Permit C4 1 1 OF TIGARD ELECTRICAL PERMIT
TIGARD #: ELC2004 -00281
, l e DEVELOPMENT SERVICES DATE ISSUED: 5/21/2004
^ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 CB -03200
SITE ADDRESS: 10135 SW LADY MARION DR
SUBDIVISION: MARION ESTATES ZONING: R-3.5
BLOCK: LOT : 005 JURISDICTION: TI
Project Description: 1 branch circuit to AC.
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: 0 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:
MCGREGOR, MARK D + LYNDIA J GRF ELECTRIC
10135 SW LADY MARION DR 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 684 -4083 Phone: 503 - 829 -4146
Reg #: LIC 76751
SUP 1655S
FEES ELE 3 -484C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/21/2004 $46.85
[TAX] 8% State Surcharge 5/21/2004 $3.75 Rough -
Elect'I Final
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 fo i OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -0699 1 -800 -3 •-
Issued y: ► _ .. ` • Permit Signature:p_e_
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: .7-4 t C' �� DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
~ FOR OFFICE USE ONLY • electrical Permit Application Received � Electrical
Date/By: Z f 1 5 Permit No •, l - O1
City of Tigard RECE1V [ ® Planning A +prov Sign
Date/By: Permit No.:
- • 13125 SW Hall Blvd. Plan Review Other
. Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: 503 - 598 -1 516 Y 1 f / �� Post - Review Land Use
LaF � su + 1 Contac t Case No.:
Internet: www.ci.tigard.or.us 6 *� ! + Contac 1,uris: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -417/ 111 ' =""' - "' Name /Method: . I (� Supplemental Informa
•
PUNNING/ENGINEERING JJJ 111
`
. . .. . `: TYPE :OF WORK ` ..: `;, .'':'..:'- :' • :PLANREVIEW (Please check allthat apply)'::.:
❑ New construction U j Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
R.Addition/alteration/replacement El Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
... . " CONSTRUCTION ` 1 & 2 family dwellings four or more residential units in
i & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: 0 Egress/lighting plan ❑ Other:
' JOB SITE INFORMATION,and••LO.CATION', . Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: (r t i 3 c S it La. a j Ault ii, Y %'d el FEE* SCHEDULE ` .
Suite #: - Bldg. /Apt - ,-') . Number of inspections per permit allowed
Project Name: tl/f e ,f -z,�e a U r" Descriptiou , I Qty Fee (ca.) Tots! 1
1. New residential - single or multi- family per j
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service Included:
1000 sq. ft. or less 145.15 4
•
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
-. DESCRIETION OF: WORK; ' 'l: s ervice an d/or feeder 90.90 2
S ervices or feeders - installation,
- ' Y" G ^ t", 4 alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
601 amps to 1 000 amps • 240.60 2
�I'RG1pTY :OWNER': ]. (] TE 454.65 2
Over 1000 amps or volts
Name: / 111 . ; ( -AI_ (V c_ e j't? 0 t Reconnect only 66.85 2
Address: / t, < ? 6 C • J i,,rj £ J, 4 i1 r Temporary services or feeders - installation,
`- ft' ✓1� alteration, or relocation:
City/State /Zip: • ( i ►�, ? rte? 200 amps or less 66.85 1
Phone: I - u Lt -- t __/J Y- Fax: 201 amps to 400 amps 100.30 2
401 to 600 amps
[33.75 2
sdjPl?IIIGAN �;;i';i: `._',, , ... ❑ CONTACT`I'F{RSON Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip:
B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 t "j P.?" • Y `S 2
Pnone: Fax: Each additional branch circuit j 6.65 2
E -mail: Misc.(Service or feeder not included):
!, :. J . ; Each pump or irr c 53.40 2
CONxRAC`ICOR::.. 53.40 2
:
�' °'�' ; -'' � ,. ,.� ; '''' Each sign or outline lighting •
Job No: Signal circuit(s) or a limited energy panel,
- alteration, or extension Page 2 2
Business Name: e JL.f . 0 e -1:1,-- j C. Description:
Address: I 5 n S , pin Y2i r bya � r
C1t /State /Zl /� Each additional inspection over the allowable in any of the above:
y p: ! V I /it I 1 _ Q ') 1� • �( ' 17 _ Per inspection per hour (min. 1 hour) 62.50
Phone: 9 ) 3 - Q yGt -- Lt / `1-(p Fax: Sb 3 - 8 Z-9 - 5 7 9-7 Investigation fee:
Other:
CCB Lic. #: 7 b c Lic. #: 3 — `f e t {-
- '= E[ectrical:I' erntif:Fee's *: ":' .' ..`' ':. ' . : • ,�
Supervising electrici s - Plan Review (25% of Permit Fee) $
Print Name: W;)); �„ K j�, S $ State Surcharge (8% of Permit Fee) $ -
,) ) - I _� -
-4 TOT PERMIT FEE $ i `, C. ) _
Authorized P tt
t W Lf Notice: This permit application expires if a permit is not obtiiined within
Signature: • Date: 180 days after it. has been accepted as complete.
*Fee methodology set.by Tri- County Building-Industry Service Board.
• (Please print name)
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CITY OF TIGARD ' 24 -Hour
BUILDING Inspection Ling; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Re.ueste• Co — AM PM BUP
/
Location 5 - 14 ! i - --EJLi Suite 9'61E5 MEC
Contact Person Ph ( ) 3s' PLM
Contractor Ph ( ) SWR �
BUILDING Tenant/Owner ELC , R 0 D /7 - ' R ?
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain i /
Slab Inspectio A9=i.� SIT
Post & Beam
Shear Anchors 4 /: t , i / , 0 6
Ext Sheath /Shear l V
Int Sheath /Shear
Framing
Insulation
Drywall Nailing /
Fi rewal I
Fire Sprinkler
Fire Alarm / /
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING -
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC AL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Ina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
`$ Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line I (�..., ��
ADA Date 4[21 Ins ector e � ?U LE- Ext
Approach /Sidewalk p
Other: -
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL