Permit CITE' Of TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00292
COMMUNITY DEVELOPMENT
DATE ISSUED: 5/22/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DA -03700
SITE ADDRESS: 15326 SW MCINTOSH TERR ZONING: R -7
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT : 032 JURISDICTION: TIG
PROJECT: MCDANNIAL
Project Description: Installing (2) branch circuits for A/C and Furnace.
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:
MICHELL MCDANNIAL OREGON INTEGRATED CONTRACTING
15326 SW MCINTOSH TER 6720 S. KNIGHTS BRIDGE
TIGARD, OR 97224 CANBY, OR 97013
Phone: 503 - 313 -3980 Contact #: PRI 503 - 880 -8649
FEES
Description Date Amount Reg #: ELE 3 -534C
[ELPRMT] ELC Permit 5/22/2008 $53.50 LIC 158482
[TAX] 12% State Surchar 5/22/2008 $6.42 SUP 38535
Total $59.92 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:
L
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.
Electrical Permit Application
City of Tigard o Received 5 gr o8 6�_ Permit No.: F'� =—
D
• 13125 SW Hall Blvd., Tigard, OR 97223 D� o P lan R evview /.�� � �,�� j �`.,
Phone: 503.639.4171 Fax: 503.598.1960 0 Date/By: Other Permit: / - I t7 fitJ 0' W�`�
r I G n It p Inspection Line: 503.639.4175 SQr ` "mate Ready/By: lens: ® See Page 2 for
Internet: www.tigard- or.gov ...„0...„001 e Q . V 1 5 N otified/Method: Supplemental Information
E OF WORIji ►T L PLAN REVIEW
❑ New construction dd /alteration//replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE E INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
3 Z 6p S a} ( 100117 or more. occupancy.
Job no.: Job site address: l 5 / i LTv TC ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Q ^Y I .rfJ '7 Z Z ❑ Health -care facilities.
0 Supply voltage for more than
!J, ` ❑ Hazardous locations. 600 volts nominal.
Sutte/bldgiapt no.: J Project name: 14 C 1 a ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description
I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
/ / Limited energy, multi - family 75.00 2
/
IC C k-I- f j ��e G� residential (with above sq. ft.)
I Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
[ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: / (�/ e,,/ 7141,i44/ f 1 401 amps to 600 amps 160.60 2
fi 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, t
first branch circuit 46.85 /,`G • 2
Address: Each add'l branch circuit / 6.65 ( .V7 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: OIC Electric inc Signal circuit(s) or limited -
energy panel, alteration, or
Address: 6720 S Knights Bridge Rd extension. Describe: Page 2 2
City/State/ZIP: Canby, OR 97013 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 8808649 Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: IM482 Electrical Lic.: 3 - 534c I Suprv. Lic.: 3853s Industrial plant per hour 73.75
/ ELECTRICAL PERMIT FEES
Suprv. El i signature, required: Subtotal:
e---- 'S - 5 o
Print name: Steve L Morris Date: 5 2 �7pe,e5' Plan review (25% of permit fee):
State surcharge (12% of permit fee): 6,1 s ip?'
Authorized signature: TOTAL PERMIT FEE: 5 q 2
This permit application expires if a permit is not obtained within 180
Print name: — 6.-4 1 0.--s — ., 9? 0 Date: C72 Z Qe• i - ' days after it has been accepted as complete.
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2008 -00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502/2008
Phone: (503) 639 -4171 1 h
Inspection Requests (24 Hrs.): (503) 639 -4175 "' —
INSPECTION WORKSHEET FOR DATE: 6/17/2008 TIME: 7:00AM PAGE: 40
5 zarr- - 0i , 6/- 44
SITE ADDRESS: 15326 SW MCINTOSH TERR CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT #: 03 TYPE OF USE:
PROJECT NAME: MCDANNIAL
DESCRIPTION: Installing (2) branch circuits for NC . id Furnace.
OWNER: MCDANNIAL, MICI-IELL PHONE #: 503-313 -3980
CONTRACTOR: OREGON INTEGRATED CONTRACTING PHONE #: 503880 -8649
Inspection Request Scheduled For: Date: 6/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 071385 -02 503.233-1779 a.
Corrections/Comments/Instructions:
:5b t o io 44../lw 0 A- u, 1 . 44 - — d, r z- 3 . g -m,/' 5
`r PAS " PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 _ Date: 17 3 Phone #: (503) 718 - 0 6 -Vs