Permit CITY OF TIGARD'. ELECTRICAL PERMIT
11111* P ERMIT #: ELC2004 -00690
D EVELOPMENT SERVICES D ATE ISSUED: 10/27/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 101 AB - 01501
SITE ADDRESS: 07555 SW HERMOSO WAY
SUBDIVISION: HE MOSO PARK ZONING: MUE
R
BLOCK: LOT : 021 JURISDICTION: TIG
Project Description: Extend single and double duplex receptacles from existing in reception area.
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:
JOENS, JOHN D MARJORIE A GREENWAY ELECTRIC COMPANY
7545 SW HERMOSO WAY 9460 SWTIGARD STE. 104
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 503 - 620 - 6020
Reg #: LIC 153421
ELE 34 -617C
FEES SUP 5025S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/27/200' $53.50
[TAX] 8% State Surcharge 10/27/200' $4.28 Rough -in
Elect'I Final
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
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: G %� Permit Signature: __1R,-e— c\i) \
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 639 -4175 by 7:00pm for an inspection the next business day
,- • ,
Ele- ' - igat.Permit Application
W
ci L., igard
4 '
iveLTigard, OR RECEIVED „,, .,, - - „,,,,,,.: 7
13125 S. 9'7223
A ,
Plan %win
Phone: 503.6394171 Fax: 503 4 : i 'lltifti' : , '"i I . i '. Datelay: Other Permit:
filSpedigii Line: 503,639.4175 UCT 26 2004
___. „Am- .AJL. Date RilailY/BY;
Interila: www.citigard.or,w, Notificd/Mothod: ri 6 ruppl l'As n a t,:it r io attna
';;I:, ':: 01;:liIMM r ';',.•,,j' :.:•;,.,, ,..,:,......:::::::::'.,•:.',,,..? :::,:4 , ,::?::?.:Tx4$44 , 14,4*:: . ..,?: , .% - :..J,:,: ; :i....!:.:'::.,::;:,,,; , :.:qv. ; '!?; - , , :
El New construction Q "Allirsr. tiVi.,71,i6 . rwir': 1 en t Plea. Se Chock all that apply;
1::] Dentition 0 Other: 0Service over 225 amps, oomm'l 0 Hazardous location
, , „_,... .. „,.; „.,..,.,,,,", °Service over 320 amps — rating DBuildng over 10,000 sq. ft,
;C...7;'■:;1:',':::.......r,..`.:':,.4...:A.:i2::.P.:1.;:j,:: '.!':.,0-4/i1.i,"itilT:.-00014.11:1X0C:'‘:,:::.:;7:k,:: ..;:::.•...:: i'-:',• :i": of 1- and 2-fumily dwellings 4 or more new residential
El 1- and 2-family dwelling M Cornintscial/industrial ['Accessory building °System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
CI Multi-fatnily 0
• Master builder 0 Other
DOccupant load ova 99 persons °Manufactured stmotures or
*.101iilti(j/0:00*...:,...'.'R...'..E4;.':'.. 0Egcss/ Owl RV park
Job no.: 304137-1 Job site address: 7555 SW Hermosa Way Ofiganb-care facility ['Other: - — Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard Or The above are not applicable to temporary construction service.
.0.:6;
Suite/bldg./apt. 110.7 Project name: Minuutema n Press
. . amo. I cp I Ife. 1 Tem I 7
Cross street/directions to job site: 72' to Hermosa Way Nov residential single- or multi-flimlly dwelling unit.
Includes attached garage,
sq. ft. ctr less 145,15 4
Subdivision: Lot no.: Ea. add"! 500 sq. ft. or portion 33.40 1
- limited energy, residential 75.00 2
Tax mapipmeel no.: —
., . . Limited energy, non-residential 75,00 2 • : C;";: i i i . :.':'.. ? :: 1 .:" . ..?: ' t * : ; .• 'a : W...tOik,: :i., EM or mo
dwelling. service and/or feeder 90.90
Extend single and double duplex receptacles from existing in R etii..- - 2
Services or feeders installation, atm:radon, und/o relocation
200 amps or less 80,30 2
' 7.: ,.:'... 201 It 4 °° =Ps 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 1 own which is not 201 amp to 400 amps 100.30 2
intended for sale, lease, ren; or expbunge, according to ORS 447, 449, 670, and 701.
401 amps to 600 amps 133:75 2
Owner signature: Date: iirsinch circuits — new, alteration, or extension, er Pond
. .
. : .':'. ' 'a , l ." :: : :',.?..!.'n ' ' . ? .. 4:r..'0.1041,414. itt*PAV......: A F" f.." br circuits with
service or feeder fee, each
6.65 2
Business name: Greenway Electric branch circuit
a Fee for branch oircuits
Contact name: Byron HayzJett
without service or feeder fee, t 46 lit 2
each branch circuit
Address: 9460 Tigard St Suite 104
Each add'l branch circuit I 6.65 Ce .1 2
City/State/ZIP: Tigard Or Miscellaneous (service or feeder not included)
. Pulep Or iffIgiiti.011 circle 53.40 2
Phone: (503-620-6020) Fax: : (503-6204124)
Sign or outline lightin 53,40 2
E-mail:
Signal circuit(s) or limited-
., :''''"..::, I ... .. ..,".:,•!:: ,....•,,,,-,:;:;,(..:, ''.-;]'..;:,...,.., energy panel, alteration. or
extension. Describe: Page 2 2
Business name: Greenway Electric
Address; 9460 Tigard St Suite 104 Each additional inspection over allowable In any of the above
Per inspection 62.50
City/Stoic:12,1E Tigard Or Investigation per hour (1 hr rain) 62.50
Industrial plant per hour 73.75
Phone: (503-620-6020) 'fax: (503-620-6124)
,‘::::::10.4f4tiliCAD:;:1011trt.41M.:'
CCB Lie.: 153421 Electrical Lie.: 34 Suprv. Lic.: 50255 Subtotal 45 3
, so
Suprv. Electrician signature, required: j ti . Plan review (25% of permit fee)
• • State surcharge (8% of permit fee)
Print name: ._, e., 1 / - R . ,,,,,, 7 late: 10/26/2004
TOTAL. PERMIT FEE .51 .1
Authorized gnature.
This permit applicatteeeti r. nn
res Ifs permit Is not obtained within iso
days afte it
Print narae: Date: * Pee methodology set by Tri-Counry Building industry Service Board
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