Permit vii` CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00981
DEVELOPMENT SERVICES DATE ISSUED: 12/28/2005
`� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134AB
SITE ADDRESS: 11316 SW IRONWOOD LP ZONING: R - 4.5
SUBDIVISION: ENGLEWOOD LOT : 007 JURISDICTION: TIG
Project Description: Service and branch 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: 10 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:
MARK DOUGLAS BAILEY'S ELECTRIC LLC
11316 SW IRONWOOD LOOP 2160 SW LEEWOOD DR
TIGARD, OR 97223 ALOHA, OR 97006
Phone: 503 - 524 4727 Contact #: PRI 503- 849 -3134
FEES
Description Date Amount Reg #: LIC 159814
[ELPRMT] ELC Permit 12/28/200` $146.80 SUP 51155
[TAX] 8% State Surcharge 12/28/200` $11.74 ELE 34 -389C
Total $158.54 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 1-80:f 32 -2 4.
Issued By: AO /! Permittee Signature / —_
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.
,E1e�.' rical Permit A 'tic l V FOR OFFICE USE ONLY .
City oT Ti and Received
g EC 2 $ 10 05 Date /B . A�0 • Permit No....,, f ,0 •••• / 0 t I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.59 4/ OF . /��ir�p ,j; :I` l)`' Date/By: Other Permit:
Inspection Line: 503.639.4175 BU� ��G _- � -•_ ' _ � DateReadyBy: luris: ® See Page 2for
Internet: www.ci.tigard.or.us NG �I(✓� {� ' Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW -
❑ New construction J Addition/alteration /replacement Please check all that apply:
1:1 Demolition ID Other: ❑Service over 225 amps, comet ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
' CATEGORY OF CONSTRUCTION ., . of 1 - and 2- family dwellings 4 or more new residential
CI I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
C:1 Multi - family CI Master builder 12 Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
,JOB" SITE INFORMATION AND LOCATION, ` ['Egress/lighting plan RV park
DHealth -care facility ❑Other:
Job no.: Job site address: 17' 3 / (o (-4-) -4tL , A- ) v " '1Submit 2 sets of plans with any of the above.
City /State/ZIP: 77 c ,-s141 >, p#2 ? 7 z Z 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: • FEE* SCHEDULE ,
Description I Qty. I Fee. I Total ""
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK • - . • Each manufactured or modular
5 fe �', / dwelling, service and/or feeder 90.90 • 2
ie - `t4`'`if r° Services or feeders installation, alteration, and /or relocation
200 amps or less /1 80.30 gp . 2
E PROPERTY OWNER . : - _ ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: jex-L Ai 4#2K. 601 amps to 1,000 amps 240.60 2
Address: // 6, 5 W 1 ,,1 7 LA:J`O Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: 6 D 0/t._ Q 7Z' Z3 Temporary services or feeders installation, alteration, and /or
Phone: (5 2) 5 _ 4 - 200 a amps ? -7 I Fax: ( ) 2 m p s
/ 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
. 0 A PPLICANT • ' .❑ - CONTACT .PERSON ' , A. Fee for branch circuits with
' - service or feeder fee, each / 0 6.65 � ,�u 2
Business name: branch circuit tv )
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:
( ) I Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited • CONTRACTOR energy panel, alteration, or
Business name: )C extension. Describe: Page 2 2
�� � lam s � ec 2, �
Address: �lG p 5 - � - to �d31/ Each additional inspection over allowable in any of the above
/ n Per inspection 62.50
City /State/ZIP: 4C� U _ 97 6 Investigation per hour (i hr min) 62.50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT - FEES* _
CCB Lic.: /s j 1/5/ Electrical Lic ? / y / -G Ve Suprv. Lic.: �l /SS Subtotal / i(
Suprv. Electrician signature, required� Plan review (25% of permit fee)
Print name: 14' ,1 5c 4 { ,� t r�� Date: /2 - 2 - c e r — State surcharge (8% of permit fee) �� • '1 t�
TOTAL PERMIT FEE /
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
.• Number of inspections per permit allowed.
i:\ Building \Pernits\ELC- PennitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
Pagel - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:' - -
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL
Fee for each commercial system $75.00
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
,
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building U'enn its \ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION ., , .,.. PERMIT #: ELC2006-00981
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12128/2005
Phone: (503) 639-4171 ./1°Nilt
Inspection Requests (24 Hrs.): (503) 639-4175 ,,, ---..,
INSPECTION WORKSHEET FOR DATE: 6130/2006 TIME: 7:15AM PAGE: 6
SITE ADDRESS: 11316 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 007 TYPE OF USE:
PROJECT NAME: MARKS
DESCRIPTION: Servico and branch circuit.
OWNER: MARKS, DOUGLAS PHONE #: 503-524-4727
CONTRACTOR: FINLEY'S ELECTRIC LLC PHONE #: 503
Inspection Request Scheduled For: Date: 5130/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 03076B-01 5(X4524-4727 y • •
Corrections/Comments/Instructions:
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Inspector: Date: (51 TyLy 6 4 Phone #: (503) 718- 21441,-
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CITY OF TIGARD
BUILDING 'DIVISION ,.
A Ili • PERMIT #: FLC2005•00981
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: unarms
Phone: (503) 639-4171 4 01 1 1pittli
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/912006 TIME: 7:04AM PAGE: 10
SITE ADDRESS: 11316 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: OW TYPE OF USE:
PROJECT NAME: MARKS
DESCRIPTION: Seivice and branch circuits.
OWNER( ARKS, DC)L1GLAS' PHONE #: 603-624.4727
CONTRACTOF ttn"S ELECTRIC 1_11.: PHONE #: 503-849- 31 34
Inspection Request Scheduled For: P = e: 2/9/2006 Pour Time:
Code # Inspection Description Confirm - Contact # Message ,
120 Electrical rough-in 0265134-01 603-516-4960 V
Corrections/Comments/Instructions:
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Inspector: . G kR./ N9 i if
Date: i 6 Phone #: (503) 718- iii4b
CITY OF TIGARD
BUILDING DIVISION PERMIT #: .LC200~,.( #) ; ;1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2I /70(J6
Phone: (503) 639 -4171 1#60 411411A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 21612006 TIME: 7 :f AM PAGE: 19
SITE ADDRESS: 11316 SW IRONWOOD U CLASS OF WORK:
SUBDIVISION: ENGLEWWOOD LOT #: 007 TYPE OF USE:
PROJECT NAME: MARKS
DESCRIPTION: Seivice and branch circuits.
OWNER: MARKS, DOUGLAS PHONE #: E03 5244727
CONTRACTOR: BAILEY'S ELECTRIC LLC PHONE #: 503-849-3134
Inspection Request Scheduled For: Date: /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
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FAIL
ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .- 1C Wa4 Date: 21 60 Phone #: (503) 718- 1
CITY OF TIGARD _ . EL c.
BUILDING DIVISION PERMIT #:0? -60 %7'/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ] / 3 / 4 ! ° 0 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: / a(, - 6(0 Pour Time:
Code # Inspection Description on' - Contact # Message
/20 oas oL -al 3 - '9-3/3
Corrections /Comments/ Instructions:
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Inspector: ° "R , `i -O3 Q Date: b 26 6 Phone #: (503) 718- 2J %
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CITY OF TIGARD i
,l . s•
BUILDING DIVISION
4
PERMIT #: ELC2005.00981
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/280006
* •
Phone: (503) 639-4171 / l illittl . i
A I .
Inspection Requests (24 Hrs.): (503) 639-4175 ,, - —
INSPECTION WORKSHEET FOR DATE: 12/29/2005 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 113Th SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENG( .EWO 0 D LOT #: 007 TYPE OF USE:
PROJECT NAME: DOUGLAS
DESCRIPTION: Service and branch circuits.
OWNER: DOUGLAS, MARK PHONE #: 503-6244727
CONTRACTOR: BAILEY'S ELECTRIC LLC PHONE #: 503-849-3134
Inspection Request Scheduled For: Date: 12/2912005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical seivice 024147-01 f.'4)3- 849-3134 ( Y N
Corrections/Comments/Instructions:
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Inspector: g Date:I 45--- Phone #: (503) 718- 2-4iii •
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.. . . .