Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00324
In DEVELOPMENT SERVICES DATE ISSUED: 5/17/2005
�.� I l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104AB -00200
SITE ADDRESS: 11975 SW MORNING HILL DR ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 1 LOT : 008 JURISDICTION: TIG
Project Description: 4 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: 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:
GALLAGHER, VINCE DRYER ELECTRIC INC
11975 SWMORNING HILL DR. 9409 NE COLFAX ST
TIGARD, OR 97224 PORTLAND, OR 97220
Phone: 503 - 117 -5667 Phone: 503 - 771 -5667
FEES Reg #: ELE 26 -1142C
LIP 153466
Description Date Amount
SUP 2876S
[ELPRMT] ELC Permit 5/17/2005 $66.80
[TAX] 8% State Surcharge 5/17/2005 $5.35 REQUIRED ITEMS AND REPORTS
Total $72.15
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- - 332 -2344.
Issued By: , Permittee Signature: C Ci
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 FOR OFFICE USE ONLY
•
City o f Tigard
13125 SW Hall Blvd., Tigar. r-, G '�CD DatePlan /B : e5 5 0 0 Permit No../ _ ,,,,as,_. .
. ReceiRiev ved
Phone: 503.639.4171 Fax: '51 • 40/ 0 1 0/
:.' • Date/B : Other Permit:
Inspection Line: 503.639.4175�ll,� Date Ready/By: ®See Page 2 for
Internet: www.ci.tigard.or.us MAY 16 2005 Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction G tt n/re lacement Please check all that apply:
BU v V 1 �� p ['Service over 225 amps, comm'l ❑Hazardous location
El Demolition t er:
['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
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Multi- family ❑ Master builder ❑Other: ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
Job site, address: i'1 1 S Sw yyto ❑Health -care f acility ['Other:
Job no.: o7 3
1 ` QNIN� Kau- Submit 2 sets of plans w any of the above.
City /State /ZIP: 't-i 6,08.9 a Cog- 1-11-2-9 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: C
�6. FEE* SCHEDULE
Description I Qty. I Fee. I Total I *'
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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
U _ n ( N � dwelling, service and /or feeder 90.90
l � 2
`� � �.�' Q U.) r � Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
. , r n d/ La( ' % J 401 amps to 600 amps 160.60 2
\J,
Name: V�t/C�., 601 amps 1,000 a s to 1,000 am s 240.60 2
Address: CD J Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
� relocation
^
Phone: (502 ) L (C6147) Fax: ( ) 200 amps or less 66.85 I
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
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
— 13. Fee tar branch circuits
Contact name: without service or feeder fee, Q
each branch circuit 46.85 4'p• 2
Address:
Each add'l branch circuit 3 6.65 (q,9S 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: D R �, -1, i ' c.
Address: b Q J Q 63 60' Each additional inspection over allowable in any of the above
1`' V Per inspection 62.50
City /State /ZIP: 2b(zrr► rpt sD QZ. q,28t. Investigation per hour (I hr min) 62.50
Phone: ( 553 ) 1 / I + - S, b"1 Fax: ( )11 y - ID4 6 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: ISs q 6 ( Electrical Lie.: 24- 1142,L Suprv. Lie.: 28112S Subtotal 4 t 0 p
Suprv. Electrician signature, required: /`' ,, Plan review (25% of permit fee)
Print name: rl ('�,.1 lbS Date: 5 _` 27(:). State surcharge (8% of permit fee)
GA ` TOTAL PERMIT FEE 1 2 , is
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:\ BuildingWermits \ELC- PermitAppdoc 12/03 440- 461ST(I0 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELG2005r00324
13125 SW Hall Blvd., Tigard, OR 97223
AI; DATE ISSUED: 5!17!2005
Phone: (503) 639- 4171 l o-lil .
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!!+�
INSPECTION WORKSHEET FOR DATE: 9/27/2005 TIME: 7:05AM PAGE:
SITE ADDRESS: 11975 SW MORNING HILL DR CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 1 LOT #: 008 TYPE OF USE:
PROJECT NAME: GALLAGHER
DESCRIPTION: 4 branch circuits.
OWNER: GALLAGHER, VINCE PHONE #: 503.117 -5667
CONTRACTOR: DRYER ELECTRIC INC PHONE # : 503- 771 -5667
Inspection Request Scheduled For: Date: 9/27/2005 Pour Time:
• Code # Inspection Description Confirm # Contact # Message
199 Electrical final 016715 -01 503-590.7381 N
Corrections /Comments /Instructions:
;) Z i e > A4 )-- l tt di tek bleeti.g.- (r.e ce, it - , . f f,e , € .e b)
1 1 1 04 -5 e 6 > 5S solee
(----
Q 1 A/0
s -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
ft
Inspector: Date: Phone #: (503) 718-