Permit C ITY OF TIGARD- ELECTRICAL PERMIT
PERMIT #: ELC2006 -00387
� DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
- y�' I -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S104DA -12300
SITE ADDRESS: 13061 SW MERLIN PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - WEST LOT : log JURISDICTION: TIG
Project Description: (2) branch circuits for NC & GFI. Job # 4704.
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:
MARTHA BROWN HILLSBORO ELECTRIC
13061 SW MERLIN PL 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 431 -5155 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -4399C
[ELPRMT] ELC Permit 7/14/2006 $53.50 LIC 134481
[TAX] 8% State Surcharge 7/14/2006 $4.28 SUP 4941S
Total $57.78 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: c:
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.
07- 13 -'06 14;07 FROM- Hillsboro Electric 503 - 601 -3680 T -798 P002 /002 F -355
;, . � Ele ztrical Permit Appl 1i , E I V E D
Cx ty of Ti and Received (/
g Rccciv /A U6 Permit No.: +� (,G A �6 -
t 13125 SW Hall Blvd Tigard, OR 97223 JUL 1 4 20064. *� r Pl an Review
y
Phone: 503.639.4171 Fax; 503.598.1960 "
•; -d� l i� Date/By: y: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGA'r� • 1 Date Ready/By; 1 �; RI See Page 2 for
Internet: wvfw.ci.tigard,or•us BUILDING DIVI •., Notified/Method; 1 , - Suppirmental Information
.::: : - . .. . • • : ;.. : :... )y .QF: WORK :. ..:,•,::..:.::,:, ` .: :PLAN REY1 :. :.;..,..
1:2 New construction Addition /alteration /replacement Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
0 Demolition ❑ Other:
:. -
. .. amps rating ❑Huildng over 10,000 sq. ft.,
.,. ..... .
CATEG.QRY :' OP CQNSTA SON erwi over 320 amp
o ] - and 2 family dwellings 4 or more raw residential
1- and 2 - famil dwelling El Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one w structure
reside
Multi ❑Building over three stories ❑feeders, 400 amps or more
[2 y ❑ Master builder O ther:
Occupant load over 99 persons ❑Manufactured structures or
. :. ;. :: ?' : : ' :: : :.; !OB. :811�'T. INF'QRMATIONi; '
, Al. • :; .Ir.Q ATI01 park . ........ :. :. :- : : : : :�,,, ,:. ...... ........ . :..:,....: . :!� :; � . , ess/lighting plan RV Pa
_ .... ❑Egr R k
.. ........
Job no.: 41 64 Job site address; 1 SI) WA vi VA _ ❑health facility ❑Other:
Submit 2 sets of plans with any of the above. •
City /State/ZIP: i ; A A , rip,- O — 7J �� The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: * ' •S
��JY 'v"�
benrIptfou I Qty. 1Be Total
Cross street/directions to job site: New residential single- or multi - fancily dwelling unit,
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision; Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 l
..
Limited energy, residential 75.00 2
Tax map /parcel no.: ; ..:: `'' ; : • .non-residential 75.00 2
D SC Rdlfl1ON. OF: wO Rx
.: .. -:: ... ............ .. ed energy,
tml gY
' "'" ' "- F,ach manufactured or modular
Al t f 1 1J{ f'' ]mot —,c dwelling, service and/or feeder 90,90 teration, and 2
1 Services or feeders installation, alteration, relocation
200 amps or less 80,30 2
n P 106.85 „ .,.:,:.:. 111IE' 13t I Y '.OWIiTE amps 2
�i ;:: ❑ T1E;
I /� /,y,� "' ' 401 amps to 600 amps 160 -60 2
Name: U! A.►� U \ N U ) V\ 601 amps to 1,000 amps _ 2 40.60 2
Address; Over 1,000 amps or volts 454.65 2
Reconnect only 66:85 2
CitylState/ZIP. Temporary services or feeders installation, alteration, and/or
Phone: 7) - 1 5c r 7AL-z)
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
' ,
A.F
JiC Fee for branch circuits rrouit
s with
A I service or feeder fee each
ttj A - 6 -65 2
Business name;
1 branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1
Address:
first branch circuit 46.85 1 , 2
Each add'! branch circuit ( 6.65 (j -(D,f 2
City/State/ZIP: Miseetlaneous (service or feeder not included)
Pump or irrigation circle 53.40 2 Y
Phone: ( ) I Fax! ;
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
.... ......
.a,.. . , .. , r r Gt7P1T1R:+#.Cx'OR! :..i .; ...
Panel. alteration o r
Business name: i 1 / 1 A > ' " extension. Describe: Page 2 2
Address: i A / • L U Each additional inspection over allowable in any of the above
`-. Per inspection 62.50
City /State/ZIP: #'t ll A sl V f ( 111/A -t I Investigation per hour (1 lir min) 62.50
Phone: ) 47- „ & (�! AA / e Fax- (Se2) )(DOH �( „�O Industrial plant per hour 73.75
tt l t Iry ° :• : :...,
. ; . ' : .:... :. : LL 1p Alt FE S. .: :
CCB Lie.: l R l Electrical Lic.:74 -q i Suprv. Lic.: L 1‘ Subtotal .
Suprv. Electrician signature, require` , Plan review (25% of permit fee)
Print name: t , Date; �I ",I 610 State surcharge (8% of permit fee) 2
- t
TOTAL FEE .-
Authorized signature: This permit application expires if a permit is not obtained Within 180
days after it has been accepted as complete
Print noise; Date: • fee methodology set by Tri - County Building Industry Service Board
•• Number of inspections per permit allowed.
isIHuildinglpentiilAttC- PormitApp.doc 12103 440 -4615T(10/02 /COMlw2a
1.. .;
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELC2O06 -00387
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639 -4171 A�alt
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/3/2006 TIME: 7:OSAM PAGE: 31
SITE ADDRESS: 13061 SW MERLIN PL CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW WEST LOT #: 109 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: (2) branch circuits for A/C at GA. Job #4704.
OWNER: BROWN, MARTHA PHONE #: 5Q3- 431 -5155
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503 - 439.9666
Inspection Request Scheduled For: Date: 813/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 A/C or heating unit circuit 034310 -01 503 -53Q -2953 Y
)11 t%I..G (/\/__ .
Corrections/Comments/Instructions:
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Alm u i'-i
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...... CD
K PASS I I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: C i/ F Date: 8 ' ' C Phone #: (503) 718- Z6 1 1 ci