Permit AIWITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00523
I
DEVELOPMENT SERVICES DATE ISSUED: 7/26/2005
r �� 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S135CA -90348
SITE ADDRESS: 11048 SW GREENBURG RD 348 ZONING: R - 12
SUBDIVISION: ASH CREEK PARK CONDO LOT : JURISDICTION: TIG
Project Description: Installation of (2) branch circuits for a /c. Job No. 13, 655.
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: 6011-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:
ROWLANDS, CLEMENT B II BOONES FERRY ELECTRIC INC
11048 SW GREEN BURG #348 PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503- 624 -7028 Phone: 503 - 682 -4936
FEES Reg #: SUP 4918S
LIC 88482
Description Date Amount ELE 3 - 223C
[ELPRMT] ELC Permit 7/26/2005 $53.50
[TAX] 8% State Surcharge 7/26/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspende• • • = an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules . - set forth in OA" •52 -0S -0010 through OAR 952 - 001 -0100. You may obtain copies of thes- les or direct questions to OUNC at
503 -.46 -6699 or 1- 800 -332 -' , 4 i
Iss d By: / ►/ 4 � I Permittee Signal/WA d ////r�W-A-
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
- • NTRACT • R INS LLATION ONLY
•
SIGNATURE OF SUPR. ELEC4111 _ ' 1 _!W / DATE:
LICENSE NO:
•
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
EltI_ ________ _5 0 3.33P�i FERRY ELECTRIC No, 6447 P, 1
FOR OFFICE 1 Sly ONLY
} �ti� } �
f City 0il i t {� Received �
131 SW Hall Blvd., Tigard, OR y17 �� Date/B : < /„ Al %, PennitND.: / „I/ Z 0J
Phone: 503.639.4171 Fax: 503.1.8, / , , r � Plan Review
t^}in r � Dste/B 'Other Permit:
Inspection Line: 501639.4175 Ii Dat Rea B
lternet www,ci,rigara.or.us JUL 2 2, 7V __� y y d S See Page: for
Notlfied/Ivletllo
yr• montalInformation
+' .f < •,,. ,, :.:.:.`k:a: <F - � "Q `Y •= `�G�'� ""tit'` !�i:S' - ' •r;ES^g a.
FF,, upQ a norm
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,�d :
❑ New construction of q eq. �- a 1on/replacetnent P1e065 check all that apply:
❑ Demolition ❑Other: ❑Service over 22$ amps, cornm'l ❑Haaardous location
:, iip:.,� ?'d'r,T's h:, „�zhr..^,;a':11;.: � r � ''. -- ❑Service over -
s YY„ ,:,�7.}�s.�� t,y /{ ¢ • 1 ir*,., ���`. )1,hrro :9�i'si:Ri:kriil a ' Y: ,, x , a.6s as *wg� amps rating ❑ or residential
nti l
4 �a ; :.r ,! .7�. 2 A,5"w z .,Ittig , ,,.., a YZ._n NiZ7d•..mi.� „�.' =, hr�',' a I, :y .,;fi.J a s /z {''�Qt'J , } ".+',4rY o£' l - and 2-family dwellings 4 or more now residential
Sea.L•UrFi, >�St,pt�r�tli._.
24
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
Multi fannily ❑ Master builder ❑ Other: QSystam over 600 volts nominal units in one structure
7 ❑Building over three stories , 400 amps or more
' ry t �i.s1 `. ;.:. 'T 'Y ; .A,C • :y��@ � ail ,�' S8 t.`:7...� , i3 R r?; L Y� si t is.� �'R Xd? ['Occupant load Over 99
t 1 Ct� L i.l i:f, �1ai "'i'Mf �y� �� PRNNs F lr persons ❑M
_.0 ,, ,. .�_,-. ,1a 1 4 ?r^yr::N .t ::Ntti2e ❑ Egress/lighting plan RV park
Job no.: )3, 65 0 S Job site address:
/' O 3..k, GrQa„ Health- carcfacility ❑Other;
Submit 2 sets of plans with any of the above.
City /State/ZIP: 3 t�-' i;,20 r f The above are not applicable to temporary construction service.
•Suitc/bld /a t. no,, c t Y yR ? r` }, M. s ��
g p Project name: :i a .. ; 1_ :i �,'..tiy, i '�{?� 4 E)- a 7 t c:i7 d. ' ....
Description Qty. ltaa _ Toot
Cross street/directions to job site: New residential single- or Multi- family dwelling unit-
- , Includes attached garage.
1,000 sq.. ft. or less 14.5.15 4
Subdivision: I Lot no.: Ea. add'I 500 R. ft. or portion 33.40 I
Tax rr13p /parcel no - Limited energy, residential 75.00 2
0. >'`. y16 '% fi ' : � T', m : �x ,f < •:: :, - .�rs�:•,•: . °P- Limited - -
.�,� . -�.�� �� .: ;sYM:.. .2. .�hM' : s�-.. g :;ffii�i:1c,C= ^...y..,,r�irr ��.•.�*7;r_V ..R_•. energy, non - residential
��:� •r,� , e. .. ,r.'' 4 .I )1.. Q' 10�;; :a`�a'`; . t a ✓ v'i >i;::h� :,i' Y,, .�, �� >p.:, S „Tl" y. y A gyr 75.00 2
.
t r u'Lc:e. ^e;:.rat,t�,�� .:: ,.\ �M� i' ^-'°.'s�: !: �y i c,`�T ?i; kdctE x f ,(' A�' ��1'
' - •t� . - �.. <- ...��fr.., :,...�n.��a.:, "�.;� Each manufactured or modular
• C r Ic 4 k p e A/c dwelling, service and/or feeder _ 90.90 2
- Services or feeders installation, alteration, and/or relocation
^ 200 amps or less 80,30 2
�1 ,x ,z x
� � � ''Ti y ' c i�'rFS''� "`:R�'1'�•• " x q � � t� ;?1. ,T Y, x S'.uum'+ '^ ,
k� _av 'V . L4?• Ali i+� };. ra t 'f ' i s M 1 ! +I � i s, c i x '*t �.?T: 201 amps to 400 a
i7 4.. ?rnLki.. _3- t k .- ` i s < t 2
y , ..+N. : ,R.o' r� 't a x1.Wi 401 a mps to 600 a mps 106.85 2
Name: P II I a!l_ �T. S "---- �- 160.60 2
s-eT v 7 601 amps to 1,000 amps 240.60 2
address: Over 1,000 amps or volts 454.65 2 -
City/State/ZIP ' - Reconnect only 66.85 . 2
6,34..7, �� Temporary services or feeders Installation, alteration, and /or
Phone: ( ) X Fax; ( ) relocation
made on property 200 amps or less _
Owner installations This installation is being 66.85 I 1
g p perty that l 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:
iz signa r Date: e: t t. a: . - : ;, Branch circuits - new, alteration or extension,
4 i:To` ,l : F ;ll a' 1L,,TRR r ', ens 8,� e ti , rrt . JT ' , J r ^ �3 wr , , C per panel
...kilt- h, 1:21.,,.>f . -D . a ' ritI1v121d � f tl� ' # l` ' 1 :ft,,, 1 U ? �`e � I t �� ,a , 9 .sy; .. A. s ee for br r f eej ts with
Business name: service or feeder f ee, each
branch circuit 6.65 2
Contact Warne: , Fee for branch circuits ' '
wirhottt service or feeder fee,
Address: each branch circuit 46,85 2
• Each add'I branch circuit 1 6.65 2
City / State/ZIP: : Miscellaneous (service or feeder not.tacluded)
Phone: ( ) I Fax: ; ( ) Pump or irrigation circle 53.40 2
E -mail: _ Sign or outline lighting 53.40 2
__..:
c }y ;i ;ii�Eti°y'Y•.,��w;F'y"`,,'�`y.. - �[ ...,- }.a�,,�,.�: x ( Sign &ICtrcult(S)OTllntlted -
V i`'.:k!�.'y -. - v, .t�la:::1 �v,ma..'! 'x�K•�kYr• i8 a��.�b f 7, 1R ,.�r"�iV f ' I 1 1 Y :4 4 {..: Y'L
- , : ,__.��, � .>t�� °,�;; -� ._ * "�� �i�_.1 ;:t.L a«?1 energy panel, alteration, or
Business name: extension. Describe: page 2 2
Boones Ferry Electric
Address: P.O. gox 628 Each additional inspection over allowable in any of the above
City / State/ZIP: jnjilSOrlillle OR 9707Q Per inspection 62.50
Investigation per hour (i hr min) 62.50
Phone: (50 3) 682-4936 I f ax: (5 0 3) 682-7946 Industrial plant per hour 73.75
'
CCBL : 88482 1 Etc 1I,ic,: -22i ' 3 1 'su r��' TA �eI •" _M e r..
, c Suprv Lie.: 7p
Subtotal cry }s�ySli� a _'.
f. Plan review (25
Suprv. Electrician signature, required: s S
t` ���/
w �1 (25% of permit fee)
- ' Print name: J e I H Jf E on Date; 7- a - O State surcharge (8% of permit fee) 9.. Z o
s TOTAL PERMIT FEE
gmature: S 7 ,7 2,
Authorized si
This permit application expires if a permit is not obtained within 180
Print name: Date: days after It has been accepted as complete
Fee methodology eel by Tri - Cowry Bwlding Industry Service Board
i Maul Id ngsPennitatELC- PcmucApp.doc 12103 ° Number of inspections per permit allowed.
440.461 ST( 10/02/coMJw2p
i - -Aw
OF TIGARD - `°-
BUILDING DIVISION PERMIT #:
ELtr2005-00523
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2006
Phone: (503) 639 -4171 a i�a i op�l�n °��'�Ibl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/1/2005 TIME: 7 :05AM PAGE: 63
SITE ADDRESS: 11048 SW GREENBURG RD 348 CLASS OF WORK:
SUBDIVISION: ASH CREEK PARK CONDO LOT #: TYPE OF USE:
PROJECT NAME: ASH CREEK PARK CONDO
DESCRIPTION: Installation of (2) branch circuits for a/c. Job No. 13, 655.
OWNER: ROWLANDS, CLEMENT B II, PHONE #: 503624 -7028
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503-882-4936
Inspection Request Scheduled For: Date: 8/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012529 -01 603 -624 -7028 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G ----. Noe l .•
Date: S ( Phone #: (503) 718 -