Permit CITY OF TIGARD ELECTRICAL PERMIT
ETIP::: PERMIT #: ELC2007 -00540
COMMUNITY DEVELOPMENT DATE ISSUED: 8/2/2007
TIGARD 1 31 25 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S109AA - 01600
SITE ADDRESS: 14378 SW 130TH AVE ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT : 004 JURISDICTION: TIG
PROJECT: MCCALLISTER
Project Description: (4) branch circuits for a/c and hot tub.
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: 3 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:
CORT MCCALLISTER JSM ELECTRIC
14378 SW 130TH 7717 SW SKYHAR DR
TIGARD, OR 97224 PORTLAND, OR 97223
Phone: 503 - 830 -2343 Contact #: PRI 503 - 866 -7304
FAX 503 - 244 -4397
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 8/2/2007 $66.80 LIC 168451
[TAX] 8% State Surcharge 8/2/2007 $5.34 SUP 5104 -5
Total $72.14 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
suspende ort�moreTRaq 180 da ATTENTION: Oregon law requires you to follow rules adopte.: • , e Oregon Utility Notification Center.
Those les are set forth in • - - 95. -• -0010 through OAR 952 -001 -0100. You may obtain c...- of these rules or direct questions to OUNC at
503. 6.6699 or 1.800.33 . 344.
Issu d By: ' 344.
y Permittee Signa ure: /• , //tr( /
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' : 1. ' AN/ DATE: (a- D-7
LICENSE NO: ' — 5? S
Call 503.63• .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.
Aug 02 07 02:57p Jeffrey S. McGinnis 503 - 244 -4397 p.1
Electrical Permit Application FOR OFFICE I:SK` ONLY
'ff Received n Ci !1/vi 7
City W Hall Blvd , Tigard C
Tigard Date /B : ED / l permit No.: G�.(/Qt,(/ <�Q
13125 SW .,OD ir i t EN Plan Review
'' 2 . Phone: 503.639.4171 Fax: j( i - Date/By: Other Permit:
T I G A RD Inspection Line: 503.639.417 q 200 Date Ready /By: lures See Page 2 for
Internet: www.tigard -or.gov AUG O 2007 Notified/Method: /(2,, Supplemental Information
TYPE OT `� PLAN REVIEW
❑ New construction Additio rya n'!a irt,:. l CPS; . �r`V Please check all that apply (submit 2 sets of plans w /items checked below):
❑ 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
® 1 - 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 ", "t -3 ",
Job no.: Job site address: 14378 S.W. 130 AVE. 10011p or more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /Stair" /ZIP: PORTLAND / OR /97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suitelbldg. /apt. no.: Project name: CORTand KELLY MCCALLISTER ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: stnrview dr. Description I Qty. I Fee. I 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
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 i 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
add an A/C CIRCUIT Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
add a HOT TUB CIRCUIT 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: CORTand KELLY MCCALLISTER 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.605 2
- Address: 14378 S.W. l30"' AVE Over 1,000 amps or volts 454.65 2
City/State /ZIP: PORTLAND OR 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)830 - 2343 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, 4-49, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, . • r panel
A. Fee for branch circuits with
❑ APPLICANT CO CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: CORTand KELLY MCCALLISTER
without service or feeder fee . 1 46.85 46.85 2
first branch circuit
Address: 14378 S.W. 130TH AVE Each add'I branch circuit 3 6.65 19.95 2 •
Miscellaneous (service or feeder not included)
City/State /ZIP: PORTLAND OR 97224 Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: (503) 830 - 2343 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: ISM ELECTRIC Signal circuit(s) or limited -
energy panel, alteration, or
Address: 7717 S.W. SKYI-IAR DR. extension. Describe: 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 - 4397 Investigation per hour (1 hr min) 62.50
CCB Lie.: 168451 Electrical Lie.: 18 Suprv. Lie.: 5104S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 47 ,g- . /Li/Le...V-(144 Subtotal: 66.80
Print name: JEFFREY S. MCGINNIS '• Date: 08/02/07 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 5.34
Authorized signature: TOTAL PERMIT FEE: 72.14
Print name: Date: This permit application expires if a permit is not obtained within 180
clays after it has been accepted as complete.
" Number of inspections allowed per permit.
I: mending Permits \ELC- rermitApp.doc 05/23/06 440-4615T(l 1 /05 /COM/WEB
CITY OF TIGARD
R �� g �'"�'�� 644141m/3A
BUILDING DIVISION PERMIT #: ELC2007- 00540
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2/2007
Phone: (503) 639 -4171 /2mm
Inspection Requests (24 Hrs.): (503) 639 -4175 au. `
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE: 82
SITE ADDRESS: 14378 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 004 TYPE OF USE: .
PROJECT NAME: MCCALLISTER
DESCRIPTION: (4) branch circuits for a/c and hot tub.
OWNER: MCCALLISTER, CORT PHONE #: 503-830-2343
CONTRACTOR: NOVALIOSTIOX CORT PHONE #: 503-866-7304
J 51vl t� I Q Jl.- t' —
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 NC or heating unit circuit 053844 -01 503- 620 -7217 N
Correction o m nts /Instructions:
i .- A. 5 CA. 6 2 07 - 0
' i P4 ( 17 5 A 5 C P4A_= 00 - oo y47
_....,
7 ....., ....____
,. (....,....„(j.
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Al
Inspector: pi Date: " / V/D7 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION. ' PERMIT #: ELC2007- 00 M0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2/2007
Phone: (503) 639 -4171 9
Inspection Requests (24 Hrs.): (503) 639 -4175 �e'I_�..
INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7 :00AM PAGE: 77
SITE ADDRESS: 14378 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 004 TYPE OF USE:
PROJECT NAME: MCCALLISTER
DESCRIPTION: (4) branch circuits for a/c and hot tub.
OWNER: MCCALLISTER, CORT PHONE #: 503 -830 -2343
CONTRACTOR: keilliLEICTRX CORT PHONE #: 503 - 866.7304
Inspection Request Scheduled For: Date: 8/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 A/C or heating unit circuit 053597 -01 503.620 -7217 N
Corrections /Comments/ Instructions:
14-ArKs2-
(CIA/
❑ PASS • PARTIAL APPROVAL n CANCEL r: NO ACCESS
►I FAIL I!1 CALL FOR SPECTION n ADDITIONAL FEES ASSESSED ‘1C// All
Inspector: / Date. Phone #: (503) 718-