Permit J' CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00562
: it : Y. COMMUNITY DEVELOPMENT DATE ISSUED: 8/10/2007
T 6AitD„ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 D D -00903
SITE ADDRESS: 08880 SW EDGEWOOD ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 006 JURISDICTION: - FIG
PROJECT: MCELEVEY
Project Description: Owner finishing electrical work. Ok'd per Hap.
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: 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:
MCELEVEY, MICHAEL J AND
ROSS, CATHY
8880 SW EDGEWOOD
TIGARD, OR 97223
Phone: 503 939.9026 Contact #:
FEES
Description Date Amount Reg #:
[HRELC] Hourly Electrical 8/10/2007 $57.87
[HRTAX] Hourly 8% State 8/10/2007 $4.63
Total $62.50 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 -010. ou may obtain copies of these rules or direct questions to OUN at 503 246 669', or 1800. ;2 2344
Issued By: 4// 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.
Electrical Permit App11__ iL ENED M - FOROFFICEUSEONLY . M
City of Tigard Date/By .. • 6 69 U Permit No 6ui2 Z - -665(1
a 13125 SW Hall Blvd , Tigard, OR 97 23• r y �Onl Plan Review '
U PI
2 : ` Phone 503 639 4171 Fax 503A 96P1 V V Date /By Other Permit
T Inspection Line 503 639 4175 G T ��� Rp D a t e R ea d y /B /� / Fa See Page 2 for
Internet www.tigard -or gov Gil , Q{ D ����� 0 � Notified/Method ( Supplemental Information
TYPSUI0 PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement 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 El 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
A
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: Job site address: � � �f1Jt�l �� too or more occupancy
U ❑ or oc Six or more e residential Recreational units ❑ creanonal vehicle parks.
City /State /ZIP: � n-12 9 ?- ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt. no.: Project name CL, r dh 0 Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: 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
Ea add'l 500 sq ft or portion 33 40 1
Tax map /parcel no.: Limited energy, residential
v
' DESCRIPTION OF WORK (with above sq ft) 75 00 2
�
\ /�'� �n r Limited energy, multi- family
� Y a AAe l s2 I C_C5\44. j9 LQi€ ej{K � CQ edvyt�Cl 2i}L 6 1,,_ residential (with above sq ft ) 75 00 2
i y Services or feeders installation, alteration, and/or relocation
0 ` t1� 1�C�� �S l �� i g yob,. I Q �rfr C 1 2 00 a or less 80 30 2
'PROPERTY OWNER ,❑ TENANT 201 amps to 400 amps 106 85 2
Name: (½ C I vl Cael " t ,p,(�{ ` 401 amps to 600 amps 160 60 2
'" � 601 amps to 1,000 amps 240 60 2
Address: as p .3 Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: (5P3) l ' l •-9 Fax: ( ) 200 amps or less 66 85 1
Owner installation: This installation is beint made ' - property that I own which is not 201 amps to 400 amps 100 30 2
intended for sale, lease,, ( ore (hap ti, . , e: • 'V 6 P S 447 449 670 and 701. 401 amps to 599 amps 133 75 2
�' i , am Branch circuits — new, alteration, or extension, per panel
Owner signature: ` (fta(,� AILS 0 .y Date: A. Fee for branch circuits with ❑ Cl ACT PERSON above service or feeder fee, 6 65 2
each branch circuit
Business name: () t • B Fee for branch circuits
Contact name: without service or feeder fee, 46 85 2
first branch circuit
Address: Sa CGS /pi 0 , 7 P Eah add'1 branch circuit 6 65 2
(/� V Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90 90 2
Phone: (.&:5) q 39 —q 426, I Fax: : ( ) Reconnect only 66 85 2
E -mail: A i / i, , yNt ael e,ve t yZ .- ` .. a r fjy.t...- Pump or irrigation circle 53 40 2
CO ' • CTOR Sign or outline lighting 53 40 2
Business name: Signal circuit(s) or limited -
(4� fbr energy panel, alteration, or
Address: extension Describe Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection I 62.50 ('2.51
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62 50
CCB Lic.: I Electrical Lic.: 1 Suprv. Lic.: industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal (
Print name. Date: Plan review (25% of permit fee)
State surcharge (8% of permit fee).
Authorized signature: . .4„, / C /�� TOTAL PERMIT FEE (n2. 5
This permit application expires if a permit is not obtained within 180
Print name: ��n ��� r Date: 69_,,,.._07 days after it has been accepted as complete.
e � ���� J * Number of inspections allowed per permit
1 \Building\Permits\ELC- Perm,tApp doe 05/23/06 440- 4615T(11/05/COM/wEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Bu Idmg \Permns\ELC- PermitApp doc 03/23/06