Permit +J '
CITY OF A
OI TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00879
:ef DEVELOPMENT SERVICES DATE ISSUED: 11/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DC -08200
SITE ADDRESS: 11640 SW GALLO AVE ZONING: R - 4.5
SUBDIVISION: GALLOS VINEYARD LOT : 013 JURISDICTION: TIG
Project Description: (1) circuit to fireplace insert.
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:
RUSTY JOBE BAILEY'S ELECTRIC LLC
11640 SW GALLO AVE 2160 SW LEEWOOD DR
TIGARD, OR 97223 ALOHA, OR 97006
Phone: Phone: 503 - 849 - 3134
FEES Reg #: LTC 159814
SUP 5115S
Description Date Amount ELE 34 -389C
[ELPRMT] ELC Permit 11/10/20W $46.85
[TAX] 8% State Surcharge 11/10/200` $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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 -80, 32 -2 4 //
Issued By: % / ,( Z . jfa Permittee Signature V /4-
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.
A t
Electrical Permit Application ; .' FOR OFI IGF. USL ONLI
DateB ii+
Received
City of Tigard 0 X a� Permit No ,, _ OD ill
13125 SW Hall Blvd., Tigard, OR 97223 `l Plan Review f✓
Phone: 503.639.4171 Fax: 503.598.1960 V 1 V 2005 /' � v -" 1 I '` Date/By. Other Permit.
Inspection Line: 503.639.4175 .0 ' " J .L . Date Ready/By Jun . ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method W / (II Supplemental Information
(ITV nF TI(ARn ✓ /I
$Littgilff LYYMIfON ' PLAN REVIEW .
❑ New construction ❑ Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
- - CATEGORY OF CONSTRUCTION of 1- 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 structure
ID Multi - family ❑Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
- JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: 7/6 yo 56, Y il/,e_ ❑Health - care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State/ZIP: ,,,,2 p 2 7 2 Z 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name:
FEE* SCHEDULE
Description I Qty. I Fee. I Total I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
K 2:° 7,3' //-15-`re---7.--- dwelling, service and/or feeder 90 90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON 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: without service or feeder fee, 1 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: ( ) Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
6-/e,....--A extension. Describe: Page 2 2
Business name: �a,(/.., s / � 4-- �-�-
/ J Each additional inspection over allowable in any of the above
Address: s'2/ 6, Q s(,) Lee wpb p 1/2_ Per inspection 62.50
City / State/ZIP: /Ve / 0/2_ 97666 Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* °
CCB Lic.: / 5 j V e -/ Electrical Lic.: 3q_4. 2sq Suprv. Lic.: S /ASS Subtotal
Suprv. Electrician signature, required: - r Plan review (25% of permit fee)
Print name: Date: ` State surcharge (8% of permit fee) 3 .7,
, D
TOTAL PERMIT FEE 572 60
Authorized signature: This permit application expires if a permit is not obtained within 180
. days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•r Number of inspections per permit allowed.
i \ Building \Pennits\ELC- PennitApp doe 12/03 440- 4615T(10/02/COM/WEB
r ! q
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
[RESIDENTIAL ONLY:
Fee for all residential systemcombined .. $75.00
Check Type of Work Involved;
El Audio and Stereo System §*
❑ Burglar Alarm
❑ Garage Door Opener*
El Heating, Ventilation and Air •nditioning
System*
❑ Vacuum Systems*
❑ Other:
I
COMMERCIAL WORK ONLY: _ _ __ j
Fee for each commercial system '.75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls •
El Clock Systems
❑ Data Telecommunication Installa on
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging S stems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
t \Burlding\Pennrts\ELC- PermitApp doc 04/03
CITY OF
��n m m n�*o TIGARD
BUILDING DIVISION '
��.��..~~� �.~.�,~~..
PERMIT #: �C20�U�7
9
13125SVV Hall B�d,T�a�.OR87223 DATE ISSUED: 11/10/2O05
Phone: (503) 639-4171
Inspection Raquea����Hnaj: (503) 639-4175 *�0�■ ^ �1.
INSPECTION WORKSHEET FOR DATE: 5/1212006 TIME: 7:03AM PAGE: 11
SITE ADDRESS: 11040SW0ALL0AVE CLASS OF WORK:
SUBDIVISION: GALLOS VINEYARD LOT #: 013 TYPE OF USE:
PROJECT NAME: JABE
DESCRIPTION: ('1) circuit to fireplace inerL
OWNER: JOBE.RUEy[Y PHONE #:
CONTRACTOR: BAILEY'S ELECTRIC LLC PHONE #: 603-849'3134
Inspection Request Scheduled For: [}ate: 5/12/2000 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
159 E|ect/<cal final 029791'01 508-313'4733 N
Corrections/Comments/Instructions:
.~
' '
- �
^ •
M ASS I I PARTIAL APPROVAL [ CANCEL NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
/ ms� Ili �LJ. //
Inspector: l� �`4���J�~�~ Dete���� �J�� Phone #: (503) 718'�'�~�k)
CITY OF TIGARD K° -
BUILDING DIVISION PERMIT #: ELC2005"001379
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2005
Phone: (503) 639 -4171 101 .. 4 1u�ii��'1���
Inspection Requests (24 Hrs.): (503) 639 -4175 Aalk
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7 :12AM PAGE: 138
SITE ADDRESS: 11640 SIN GALLO AVE CLASS OF WORK:
SUBDIVISION: GALLOS VINEYARD LOT #: 013 TYPE OF USE:
PROJECT NAME: JOBE
DESCRIPTION: C1) circuit to fireplace insert,
OWNER: JOBE, RUSTY PHONE #:
CONTRACTOR: BAILEY'S ELECTRIC LLC PHONE #: 503 -849 -3134
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 :0 1 - Electrical rough -in 021063-01 503-849-3134 Y
Corrections /Comments/ Instructions:
eeia ‘--1Z5://, .3/?,- 733
i Al J
PASS n PARTIAL APPROVAL 7 CANCEL I NO ACCESS
n FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: �-4--c/ 1 Date: V`V -4 Phone #: (503) 718 -