Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00089
DEVELOPMENT SERVICES DATE ISSUED: 2/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 103 CC - 06700
SITE ADDRESS: 13750 SW 124TH AVE ZONING: R - 4.5
SUBDIVISION: WHISTLER'S WALK LOT : 014 JURISDICTION: TIG
Project Description: 1 branch circuit for AC.
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: 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:
KELLY BENNETT OWNER
13750 SW 124TH AVE
TIGARD, OR 97222 -1722
Phone: 503 - 521 - 9201 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 2/7/2006 $46.85
[TAX] 8% State Surcharge 2/7/2006 $3.75
Total $50.60 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 , 1d0-332-2344. � y}'
Issued By: Al� �� Permittee Signature ./VA 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 App * . t � ��1 EIVI
•....� l t 12 x11 I lc`i. I st: c) i..
City Of Tigard.
Received
al B • i 6 , 0 Permit No,: L • _ ._040,, 1:125 SW 11a 1 Blvd, Tigard, OR 97223 1
FEB 07 20: (t Plan Review
Other Permit -
Phone: 503.639.4171 Fax: 503. 598.1960 ar.vy'jij?�'+ Date/By:
Inspection Line: 503.639.4175 � '! I Date Ready/By. /// P1 See ['me 2 for
Internet www.ci.ligard.or.us
C I T Y OFT1'�- `-v -' 4 , T Notified/Method: Supplemental Information
CITY f OF DI �+ yr It ON . . PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement Please check all that apply:
❑ Demolition 10 Other Air Conditioning ['Service over 225 amps, comm'l ❑I- Iazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. R.
CATEGORY OF CONSTRUCTION ' of I- and 2- family dwellings 4 or more new residential
® 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one strudure
1:1 Multi- family ❑ Master builder ❑ Other. ['Building over three stories ['Feeders. 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB Si1'E INFORMATION AND LOCATION ❑Egress/lighting plan RV park
['Health-care facility ['Other:
Job no.: I Job site address: 13750 SW 124 tl, Avenue
Submit 2 sets of plans with any of the above.
City/ State/ZIP: Tigard, OR 97223 -1722 The above are not applicable to temporary construction service.
Sui te /bldg./apt_ no.: I Project name: FEE" SCHEDULE
Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: Scholls Ferr to 121 turn right on Quail Creek, New residential single- or multi- family dwelling unit.
Includes attached garage.
turn left on 124th
1,000 sq. R or less 145.15 4
Subdivision: Don Morisette - Whistler's Walk I Lot no.: Ea. add'l 500 sq. R or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION WORK Each manufactured or modular
Air Conditioning installation: 4 ton.Amana add on air conditioning, indoor coil, line dwelling service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
set, condensation line, scoops for upstairs duct. Home prewired by Don Morisette. 200 amps or less 80.30 l 2
►� PROPERTY. OWNER - - -
201 amps to 400 amps 106.85 2
CI TENANT - -- -
401 amps to 600 amps 160.60 2
Name: Darren and Kelly Bennett 601 amps to 1,000 amps 240.60 2
Address: 13750 SW 124 Avenue Ovta 1,000 amps or volts f 454.65 2
Reconnect only I 66.85 2
City /State/ZIP: Tigard, OR 97223 -1722 Temporary services or feeders installation, alteration, and/or
Phone: (503)521 - 9201 Fax: (503)521 - 9201 relocation
200 amps or less 66.85 h 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 600 amps 133.75 2
Owner signature: - Date: Branch circuits -new, alteration, or extension, per panel
❑ APPLICANT I ' - ®. CONTAC F. PE A Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: Mike Cowher without service or feeder fee (y
Address: P.O. Box 55931
each branch circuit
f 46.85 t} / 2
Each add'' branch circuit 6.65 2
City/State /ZIP: Portland, OR 97238 Miscellaneous (service or feeder not included)
Phone: (503) 262 -6736, 503 -679 -6179 cell Fax: : (503) 251 - 9046 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: machvac@nethere.com Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: MAC HVAC . C9 h J
Address: same as above Each additional inspection over allowable in any of the above
Per inspection 62.50 '
City /Statef7[P:
Investigation per hour ( I hr min) 62.50
Phone: ( ) F ax: ( ) Industrial plant per hour I 73.75 ,
ELECTRICAL PERMIT FEES*
CCB Lie.: 154928 I Electrical Lie.: I Suprv. Lie.: Subtotal
Suprv. Electrician signature. required: Plan review (25% of permit fee)
Print name:
State surcharge (8%of fee) i3 '5
Date:
TOTAL PERMIT FEE 70 00
Authorized signature: -
J This permit application expires if a permit is not obtained within 180
^ / days after it has been accepted as complete
Print name: ( �Q , / I Date: (t���� ' Fee methodology set byTri -County Building Industry Service Bid
r v VV " Number of inspections per ocsmit allowed.
II f °y
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL-C2005.00039
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/20(16
Phone: (503) 639 -4171 4e- @u�ii��lf�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/9n006 TIME: 7:04AM PAGE: •14
SITE ADDRESS: 13750 SW 124TH AYE CLASS OF WORK:
SUBDIVISION: WHISTLER'S WAI...K LOT #: 014 TYPE OF USE:
PROJECT NAME: IBENNETT
DESCRIPTION: 1 branch circuit for AC.
OWNER: BENN . T, KELLY PHONE #: 603.621-m701
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 026587 -01 603.62i-920'f `I'
Corrections/Comments/Instructions:
A u. . ___ Zg. tikfx „4_14,t - xit
4 e i c K C. 2-/c 4-/Lii
c -'
PASS ri APPROVAL ❑ CANCEL _ NO ACCESS
❑ FAIL I CALL FOR INSPECTION El ADDITIONAL.FEES ASSESSED
Inspector: — Date: Phone #: (503) 718-