 SW SKYHAR DR
TIGARD, OR 97223 PORTLAND, OR 97223
Phone: 503 - 260 -6671 Contact #: PRI 503 - 866 -7304
FAX 503 - 244 -4397
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 7/7/2008 $73.45 LIC 168451
[TAX] 12% State Surchar 7/7/2008 $8.81 SUP 5104 -S
Total $82.26 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: �S 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.
Jul 06 08 12:20p Jeffrey S. McGinnis O 503- 244 -4397 p.1
- Electrical Permit A licatia
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City of Tigard
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% I.* 7� Ay Permit No.[ _
13125 SW Hall Blvd., Tigard, OR ` A n/ R � cw
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a Phone: 503.639.41 Fax 503-598.1960 J S* P Other Permit
f I t .‘ 1, D Inspection Line: 503.639.4175 ` ` `` Cj t , to ReadyfBy: tuns- RI See Page 2 for
Internet www.tigard- or.gov � \ -C ` � 1°1 Natified/Method: 7 7 Supplemental Information
TYPE OF WOR. Ave ` �, PLAN REVIEW
❑ New construction ® Addition/alterationireplacement Please check all that apply (submit 2 sets of plans w /ilerns checked below):
El Demolition Other ❑ Service or feeder 400 amps or more ID Building over three stories.
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
0 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family 0 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 ", "F ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 16145 S. 1033" Ave. looHP or more, occupancy.
❑ Six or more residential units. ❑ Recreational vehicle pairs_
City /State/ZIP: Tigard / OR 197223 ❑ Health -care facilities. ❑ Suppiy voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Kitchen remodel ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: oeaCripl na ) Qiy, I ter ( Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft or less 145.15 4
Ea. add'I 500 sq. 11._ or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK ( eve sq. ft.) 75.00 2
Limited energy, multi - family
Remodel kitchen residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation _
200 amps or less ' 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Mark and Amy Reilly 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 16145 S. 103rd Ave. Over 1,000 amps or volts ___ 454.65 12
City / State/ZIP: Tigard / OR 1 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)260 -6671 I Fax: ( ) 200 amps or less 1 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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 — ntw, alteration, or extension, per panel
I A. Fee for branch circuits with
❑ APPLICANT Egli CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: D &T Interior Solutions B. Fee for branch circuits
Contact name: Todd Engerman without service or feeder fee, 1 46.85 46.85 2
first branch circuit
Address: 9705 S.E. Pine St. Each add'l branch circuit 4 6.65 26.6 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Portland / OR 1 97216 Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: (503) 260-6671 Fax: : ( ) Reconnect only 66.85 2
E -mail: todd@dntinteriorsolutions.com 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: 771'7 S.W. Skyhar Dr. extension. Describe: I Page 2 2
City /State/ZIP: Portland / OR / 97223 Each additional inspection over allowable in any of the above
Per inspection ! 62.50
Phone: (503) 866-7304 Fax: (503) 244-0397 Investigation per hour (1 hr min) 62.50
CCB Lie.: 168451 Electrical Lic.: C218 . Suprv. Lic: 51045 a- t Industrial plant per hour � 73.75
t ELECTRICAL PERMIT FEES
Suprv- Electrician signature, required: r 1 � • t
t ' Subtotal: 73.45
1 o' Plan review (25% of
Print name: Jeffrey S. McGinnis Date: 07 - 07 - 08 ( permit fee):
State surcharge (12% of permit fee): 8 -81
Authorized signature: TOTAL PERMIT FEE: 82.26
Print name: Date: This permit application expires if a permit is not obtained within NO
days after it has been accepted as complete.
CITY OF TIG/V,„
„i
BUILDING DIVISION \
A PERMIT #: ELC200B-003
D ATE 9,1
13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 7/1/2008
Phone: (503) 639-4171 kguitmo
Inspection Requests (24 Hrs.): (503) 639-4175 4. :11!. •
INSPECTION WORKSHEET FOR DATE: V/1E42008 TIME: 7:00AM PAGE: i '1
SITE ADDRESS: 16'145 SW 103R[) AVE CLASS OF WORK:
• SUBDIVISION: RIVERVIEW ESTATES LOT #: 035 TYPE OF USE:
PROJECT NAME: REILLY
DESCRIPTION: Installing (5) branch circuits for [When rern')del.
OWNER: REILLY, MARK & AMY PHONE #: 603-2G06671
CONTRACTOR: JSM ELECTRIC PHONE #: 603,866.7304
• Inspection Request Scheduled For: Date: 12/16/2008 Pour Time:
Code # Inspection Description Qi ir Contact # Message
199 Electrical final 079050-01 ) 603-709-8732 N
•
Corrections/Comments/Instructions:
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146 Pi.,0142;03., e TA xi.. 01,),,Q
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PASS El PARTIAL APPROVAL III CANCEL 0 NO ACCESS
I I AIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
• Inspector: C.Y . . 0 OS6 I.., Date: Ili( ile
Phone #: (503) 718-
• _
CITY OF TIGARD
BUILDING DIVISION' 1 • PERMIT #: ELC2008-00384
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/112008
Phone: (503) 639 -4171 lit
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' `—
INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE: 61
SITE ADDRESS: 16145 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: RIVERVIEW ESTATES LOT #: 036 TYPE OF USE:
PROJECT NAME: REILLY
DESCRIPTION: Installing (5) branch circuit:: for kitchen remodel.
OWNER: REILLY, MARK & AMY PHONE #: 503 - 260.6671
CONTRACTOR: JSM ELECTRIC PHONE #: 603- 866 -7304
Inspection Request Scheduled For: Date: 7/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 073037 -01 503 -260 -6671 N
Corrections /Comments /Instructions:
•
•
!!O PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
4 ' FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: /1 -54 1 1/6 4 Date: 7 23 -- P Phone #: (503) 718-
• CITY OF TIC��,- -r,
BUILDING DIVI PERMIT #: ELC2008- t10384
13125 SW Hall Blvd., Tigard, OR 5 ... - -. DATE ISSUED: 7/712008
Phone: (503) 639 -4171 ' �I
I nspection Requests (24 Hrs.): (503) 639 -4175 . �!�+L
INSPECTION WORKSHEET FOR DATE: 7/18/2008 TIME: 7:OOAM PAGE: 37
SITE ADDRESS: 16145 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: RIVERVIEW ESTATES LOT #: 035 TYPE OF USE:
PROJECT NAME: REILLY
DESCRIPTION: Installing (5) branch circuits for kitchen remodel.
OWNER: REILLY, MARK & AMY PHONE #: 503- 260 -6671
CONTRACTOR: „ISM ELECTRIC PHONE #: 503 - 866 - 7304
1
Inspection Request Scheduled For: Date: 7/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 07279 01 503 -26(? 6671 `
4 � i°
Corrections /Comments /Instructions: I ° —.� i CALL OA
V
N® a l O W P T A 6S u
1 kcy cua shy - ,
AP 18o 1
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•
❑ PASS n PARTIAL APPROVAL ❑ CANCEL XNO ACCESS
1E4 FAIL KCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C • N 1 Date: 1 I l ati Phone #: (503) 718- 'WAAL