Permit CITY OF TIGARD ELECTRICAL PERMIT
TIGARD ,.
PERMIT #: ELC2006 -10025
DEVELOPMENT SERVICES DATE ISSUED: 3/7/2006
---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S102DC -00200
SITE ADDRESS: 09325 SW EDGEWOOD ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 016 JURISDICTION: TIG
Project Description: (1) 200 amp service.
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: 1 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:
DOUG GEOFFROY REDS ELECTRIC CO INC
9325 SW EDGEWOOD ST 2002 SE CLINTON ST
TIGARD, OR 97223 PORTLAND, OR 97202 -2245
Phone: Contact #: PRI 503- 233 -6467
FAX 503 - 233 -1281
FEES
Description Date Amount Reg #: ELE 26 -152C
[TAX] 8% State Surcharge 4/1/2006 $6.42 LIC 4443
[ELPRMT] ELC Permit 4/1/2006 $80.30 SUP SOLOS
Total $86.72 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: r1 Permittee Signature: Lf /e, A\
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.
•
CITY OF TIGARD
ELECTRICAL PERMIT
45�Bl iY '> i l BUILDING SERVICES DIVISION
r I 13125 SW Hall Blvd., Tigard, OR 97223
„_, �---' 503 - 639 -4171 www.tigard - or.gov PERMIT #: iLC aZl 6`�o_C�
DATE ISSUED: 3 - 7 - 66
SITE ADDRESS: 013,25- Sk >✓ { k, e,1,.,0 0C,L ')— PARCEL #: -_- - -_
BLDG /STE #: _ ZONING:
SUBDIVISION: LOT: JURISDICTION:
This is an interim permit issued during computer system maintenance.
Construction work and inspections may proceed under this permit number.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
PROJECT DESCRIPTION: 0 200 �� _� ��r 91 E- •
RESIDENTIAL . TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500 SF: _ 201 - 400 amp: _ SIGN/OUTLINE LTG:
LIMITED ENERGY: _ 401 - 600 amp: _ - _ SIGNAL /PANEL: MANF HM /SVC /FDR: 6 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: 1 W/O SRVC OR FDR: PER HOUR: -_
401 - 600 amp: EA A DD 'L BRANCH 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- .... FEES
Name: -D� Cre.Sj ro■q Permit Fee $ ._. �lI Address: _93,,,z5 _93aZ S � u ,� Plan Review Fee $
City/State/Zip: S - State Surcharge (8%)
Phone: Other Fee: $
Other Fee: $
CONTRACTOR
Name:
Total Fees: $
Address: ,72174 s6
City /State /Zip:
Phone: ,; 03- ..33 Fax: = - ,L )
CCB Lic #: Y
Elect. Lic. #:
Supr. Lic. 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -1987 or
1- 800 - 332 -2344.
Issued By:,77: 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. ELECTRICIAN: DATE:
LICENSE NO.:
Call 503 - 639 -4175 by 7:00 AM for an inspection that business day.
Note: If you cannot schedule an inspection while the system is down, please call 503 - 718 -2433 for assistance.
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.
I:\ Building\ Forms\ ManualPermitForms \ManualELCpermit.doc 03/06/06
Mar, 7. 2006 10:32A4 �kli- No. 2351 P. 1
Electrical Permit A
City of Ti and MAR 06 E€ 2 J v ( � ' 1° 131SW Hal1 BvdTigrd, OR 97223 W f �
Phone: 503.639.4171 Fax: 503.598.1960 1u "' i ' Date/By, Other Permit:
Inspection Line: 503.639.4175 tc -liN i • __s �Y'- t Date Ready/By: rum: ia Set Pa 2 f or
Internet: www.ci.tigard.or.us V i 1 1F k ° - Notified/Method h Supplemental Information
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❑ New construction 'P. ddition/alteration/replacemcnt Please check all that apply: •
❑ Demolition ❑ Other: c
❑ Service over 225 amps, comm'l ❑Hazardous location
T ❑ Servi a over 320 amps — rating ❑Bunting over 10,000 sq. ft.,
� !:: �ti ,r ::. ')' r•• , t Na :.r r'Q - " Yi'. •,y . t : U' 4
.:4, , r r .1,;, '} f�t'�: '`;A "r'ti•(( o ° , ( , T 1 .0 fi e, i'�r `><.1r:���5 '431- .: .: •a.. ,` _
- �. ��, . ;ti��,�1��9 ;�s:?��'�c >if ;��t;? <': :'i�`!i!.!s19�0 ', Nt+ �� °' {..( ; ;����vw'�+: ? ;1+�,'. ;7j ;; of ] and 2-family dwellings 4 or rnore new residential
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
1 g ❑System over 600 volts nominal units in one structure
Multi -famil ❑Building over three stories ❑Feeders, 400 amps or more
y 0 builder 0 ❑Occupant load over 99 persons ['Moment 1 structures or
� ';i'f' F. �, l'
e;a'; RV ,�i ; ;� ; '}.. g.� ; ,g . ,� ,..p ` ]N� „� � ■y � ;o " 1 ,c � a�zz F�!^( 5) 7 � . ❑1? ess/li htin plan
park , ; „4.. ::�R'a•.t1:..., - , <, �, �,..., N�, f,:. �..., �;, P�� k�t� " �,M � ...,. .� � 1:i, ,..YN�.a,sU''�,.' €� t; gP ❑
Job no.: I Job site address: 93,25 SA l q C ❑Health -care tiicility Other:
l Submit 2 sets of plans with any of the above.
City /State/ZIP: —.1--- ^ � . The above are not applicable to temporary construction service. .
Suite /bid / t no.: r Project c - V °” e:'' 1 'i'' " ;',.�'' , e"'S.,,tb tl9 't.: ?� \,.,�4„
o ect name:: nn - +" t i u..., ' ': .a. :,1 ", k¢' ' „o
g' J C. C 0 Description , I Qtr, f Fee I Taw
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
-- - Includes attached lora 1 e. .
1,000 sq. ft or less 145.15 4
Subdivision: [ Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
_ Limited energy, non - residential 75.00 2
n � A a „w, x._. m an., +•. , � �
. t sj ;i1,0 i t 's`' i ' t'` "fit "iSE �I ,� , ,� � t 4 i f ; y :, •
a.' ,yi , >v
` ; ;• ∎• „i Aat t� n s'tw . . , . 7 4,, �.irn..�:iz',' r , , 444, ' . ? ;t” r , E ac h manufactured or modular
dweiliiig, serYriCe 8tid/iir'feed't'r . .. ..90:'90 2
Or U t e ''e Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 13_3O 2
;y +, `)'wy;. c4 it M;'i c i . „CAA. t` F a , s . S t, 4 ti 201 amps to400 amps 106.85 2
.' .ti, _l .1A.. ... _ - ..� r J lie ' ,. , ais.;,, V.. r.' '
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401 amps to 600 amps 160.60 2
Name: b V ci 6 ,e 0 Li 601 amps ro 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /Stata'ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I F ax: ( ) relocation
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, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: . Date: Branch circuits — new, alteration, or extension, per panel
: ` L f� d . '';i ° r ' , ' ` ' i " '' 1i..ta A Pee for branch circuits w ith
,+� � �(, �i ° �' y hj' tM {� 'S'm "' ��.�'��t�,�, y t�'d'
h : �y 1 "k, •,,• 1 yA'iW.:I3,1 'I '�f sal.. `+"�y „. . ; ,4'.4 ti .9'1T.%,.,
"" service or feeder fire, each
Business name; brand; circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46,85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle . 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E -mail; Signal circuit(s) or limited -
r' µ t o a M' e } u t� ;'rw . n . aT' ry r, { H e, ener panel' alteration, or
l n s �- �4�,r:��:s: �7t�4'�7i?b� ...:'F ,. : : �s : ;� + "�,�. ;: ����yy;rt•�, 5 >�,i ;gip. ;. °tyy"''' gY p
extension. Describe: Page 2 2
Eus
Red's Electric Company
Address 2002 SE Clinton Each additional Inspection over allowable In any of the above
Portland, OR 97202 Pcr inspection 62.50
City /Sea (503)233 - 6467 FaX (503)233 - 1281 Investigation per hour (1 hr min) 62.50
Phone: ( CCB# 4443 Elec. Licit 26 - 152C Supry LIc.# 5010 - Industrial plant per hour T 73.75
14 4' ; ,: ri f�� J I '' TW E) ftVZ00.� 'i��). <:FSe,�E:: �?'.t`�;1:A8Z
CCB Lit Subtotal -Z(.\ 30
•
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print narnc ` �,�A � 0� Date: !yJ I 00
State surcharge (8% ofpermit fee)
f tit / I TOTAL pERMI M FEE . �� . 7- �
in Authorized signature: 1 This permit application expires if a permit hl not obtained within r
- days after It has been accepted as complete
Print name: Date: • . Fee methodology set by Tri-County Building Industry Service Board
' b• Number of inspections per permit allowed
i:1Buitding1perm its \ELC.P mitApp.doc 12/03 440.4615T(10/02/COM/WEB
CITY OF TIGARD RECEIPT
DEVELOPMENT SERVICES
RECEIPT DATE: -
/ ai 41VeiI� 13125 SW Hall Blvd., Tigard, OR 97223 JURISDICTION.: )
-
- -- -- 503- 639 -4171 www.tigard - or.gov CASHIER DATE:
CASHIER RECEIPT #:
LINE ITEMS:
Case No. Fee Description Revenue Acct. No. Amount Due
•
•
I i
I _.
i I f
Total Due: $ .
❑ SEE ATTACHED FEE SCHEDULE.
PAYMENTS:
Payer:
Method 1 Initials Check No. Confirm No. 1 Amount Paid
Total Paid: $ ': %,
I:\ Building\ Forms\ ManualPermitForms \ManualReceipt.doc 03/01/063/6/2006
CITY OF ��mw m n�'u nn�m��n���
BUILDING K�U��U��U��N� ' -
DIVISION "~~"~~"° PERMIT #: ELC2006-1(u)25
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1312SSVV Hall B|vd.. Tigard, ORA7223 ^ ~ DATE ISSUED: 3/7/2006
Phone: (503) 639-4171 A i II\
Inspection Requests (24 Hrs.): (503) 639-4175 ° � 1 .xl■11..
INSPECTION WORKSHEET FOR DATE: 51112006 TIME: 7:00Alvi PAGE: 6A
SITE ADDRESS: 09825 SW EDGEWOOD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 016 TYPE OF USE:
PROJECT NAME: 8E[)FFR[n'
DESCRIPTION: (1)2OO amp xetvixe.
OWNER: GEOFFR0Y.DOUG PHONE #:
CONTRACTOR: REDS ELECTRIC CO INC PHONE #: 503';13-67
Inspection Request Scheduled For: Date: 6/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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y< PASS 7 PARTIAL APPROVAL I I CANCEL I I NO ACCESS
I I FAIL __ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
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Inspector: �� 0�� �\�� Lk: Oa�e� �� ^ \J4v Phone #: /503\ 718'
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CITY OF TIGARD fit -
BUILDING DIVISION ' PERMIT #: o ZOO — / b 0 ZSJ
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 : z� +f��l j
i �lsl
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 3 � � CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
• Inspection Request Scheduled For: Date: 3 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
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n PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
a FAIL I) CAL FOR INSPECTION n ADDITIONAL FEES ASSESSED
•
Inspector: Date: 3-/' 7 06 Phone #: (503) 718-36/0
CITY OF TIGARD E
BUILDING DIVISION ; L. _ , - , PERMIT #: 2Q6( -/ jj
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 keploy tilj
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9 3 L3 Ed L CLASS OF WORK: '
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-13 _0 4 ' Pour Time:
Code # Inspection Descri tion Confirm # Contact # Message
j e 4Ap_c_:(......z..) 1/s__ ,2 33 -6V6 7
Corrections /Comments /Instructions: 2 32.S 3
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PASS APARTIAL APPROVAL CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: GAZAa. ( W L Date: 3 1 06 Phone #: (503) 718- 6