Permit ;' CITY OF TIGARD
ELECTRICAL PERMIT
NI
1 ' PERMIT #: ELC2008 -00564
COMMUNITY DEVELOPMENT DATE ISSUED: 10/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 114BC -04400
SITE ADDRESS: 10484 SW BONANZA WAY ZONING: R - 7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT : 081 JURISDICTION: TIG
PROJECT: MAJNARICH
Project Description: (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: 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: 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:
REX MAJNARICH HILLSBORO ELECTRIC
10484 SW BONANZA WAY 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 503 - 538 - 2953 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -499C
(ELPRMT] ELC Permit 10/6/2008 $53.50 LIC 134481
[TAX] 12% State Surchar 10/6/2008 $6.42 SUP 4941S
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 ma o.;1 o.ies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: /".
- / ii` Permittee Signature: 0 , 1 ' t
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.
10- 03 -'08 15:27 FROM - Hillsboro Electric 503- 601 -3680 T -017 P002/002 F -115
r
fectirical hermit Appficatio® , . t
,� •i , . C ®f Tigard Permit No.:
':' ,‘ a: •,. • J Y '',''4,.1.
Blvd Tigard OR 9 %
-, , ' i ¢. 11atdH : ii ', •
'7.i', .` ' 13i2S SW Hall '', Phone: 503.639.4171 Fax: 503.598.1'ci �� ` •
[,
t i ` y \ I I i, lns ps coon Line: 503- 639.4175 �•` % % I � '''' Other Permit:h - t / 7 7
Internet: Www.tigard -0r.gov `eZ ' el - Page for
.... r Supplemental Information
TYPE OF WORK '\
� t= �' PLAN REVIEW
❑ New construction C1 Addition/alteration/ • :.
0 .,' �t„ � Please Che all that apply (submit 1 Sets of plans watams checked below):
4. [] Demolition l J am: - ❑ service or feedar 400 amps or more ❑ Building over three stories.
where the available faun current ❑ Marinas and boatyards.
Ei CATEGORY OP CONSTRUC rION exceeds 10,000 amps at 150 volts or ❑ floating buildings.
1 and 2 dwelling ❑ Commerelal/industtial I=1 Accessory building
less to ground, or exceeds 14,000 ID Commercial-use agricultural
[] Multi - fhmil Ir+ for all other installations. buildings,
Y ❑ Master builder ❑ Other: E1Fim pump,
❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
I � D Jig!, ❑ Addition of new motor load of ❑ "A ", Ir. "1 "1-3'.
L
Job no.: Job site address: li I 1 I.!i / r 1 or m ore.
J occupancy.
City/State/ZIP: �Q/� ID or more residential units. ❑ Recreational vdbicic parks.
i 4 ce. 1 0 Health -cam facilities. ❑ Supply voltage for more than
Suite/bldg./apt. no.: 1^ � ❑ Hazardous locations. 600 volts nominal.
Project name: Q�r l ^ ` ❑ St vivo or feeder Epp amps or more.
Cross street/directions to job site: U ]�rE SCt >E
Demi. We Ei , •
New residential single - or multi - family dwelling unit,
Includes attached garage,
•
Subdivision: , no.: 1,000 4,q, ft. or less '
145,15 4
Tax map /parcel no.: — - ga. add'I S00 sq. ft. or portion 33.40 1
11ESCRIPI ION OF WORK Limited energy rt sidential
(with above sq. ft.) 75.00 2
V I ( I/' � C(J limited cony. multi - family
■ resdential with above . ft, 75-00 2
T Servlcts Or feeders lnatallationolteration and/or relocation
El PR(1PER7Fy OWNER 200 amps or less 80.30 2
. 0 TENANT
t t r 106.85 2
Name: 401 Amps to 600 amps I -
z
Address; 601 amps to 1,000 amps _ 240.60 2
Over 1,000 amps or volts
—
City /State/ZIP: Temporary services or f 454.65 2
htllatlon, alteration, and/ar
Phone: ( ) relocation _
Fax: ( ) 200 amps or less 66.85 . 1
Owner installation: This installation is being made on pro perty that I own which is not 201 amps to 400 amps _ 100-30 2
intended for sale, lease, rent, or ex.ehange, according to ORS 447, 449, 670, and 701. 401 s to 599 Amps 133.75
Owner signature:
Data: Brllut:h deaths new alitraltl or ext enelota r n el 2
[] , gppLlGgN - r ; .' 0 �=" f or b rar•c}t circu w trh
oe
.. .. .... CONTACT IPEBSON . :. above service or feeder fee;
Business name: — ' each branch circuit 6.65 2
B. Fee fbr branch circuits
Contact name: wifhota service or feeder fee, 1 , /
first branch circuit 46.85 `--te 2
Address: Each add'I breach circuit
6.65 . - 2
City /State/ZIP: Miacdlaneoni (service or feeder not Included)
Each manufactured or modular
Phone: ( ) Fax :: ( ) dwellin service and/or feeder 90.90 2
E -mail:
Reconnect onl 66 2
ihttnp or irrigation circle le 53.40 - 2
CON'fRAGTOR, Sign or outline lighting 53.40 2
Business name:
HILLS$ORO E • T,r,C Si gn alc ircuits)orbruited-
end pal' alteration, q or
Address: . 21185 NW EVERGREEN PKWY # 110
extension. Describe; pass; 2 2
City /State/ZIP: RILLSBORO OR 97124
Each ad ins don over Allowable to an of the above
P1164 ( 5 0 3) 439-9666 Fax: ( S 0 3 Per inspection 62.50
) 6 01- 3 .8 1 Investigation per hotu 62.
CCI3 Lic.: 134481 Electrical Lic.: 3 4 - 4 9 9
Suprv. LiC. 4941 Industrial plant per hour 73.76
Suprv. Electrician signature, required: I ELECTRICAL PERmirr FEES a
�� �+'" Subtotal:
Print name: JOEY V ITACce Date: Plan review (25% of permit fee):
D a State surcharge (12% i
Authorized signature:
arg ( permit fee): , .
TOTAL PERMIT FEE: 5 , Gil.
•
Print name:
This
- bate:
--
permit p ppiitstlon capi If a p ermit is not obtained within 180
t:lBuil n days after it hen been accepted as template
d glPamitd�BLC- PUmirApp.doc 05/23106 ' Number of inspections allowed per p€nhit.
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
E �).,E i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Jai m 10//6/2006/200 0 8
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/8/2008 TIME: 7:00AM PAGE: 0
SITE ADDRESS: CLASS OF WORK:
10484 SW BONANZA WAY
SUBDIVISION:
RI VERVIE /ESTATES NO. 2 LOT #: t181 TYPE OF USE:
PROJECT NAME: MA.INARIt:I
DESCRIPTION: (2) branch circuits.
OWNER: MAJNARICH, REX PHONE # 503 - 538 -2953
CONTRACTOR: HILLSEORt ELECTRIC PHONE # 503-439,9866
Inspection Request Scheduled For: Date: 10/8`2008 Pour Time:
Code # Inspection Description ' onfirm # Contact # Message
199 Electrical final 07€42B -01 503 -538 -2953 Y
,
Corrections/Comments/Instructions:
50 t1/
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to re N Nsi___ - - 6 5 /J
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$PASS I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: d t e) Date: 1 1 Phone #: (503) 718 - i IV