Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00504
DEVELOPMENT SERVICES DATE ISSUED: 9/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135DD-03619
SITE ADDRESS: 11560 SW 90TH AVE ZONING: R - 4.5
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (3) branch circuits for remodel. Job # 100806.
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:
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: 2 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:
QUILLEN, DEANNA MARIE BOONES FERRY ELECTRIC INC
11560 SW 90TH PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503- 682 -4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 9/7/2006 $60.15 LIC 88482
[TAX] 8% State Surcharge 9/7/2006 $4.81 SUP 4918S
Total $64.96 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503- 246 -6699 or
1 -800- 332 -2344.
Issued By: �/ Permittee Signature: \ ;y (Ai v\ _
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- Electrical Permit A s -toil Re ceived . `. _ F OR:O � FFI EEc ONLY . • nn g -J / mcal ,
- ! .r - _ -
_ `, 4 Y! Date/By J tJ 0 — Permit No.: LCa/ al ) 0
City of Tigard Planning Approval Sign
3125 SW Hall Blvd. Plan E P 0 7 2006 Date/By: Permit No.:
Plan Review Other
;) i gar d , Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
. Phone: 503- 639 -4171 Fax: tit, j �$; r9601VIS1 Post- Review Land Use .
� /�i�a�d�yi aril �� Date/By: Canso .:
- e�� Contact Jur Su See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: 7 -) Supplemental Information.
�.,,� �. TYPE g s ::,;; a : ,.�._
t.��. �` .il�,;�m, ^s ®F WCQRK� �� 4 �t ��� ;„�: �,4N ,.nx ease c _hfatrfl � r ,,,, ; ,, .0 ,,:�
�,. w.�_ .. > ....,,_ �.. � .. � � _.. ., ,.�. �. � -° �° � heck all?t _ y ) z'��;;- r�:�����F
. � , �... EEk ,. ..� - .. � :. s =� -.� '. PL . � .REY.IEW�'��'� _ _ ..v. � Pp- _ ��`?�� - ..� »,, _s�rwa
❑ New construction ❑ Demolition El Service over 225 amps- ❑ Health -care facility •
commercial El Hazardous location
E4 Addition/alteration/replacement ❑ Other: [] Service over 320 amps- rating of ❑ Building over 10,000 square feet,
41, a lcCATIEGORY..OFX S" RUCTION VE'R.W; I & 2 family dwellings four or more residential units in
2I 1 & 2- Family dwelling ❑ Commercial /Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family
❑ Occupant load over 99 persons 0 Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
,: tgall,QO , ITjt�tF ° ' ;
�' � °' s �" � l;�t ;.. Submit sets of plans with any of the above.
��° and'�'LOCATION;s�,��� u m
,:�,. „�
^ � 5,..„... �� The above are not applicable to temporary construction service.
Job site address:
\ \ C'c PN)e . ;::,`; ' `c".. "� , : ' se - ,t;” ;;ti. - s ` ts" I "ISS t€r ,o ,..
,�.= °.ice �_.a.� w = =:�:�k�E��SCIEDULE�. ..- ����'..,<�,��f?�� `�'�.. «'��
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: (. " ► rvri Description Qty Fee (ea.) Total
New residential- single or multi - family per 1
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
ti Sri v , r sa s` , r� r ""
`, . `?��� .�.,�.. aCRII'�TION;,IOF��WORT{� .i 41,mi service and/or feeder 90.90 2
Nr �p Services or feeders - installation,
` ► `>�a —L alteration or relocation:
u 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
PROPmoYI:OWNERs., ' "' _' ENAI�TT v _ • ',; 601 amps to 1000 amps 240.60 2
�� Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation, .
City/State/Zip: alteration, or relocation:
p 200 amps or less 66.85 i
Phone: Fax: 201 amps to 400 amps 100.30 2 •
PPI I.0 V §T' 1 :. CONTACT E RSO -I Branch n h e rc s
y ;€ P N(,z p 133.75 2
-' A
Branch circuits - new, alteration, or
Name: extension per panel:
Address: A. Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit % 46.85 2
Phone: Fax: Each additional branch circuit 2_ 6.65 2
E -mail: Misc (Service or feeder not included): .
-;.; ' ' ;'s t t'.:, Each pu mp or ir circle 53.40 2
Each s ign or outl l 53.40 2
Job No: ( Rcio Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2
g 2
Business Name:
Boones Ferry Electri r Description:
Address: P.O. Box 628
Each additional inspection over the allowable in any of the above:
City /State /Zip: Wilsonville OR 97070 Per inspection per hour (min. 1 hour) 62.50
Phone: 6849i36 .Y Fax: 682-7946 Investigation fee:
CCB Lic. #:88482 Lic. Other:
•1 3— _ 3c' , .ketF fYd: '� i,E' ii "'- i- EN+. - � a � ¢ ,� �" F
Supervising {,, rt v° - EI'ectriealPermtees . . ... r�
electrician
� � � Subtotal $ ,
signature require. '� .....
Plan Review (25% of Permit Fee) $
/ — `1 °rint Name: • - r r on Lic. #: A 3n OS State Surcharge (8% of Permit Fee) $ 4 •
TOTAL PERMIT FEE $ Is A (p
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
•
*Fee methodology set.by Tri- County Building industry Service Board.
(Please print name)
i:\Dsts\Permit Forms \ElcPennitApp.doc 01 /03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005- 00504
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: c/7/2006
Phone: (503) 639 -4171 *d �yli;j��l 4
Inspection Requests (24 Hrs.): (503) 639 -4175 1.12.
INSPECTION WORKSHEET FOR DATE: 9/11/2006 TIME: 7 : 00AM PAGE: 27
SITE ADDRESS: 11560 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: QUILLEN
DESCRIPTION: ( branch circuits for remodel. Job # 100806.
OWNER: QUILLEN, DEANNA MARIE, PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC. PHONE #: 503 - 682 -4936
Inspection Request Scheduled For: Date: 9/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 036309-01 503 - 602 -4036 Y
1 i � � �
Corrections/Comments/Instructions:
I, 6 3 0 _
•
---
s PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY . VV Date: 9 it 66 Phone #: (503) 718 - *Azi____
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00504
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s ��'I..
INSPECTION WORKSHEET FOR DATE: 9/¢8/2006 TIME: 7 : 00AM PAGE: 52
SITE ADDRESS: 11560 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: QUILLEN
DESCRIPTION: (3) branch circuits for remodel. Job # 100808.
OWNER: QUILLEN, DEANNA MARIE. PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503 - 682 -4936
Inspection Request Scheduled For: Date: 9/W2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 036226-01 503 -882 -493; Y
Corrections /Comments /Instructions: i
51 4 1° 61:11c
{
PASS I I PARTIAL APPROVAL CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: �' N 6 LE Date: �'$ 06 Phone #: (503) 718 -1 -1440