Permit CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 - 00534
COMMUNITY DEVELOPMENT DATE ISSUED: 8/1/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 AB - 07500
SITE ADDRESS: 09390 SW INEZ ST ZONING: R - 4.5
SUBDIVISION: PENROSE TERRACE LOT : 020 JURISDICTION: TIG
PROJECT: MALLETT
Project Description: 4 branch circuits: AC, furnace, GFI, hot tub.
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: 3 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:
MICHELLE MALLETT HILLSBORO ELECTRIC
9390 SW INEZ ST. 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
•
Phone: 503 - 624 - 7777 Contact #: PRI 503 - 439 -9666
FAX 503 -601 -3680
FEES
Description Date Amount Reg #: ELE 34 -4399C
[ELPRMT] ELC Permit 8/1/2007 $66.80 LIC 134481
[TAX] 8% State Surcharge 8/1/2007 $5.34 SUP 4941S
Total $72.14 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: , . Permittee Signature: e7Y7
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.
� 31 -'07 15,44 FROM-Hillsboro Electric 503 - 601 -3680 T -360 P002/002 F -944
AVMI A. V, ,,,,l. c■arFtrl[11•,a4av�a F {)12 ()f• I• I( 1. 1 til. 1)1
'Cit of Tigard �r lt! p i
[� � � � � i , ,, a ermt No.. ., OR 97223 p.„ - 1J
Phone: 503.639.4171 pax: 503.598.1960`. 1., ''y„ l �' Date/By; Other Permit;
Inspection Line: 503.639.4175 AUG ® ¶ Y � L fv i Y . tt. I Date Read /B Ser Page 2 for
Y NH::
Internet: WWVv.ci.tigard.or.uS Notified/Method; / Supplemental Information
ttitat�terr1t
TYPE:: �. r. ,
_ . .• c. "' >pA1V ;[LEVIER'..
EI r ' ` ° ",,- „r- r w ,�r>b+t d Please check all that apply:
New construction Additi ron/re t pla�emetlt pp y:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑ITazardous location
-
;a;: ; . ... , amps rating
...:. "CAT OR'Y::OF. .CONt : ps — ng 4 or m residential
over s . ft ,
a a
....;' ... ...;r . .....
. . .... ...... WIWFI igN • • :.:::.' :.: ; ' :.; ..: : `;: of l- and 2- family dwellings 4 or more new residential
ilU 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
III ulti - famil M ❑Building over three stories ['Feeders, 400 amps or more
M .
Y aster builder [] Other; Occupant load over 9 persons []Manufactured structures or
1Q 1 : E ;nyl�,O$MATj�arl.. np : �I C TJQi+ 9
❑E gess Ai g h t i n g plan RV park
Job no.: � �� rob site address: D t /
[Wealth-care facility ❑Other:
Submit 2 sets of plans with any of the above,
City / State/ZIP:.'f y • 0 017, The above are not applicable to temporary construction service,
Suit 1 n (� .,.. ....:::.;,^
Suite/bldg./apt. d /a t - no.: Project ir Ai i�jt/\ D�oription .... ..,. ..., ,'.... ...'..IrG'Pi'r tJ`L
rg� P t name: ..:.... mil? .,. �:.'::ri: '!:'�:;.. : :
Qtr, I Bee. Tots' I ”"
Cross street/directions to job site: New residential single. or multi- family dwelling unit.
Includes attached garage.
L000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75,00 2
a ,.< - - •• • . energy, non ntial 75 00 2
P3�.' *ITI.
....... ::
r::�:.i .:.:.:..::..:.:::: : :�.:r: <:•''r • Each manufactured or modular
' dwelling rvi and/or d 90.90 2
�� Services or se feedce ers installatiofeeer n, alteration, and/or relocation
br- too o 240 amps or less 80.30 2
201 amps to 400 amps s
ER'I 85 2
10 .
P b
...... .....
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, alter and/or
Phone: ( ) I Fax: ( ) relocation
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
s. L A , for «Al!T'I" . pee fo
........, ,, � 1'!' X4.1 ' : � . circuits with
LL ...: • serv or feeder fee, each
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits
fi without rs bra
service h or feeder fee, 1 46.85 13`..T 2
Address: c ircui t
^— Each add'I branch circuit 3 6,65 _1I ,c)5 2
- City /State/ZIP: Miscellaneous (service or feeder not included)
Phone; ( ) l l _ ax: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53,40 2
E -mail:
Signal circuit(s) or limited-
';;':;; CQNx'XtA1C"I'QR:`; r" - , , energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ill / 1 it
•
•
Address: klyj - J Aq � I Velt0 Each additional inspection over allowable in any of the Above
c` � 1 Q ' C p � Per inspection 62.50 Cy /State/ZIP: • �� ICN� � s / onvi,LE' Investigation per hour (1 hr min) 62.50
ii
wy
Phone: ( �.� (P�A� Pax: (603) ) �V1 2 ✓u�� Industrial plant per hour 3.75 -
1 � r;. tEC'TI CAL:PERM13r :etESt:
B Y
CC ic.; NUM Electrical I.ic,: a 1 Suprv. Lic.: 1 I S Subtotal 1� a SD
Suprv. Electrician signature, required: ' Plan review (25% of permit fee)
I. c. .IJ.� /.ice _
Print name: v f D ate; State surcharge (8% of permit fee) 6, -
J
1 ~ 1 TOTAL PERMIT FEE 17)4
Authorized signature: This Permit applleaGOe expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by 'lb-County Building Industry Service Board
• • Number of inspections per permit allowed.
I: \13uildinglPermits urLC- PermitApp.doe 12/03
440-06I W02lCOM/WFa
CITY ���� 77���������
��mn m '��"m un���m�m��
BUILDING DIVISION PERMIT #: ELC2007-80534
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 0/1/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7:00AKd. PAGE: 64
SITE ADDRESS: 09390 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 020 TYPE OF USE:
PROJECT NAME: MALLETT
DESCRIPTION: 4 branch circuits: AC, furnace, GFI, hot tub.
OWNER: MALLET'', MICHELLE PHONE #: 503-6217777
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 603
Inspection Request Scheduled For: Date: 8/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact #
``. .
199 Electrical final 053652-01 503-538-2963 - ^x
Corrections/Comments/Instructions:
p 1\(\
if
KPASS °
I | PARTIAL APPROVAL 7 CANCEL 1 | NO ACCESS
| | FAIL El CALL FOR INSPECTION H | AODOOONALFEESASSESSED
���d �
Inspector: Date: / ' / �� � Phone #: (503) 718-
�� ` _