Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00335
` DEVELOPMENT SERVP4T,ES DATE ISSUED: 5/19/2005
13125 SW Hall Blvd., Tigard, OR1 J7223 503 - 639 -4171
PARCEL: 2S111AB -06900
SITE ADDRESS: 09220 SW INEZ ST ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT : 014 JURISDICTION: TIG
Project Description: (1) Branch circuit. Job #13 -478.
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:
BROWN, RONALD & KATHRYN BOONES FERRY ELECTRIC INC
9220 SW INEZ ST PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 598 -2339 Phone: 503 - 682 - 4936
FEES Reg #: SUP 4918S
Description Date Amount LIE 88482
ELE 3 -223C
[ELPRMT] ELC Permit 5/19/2005 $46.85
[TAX] 8% State Surcharge 5/19/2005 $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- 800 - 332 -2344.
Issued By: Permittee Signature: L �Q
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.
May, 19. 2005'1 961"j�00NE���FERn� ELECTRIC No. 5723 P. 1
„.,b,,, • at �. FOR OFFICE USE ONLY
` City of Tigard
13125 SW Hall Blvd,, Tigard, OR 9 2 1ZeCOived -
Phone: 503 .639 -4171 Fax 12 �p 1 rtit No.: G
Dere/g ' Parr
-� ���
x:503,598- 2O i; Plan Re i (/V
P Line: 503-63 ta'. vie -r
Ins ectia 9.41 1' _ II 4 ii: li ` Detain ; ! O �
j ' " 'lternet: www- ci.tigard.or.us
c . Dateg,e erParmir,
y alyBy:
EVI ?;:fir± - ,, - s . „. - 1 1 F /'s� NOtift8d ethod: See Page 2 for
„�.....,.....:,, .. .,., �,�,. ,. ➢.:�.. i":{ jiia�i� "r ::,,- �;r _ _ s oppietaental f %K.�.: '':_" �r :..t9.r..i,. _ .�E, a i•'r' :' ^ ^ 5 informatio
...:,•l' X' r� 2:-Sr,: , r_. -R .n, _, 1' •.li ? "�c `6 ^i �.y - ra... Yom:, -
_ ,......,-._._ ; :6,L: ..:15 iZ::: yi " ; t.3ar�'�.. ,.,,ac:i . 4; : i.. =
New - �.,.._. _ .�'�` .,, :,�; " � � �<; ,� ; :.. .,c,y;r. r
❑ Con sCruCtlOn �� :< a�" � �....,, :,._^.�Lts�i >;jX ;aX+: r: >'k:S. .tf. :•'EV�;'+;
Addition/alteration/replaceme � c h e ck al t ? y apply:
k � 7rN ylilu :i k ekt �.i .
q Demolition 0 Other: Please check all that app
`�r:j:•A:�i; }'.J - nrry N_:�` "r *-:?77ai.: f�'r ;YS;. :.... ...✓iC; ,.^�. amps, c0 m
:•: , ?`^ t:: y ,: ;: ,.. g +s 1''+ ?I,r _ : -- _ P , rn•1 ❑Hazardo s oc
kb4a" iwiCS':f: : '.t 7 . . r ?•, ��? . ?.f;} ' "r,.,, ,v , :P:S:+ - ;; _ _ U l attop
❑Service over 225
_^. _, ..7 ='- . <:� ?'- fa;l,' .?" pies,;'- .'ry, ": cr"..'.6.,`� ; ;4;•sh": ❑ Servict;
.. � ? ?' 7 .c -,, , � _
,.• , _,.:;_:, , r ' _L � J r i 71 de.:• :�E;; ,,,.,� over 320 e
.., sf:i ;;;e: .. •; �,y:;'f%•t . :-- ".l r 'V " '�;,:: � : 7 ;'� j!': i' "' ? s ['Bulldog over r
3 t � i3A, .i 8 . d sq. ft.,
1 -and 2- family dwelling D Co ..c: >: ,�,' of 1 -and 2- f atnlly dwellings
mmerc
❑ Multi-family 1 Accessory building over 600 volts n al
Commercial/industrial Aeo SY t units in new e
%9:.R:: �;- 77:,77: ;._ >;,r;...::.,. ,;., M Other: over three lu ties
�,, ,.� .: to
�.:�,: -,..:, Master builder_ _ � stories ❑Fe Ten
.w.,.W: ,_ 7777
- ,
:.. ,.L,.,:c...� .., ,:. �,�; �: $kt_'- t: °.'9 ^�u.,<. rh "�r�: �t,�;,: Uld .,"l's %'ar'; ..:r" „ i eder5, 400 amps or rn
❑ s et>� e nominal a
} O [building ov
ah.,a.!:: as.,�.Y_ - .�.g,va,f ; ...,"1!•F A. �'4 ti "''``:; ` ,yc,'x ::;, t ❑Occu ant load more
.:a:�..,r_.>sz..,... g.4: ;: i,:i, E:i�l ?1t;Zt.2); t�' ;_a. ?s�; + ,z: ;. ;:i .! % _�«c : s .' p over 99 tusons M
lob no -: �3 u..:,,.:,.:.r ;: > .,: E . 1 P ❑ atluf�ctured
y c "+ y.- 777 7 <,� k i]Egress/lightingplan 1ZVpark structures or
> � �t ' J ob site address: �' ''
`�2 5k. .Z S ❑Health -care facility ❑Other:
City /State /ZFP: Submit sets of plans with any of
Suite/bldg./apt. no -: The F ore applicable to temporary above.
are not
3011 se
P roject name: �-./� ' jr;. •',r >, :,� ? ,:`. ,x , :r - • _ 4_ P t7+ Consfitct' Nice.
/ O W"1 ':':4. - : .
. ' li'1::,,.. : •:: .Aa 6• :1'I $ vi ?n 1 ?(� ; ' - 'r}.fu l,, ,,,e3„51.
CrOSS street/directions to job site: IIescdptlon � L. . : ` '�� °e' 6 ' =' i `
New residential single or multi family dwelling u nit. y "
Includes attached garage.
Subdivision: 1,000 sq. ft. or less 1.11 145.15 111.1111 4
Lot no.; Ea, add'l 500 sq. R. or portion
Tax map /parcel no.: 33.40 1
1 ''';f';Er :,r > >: ;. ;• -. _ Limited energy, Iesidential 7
i t .... :..77,1, •l:�a1 ;" V'�
-:�r� � 00
„ . :7777.::,, : ..,
., p
l •,.:. L %.L.. b.. s.._:f, . � h .,.:., ...:;,; 1 �. .' i 1.� �';1i��j� Iry ..; �:.. .r,j",
,777: ,. s - ,r�' i�; �'s h , . �_E ..t, ' „rr�.r Limited energy, 2
•i: , ;,•'P .:,�I ::n ,[�, „guy :1(L. : f � 't ?tA rROn4e81
:��i. ,tar,',i;8j ,P' ii `,A' :: t r' °" '7: { "+it' 75.00 2
,t, _,service and/or feeder "' :1 "z. r;_: � Each manufactured or modular ■
90.90
,rf. c"
Services or feeders in all , ton alteration, and/or relocation
�^ s- +- a, x:r;lg3 ovation
�
ery st at 1
n`!:'''dF: :Lc':c; i T SiyF.� s'SAS "r3`ty; R';:,`; �� `'
e" °" -YC - 200 amps Or less
..,,,, .E.tisL e ... .,r : • .D. -.7 ;; •e:.fi . ,.r:_ \M3 ' " • ,o { l .`•'V`. >' 7 . ,a S ' 80.30
, . , . 1 .: 7777 ..T
, ti^, -1'1 $�p�6-'y IVP : 'i:•^ ,:: 2 0 2
�- _ . 'is��l��I --K.Sisr ' r��•.. ti' i1; Y1 .a n :g , t2',.',--::',,7' :. 1 8
i.2 .:,lr ;:'h s :. '1' ; ;r i �: +rips to 400 an s
.,,....,. 01 7 1 .. ,•<,
7171 +•, ...: ,;2sr,� �: , :e'':.. .t;• �E;�;i'�s ;�� =.:;
Name: k ��� 40 106.85 2
rc� ) , t7 i x 1 amps to 600 amps I 160.60 MI 2
, e _s' \ 601 amps to 1,000 amps MI 240.60 2
Over I,000 amps or volts I 2
Phone: ( ) !Q �„ Temporary services or feeders installation, alteration, and /or
�✓ J Fax' ( ) relocation
• Owner installation: This installation is being made on property that I own which is of 200 amps or less
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. i 66.85 1
201 amps to 400 amps
Owner signature: � 100.30 111.11. 2
40
l a
amps to
w•: 600 a
' x,.71.7, i^5` Yd ;`�-'_: ,.. :j D amps 1sion,
r`•` +T V:• f.- 1:��'^ .:.�C: elt •"} ;. Si:'} ;c _ Br C � 2
:... M,' • . - 7717 _ . , < �' ; -
t� w. � 771 7707,. t" , 17 f � � ,., ; w r; ate circuits -now
-
01 7;
.,, -.. '�: ;, ;V, 11 : 'i . ",ti( 3.t¢• } :. - .,, l alteration, extension,
�.:... :..- . 777 .,_..,. ,i kaE' ".•t 'tE' �2• ^''y ,�f'.:b�,: ;,f��fn ;yr',;yY � L ;i r. 'Lt - -.' Y�: ; ;' ;y:� ,,;;fv, or e7[t n on, Per panel
:.. . 77 77 • Business name: " ^ uM' " r..:: '::.. + ;; P.M, : : :. , A Fee for branch circuits with
i fee
Contact name: b h circuit Or der fee, each 6.65 ■ 2
B. Fee for branch circuits
Address: without service or feeder fee, III
each branch circuit 46.85 2
City /State/Zip: Each add'] branch circuit me Phone: ( )
Miscellaneous (service or feeder not included) 5 2
Fax::
E -mail:
: ;„ ) Pump or irrigation circle
: :x " ..,,:,,.,,;, : ... Sign or outline 53. 2
. •- ° ,,yr :. ; •• • : t / � ..; ::')..
:;;,,Y,- ._.: z• • - - ne lighting 40
:., .
... i � , .. ... " : �,> 1
:,^D3•,; . ;, ; r :: i "•:: ::.,. ... .; :y:, Vic' :e ; .: a a
53.40 2
.te...�,.it fL.. r'�r: ,�'�? 3 r'`�.� ;y �r - - Signal circuit
(s) fie.
.:, ., • 7777 � � .;
".. trwc.::h..�, ,. ,efi..r 'l_J ���, . ✓x ' a'�+� „i�. ° ' �:�'- ^ �: ,.,� ;�, (s) or limited -
Business Hartle: �..., �C.5 ;, ., . "fs n :g< r; 't: ?1 4,
a ..., !, • r. enerBYPanel, alteratio
n, or
wanes Ferr Elec r' C
extension. Describe:
Address: P.O. Elox 628 2
Each additional inspection over allowable in any of the above
surcharge (8% of
City /State /ZIP: wi].son�rille OR 97070 Per inspection
Phone: Investigation per hour (1 min) _
(5t:03) 682 -4936 (503) 682 Industrial plant per hour
CCB Fax _ ®�
I`ia:88482 T r, w , re
n , ., J kn:r, X - Pr1-=:, '5" r r _t as d-
Su
MIME Suprv. Lie 913 i1`rY�?..tlr5 ?,S ;•: pc ra
Suprv. Electrician signature, required: a /�1/ F}
� n Subtotal t-1 ,g S
P "--'± Plan review (25% o
Print Itatne.
5-1
P ( of permit fee)
H1445'E on Date: s- / 9 -- 0,5 State
- Authorized signature: prmnit fee) 3 . 7
TOTAL PERT fl FEE SO - tce
Print Herne: This permit application expires if a permit Is not obtained within 180
Date; days after it has been .ccepted as complete
qAg ;ldh, tp " Fee methodology set by Tri - County Building Industry Service Board
B �ttnit7lfiI.C- Pemdtppp.d°e 12/03 "• Number of inspcctioas per permit allowed.
•
440 .461 sr(iwo2/COtiinvEa •
CITY OF TIGARD ii." P q7
BUILDING DIVISION PERMIT #: ELC2006 -00335
` 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2005
Phone: (503) 639 -4171 r r / dame "��/II p��I�Il�llf��11
Inspection Requests (24 Hrs.): (503) 639 -4175 ° -_..
INSPECTION WORKSHEET FOR DATE: 6/16/2005 TIME: 7:10AM PAGE: 13
SITE ADDRESS: 09220 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 014 TYPE OF USE:
PROJECT NAME: BROWN .
DESCRIPTION: (1) Branch circuit. Job #13-478.
OWNER: BROWN, RONALD & KATHRYN, PHONE #: 503 - 698 -2339
CONTRACTOR: BOONES FERRY ELECTRIC INC I PHONE #: 503 -682 -4936
i
Inspection Request Scheduled For: Da : 6/16/2006 Pour Time:
Code # Inspection Description onfirm # Contact # Message
199 Electrical final 009462 -01 603 -682 -4936 N
Corrections/Comments/Instructions:
Aldk U4)1,,,a LIALAAd ///t/i ittli e i p
.-- -
7 r c....7.i „,
•
a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C,' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i AI ,
Inspector: 11 r : Date: (Phone #: (503) 718-