Permit CITY OF TI G w RD ELECTRICAL PERMIT
GA PERMIT #: ELC2007 -00283
COMMUNITY' DEVELOPMENT DATE ISSUED: 4/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 AB -06700
SITE ADDRESS: 09255 SW INEZ ST ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT : 012 JURISDICTION: TIG
PROJECT: ALLAIRE
Project Description: Service, 2 circuits.
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: 2 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:
PAT ALLAIRE JSM ELECTRIC
9255 SW INEZ 7717 SW SKYHAR DR
TIGARD, OR 97224 PORTLAND, OR 97223
Phone: 503 - 888 -2321 Contact #: PRI 503 - 866 -7304
'FA 5 3 .a44.439
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 4/27/2007 $93.60 LIC 168451
[TAX] 8% State Surcharge 4/27/2007 $7.48 SUP 5104 -S
Total $101.08 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: PA 4 / 4 ,,t � i 1 Permittee Signature: d54- a p
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.
=' 25 07 07:31p p Jeffrey S. McGinnis 503- 244 -4397 p.1
' ;rectrical Permit Applim.RECEIVED F OR OFFICE ESE ONLY
r ► �� 3
> Z City of Tigard Dae/B ` a 0 7 . i p5 Permit Ngt C '7 .- p
N 13125 SW Hall Blvd., Tigard, OR 972330 2 2001 Plan 12evi '
C Phone: 503.639.4171 Fax: 503.598.8 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF rIGARD DateReady/13y: Juris: ® See Page 2 for
Internet www.tigard Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w/itetas checked below }:
❑ New construction ® Add ition/alteration/replacement
['Service or feeder 400 amps or more ❑ Building over three stories.
El Demolition ❑ 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 0 Other: ❑ Fue pump, ❑ Installation of 75 KVA or
SOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑Addition of new motor load of ❑ "A ", "E ", "l -2 ", "! -3 ",
10011P or more. occupancy.
Job no.: Job site address: 9255 S.W. Ittez St. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard / Oregon / 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldgiapt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: De a iption I Qty. I Fee. i Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fl. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family
Panel change upgrade from Federal Pacific to 200A Seimens residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 $80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Pat Allaire 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 i 2
Address: 9255 S.W. Inez St. Over 1,000 amps or volts 454.65 2
Cily /Slate/ZIY: Tigard / Oregon 1 97223 Temporary services or feeders installation, alteration, and /or
_ relocation
Phone: (503)888 -2321 Fax: ( ) 200 amps or less 66.85 l 1
Owner installation: This installation is being made on property that 1 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 2, 6.65 $13.30 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add') branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( )
Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: J S M Electric Signal circuits) or limited-
. energy panel, alteration, or
Address: 7717 S.W. Skyhar Drive extension. Describe: Page 2 2
City /State /ZIP: Portland OR 97223 Each additional inspection over allowable in any of the above
Phone: (503) 866 -7304 I Fax: (503) 244 -4397 Investigation Per iga 62.50
tigation per hour (1 hr rnin) 62.50
CCB Lie.: 168451 Electrical Lic_: C218 Suprv. Lie.: 5104S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: $93.60
Print name: Jeffrey S. c i is ` Date: April 25 2 Plan review (25% of permit fee): 0
State surcharge (8% of permit fee): $7.48
Authorized signature: i . `' i TOTAL PERMIT FEE: 101.08
This permit application expires if a permit is not obtained within 180
Print name: , D a t e:
days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:1 8uildingWenni tsaLC- PennitApp.doc 05/23/06 440 -4615T( I I /OS /COM/WEB.
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC7007.00283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/271 }007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _� -
INSPECTION WORKSHEET FOR DATE: 10/10/2007 TIME: 7 :01AM PAGE: 39
SITE ADDRESS: 09255 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 503,888-2321
CONTRACTOR: ISM ELECTRIC PHONE #: 503.8664304
Inspection Request Scheduled For: Date: 10/10/2007 Pour Time:
Code # Inspection Description onfirm ° Contact # Message
1 ,95 Misc. inspection 057301 -01 503.430 -6996 N
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL CANC n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: it _O Phone #: (503) 718- 1/1111
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELC2007..002B3
13125 SW Hall Blvd., Tigard, OR 97223 • *.. DATE ISSUED: 4/27/2007
Phone: (503) 639 -4171 /a m 'pp„�o ,,LI
Inspection Requests (24 Hrs.): (503) 639 -4175 �' __..
INSPECTION WORKSHEET FOR DATE: 10/11 /2007 TIME: 7 : 01AM PAGE: 73
SITE ADDRESS: 09265 SW INFO ST CLASS OF WORK:
SUBDIVISION: PENROSE. TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 603 -BBt -2.321
CONTRACTOR: JSM ELECTRIC PHONE #: 50:3856.7304
Inspection Request Scheduled For: Date: 10/11/2007 Pour Time:
Code # Inspection Description Co firm # Contact # Message
199 Electrical final 057395-01 503- 430.6996 N
Corrections/Comments/Instructions:
:47(\
. NASS I I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
fl FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 10 0 6 Phone #: (503) 718 -'Mi
CITY OF TIGARD 1 DOM 4
BUILDING DIVISION. (✓ p PERMIT #: ELC2007 -00283 li
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/2007
Phone: (503) 639 -4171 1 J /o. II�1BI�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_' "AIL
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 082515 SW INEZ ST CLASS OF WORK:
•
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 503.8t38-2321
CONTRACTOR: JStMI ELECTRIC PHONE #: 503 -866 -7304
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 050229-01 503- 866 -2321 N
Corrections /Comments /Instructi � :
0'O i.Z ti a iljV if1/a /N -z_c,
_____.......■.
______-----
n PASS ' PARTIAL APPROVAL ( I CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
Inspector; '_ / /.. / /4 Date: / `•" it Phone #: (503) 718 -
CITY OF TIGARD lip
.
BUILDING DIVISION. - PERMIT #: ELC2007 -00283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/2007
Phone: (503) 639 - 4171 �" 011 it fi • Inspection Requests (24 Hrs.): (503) 639 -4175 !�i f' _
INSPECTION WORKSHEET FOR DATE: 6/5/2007 TIME: 7:01AM PAGE: '14
SITE ADDRESS: 09255 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 508613 --2321
CONTRACTOR: JSM ELECTRIC PHONE #: 503 -866 -7304
Inspection Request Scheduled For: Date: 6/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 049608 -01 503- 888 -2321 N
Corrections /Comments /Instructions:
1 I ki i r ti
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` PASS I I PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
, I I FAIL n CA L FOR INSPECTION . ADDITIONAL FEES ASSESSED
e Ins ector: Date: Phone #: (503) 718-
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CITY OF TIGARD
BUILDING DIVISION- PERMIT #: ELC2007-00283
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 4/27/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/1/2007 TIME: 7:02AM PAGE: 45
SITE ADDRESS: 09255 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 503-888-2321
CONTRACTOR: JSM ELECTRIC PHONE #: 503
Inspection Request Scheduled For: Date: 6/1/2007 Pour Time:
Code # Inspection Description e Contact # Message
115 Electrical service 049395 503-8E4
Corrections/Comments/Instructions:
t '
o 045 IA) U. IT b (K(z, A
E Lk. Po.
PASS PARTIAL APPROVAL I I CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: r \ . Date: I -01 Phone #: (503) 718- l4
„
CITY OF TIGARD
BUILDING DIVISION" ' PERMIT #: ELC2007 -00283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 412712007
Phone: (503) 639 -4171 � *Op i
Inspection Requests (24 Hrs.): (503) 639 -4175 4±i
INSPECTION WORKSHEET FOR DATE: 5/10/2007 TIME: 7:02AM PAGE: 44
SITE ADDRESS: 09255 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Service, 2 circuits.
OWNER: ALLAIRE, PAT PHONE #: 503 -888 -2321
CONTRACTOR: JSM ELECTRIC PHONE #: 503 -856 -7304
Inspection Request Scheduled For: Date: 5/10/2007 Pour Time:
Code # Inspection Description Cam.• = Contact # Message
115 Electrical service 048017 -01 503 -888 -2321 N
Corrections /Comments /Instructions:
co o - rc : GEAtv ) 5 ieTe pia .420
- rv\s oAc.)\15 Vrbbok, IATiNINTaa.-6
�I tC R , .
ci LL 63a, I Q4) TAL
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❑ PASS I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FA, FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �l , VL Dater - 1 0'01 Phone #: (503) 718- 14)