Permit C ITY OF TIGARD ELECTRICAL PERMIT
• • { PERMIT #: ELC2006 -00333
DEVELOPMEN SERVICES DATE ISSUED: 6/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171
PARCEL: 1S135CD-10900
SITE ADDRESS: 09735 SW NACIRA LN ZONING: R-4.5
SUBDIVISION: NACIRA PARK LOT : 009 JURISDICTION: TIG
Project Description: 2 BR. CIRCUITS TO NC AND GFI
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:
BRIAN HOLMAN HILLSBORO ELECTRIC
9735 SW NACIRA LN 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 639 -9062 Contact #: PRI 503 -439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 - 4399C
[ELPRMT] ELC Permit 6/14/2006 $53.50 LIC 134481 • [TAX] 8% State Surcharge 6/14/2006 $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: ,)1 ca .
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.
06-12-'06 16:12 FROM-Hillsboro Electric 503-601-3680 T-649 P002/004 F-875
.XINSti l'Olz 01 t O\1.1
• City of Tigard rs% 1 x 1
13125 SW Hall Rivd., 71gard. OR 97
EU 1 V F il Nan Re 616r
6 -A1111121r pe Ol t: - .. ' ' 33
Phone: 503.639.4171 Fax: 503.598. 96 '‘.. 1H %. '' 1 i i . \ Date/By: lnni
Inspection Line: 503.639.4175 .;.,t4,1- '''.! 1 DM RtadY(BY:
e:1 I RI See Poen 2 foe
Internet: www.d.tigard.or.ua pli i '6. 20'2' Notified/Method: els J SuPPlea Information
. . .. . . . „ . .. . ..
'.. ,: :: ,, ,:,,, , ; .,":: . ,.: ,..1 , • ' ' : ,,,,, .1, , _••.'71 OF, W:gitki . ii' ....' ..* :: : .,..;:::,:, ,: :: , :: .: : , : ' , ' : : '' ' ' '' , . ',. PLAN : 1***: E.: ...:.,...,: : .'. :.. .. , ; . ..• . . •
1:1 New D construction ad Adavvatatt clit6 onkdad.MOIN Please check all that apply:
CIService over 225 amps. comm'l ['Hazardous location
0 emo _1. ,
0 efin - . -
° Service over 320 amps — rating ['Bulldog over 10,000 s ft
o. .,
:. '. ' ' '' ' ...i i: ' • :.: '•:, ..cAis :: :i of I and 2-family dwellings 4 Of More new residential
4 1 and 2 dwelling [] Commercial/industrial 0 Accessory building LiSyStem over 600 volts nominal units in one structure
011uilding over three stories ['Feeders, 400 amps or more
Multi 0 Master builder 0 Other:
00ccupant load over 99 persons [Manufactured structures or
;,.;",,,y::: :PO i;PiNOWICIAT.I:441k1OV.4779.t4: . ..;.‘.:...::;..:.r •U::' ElEgress/lighting plan RV park
Job no.: : Job site address; I / ' [Wealth facility ['Other.
. If 4 4. Submit 2 sets of plans with any of the above.
•
City/State/ZIPrn /AA v(A irit ...... I:3 The above are not applicable to temporary construction service.
t 3
:::;!::;.:;;::;:..)4::;!:';:::". :;' ;:;!; .. . ;. . ;:.
Suite/bldg/apt. no.:J Project name: tilk & A
ameeptiou I Qty. I Per. 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'l 500 sq, ft, or portion 33.40 I
Limited energy, residential 75,00 2
Tax map/parcel no.:
Limited energy. non-residential - 75.00 2
:::::,!Ii',,,'‘F.I''!:,',.:::.'.:•:.;':::;:,",':..;,,:.,,,'•.::::;'7PK4041n*.I.S.::0*;:.*010‘ i' ..!,:',.' Each manufactured or modular
f /` 4 17 1 C—A _ dwelling service and/or feeder _ 90.90 2
Services or feeders installation, alteration, and/or relocation
...
200 amps or less 80.30 2
•AOX ' : '''';';::::::::: , .I 2 ani 7 am:: 106.85 2
160,60 2
601 amps to 1.000 amps _
.
240.60
2
Address: sA lAkt.. ,.0 1, i tea)vte 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
Phone: (W)) (19 el iy eei,. 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: bate: Branch circuits — new, alteration, or extension, per panel
itZli:::;1 i; IkkArr.:.:: i::r;:;:;: it;:" k Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
..„
R. Pee for branch circuit
Contact name: s
without service or feeder fee, \
46.85 qu.'5 2
Addr fir% branch circuit
ess:
9-- Each addl branch circuit ‘ 6.65_1 ,-(J') 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 Signal circuit(s) or limited-
:' i'i:::: H . :! . ;:l'I' ext enera
ension an D eL es alt era tion cri be . or Page 2 2
Business name: LIC Elt ay
.Address: ) Cve,
Each additional inspection over allowable in any of the above
kA .• - D
Per inspection 62.50
City/State/Z1P: st ro 0, ari — Investigetion per hour (1 hr min) 62.50
1 i.
Phone: ( r 1 ..—•• I Fax: ( Industrial plant per hour 73.75
,, ; , . , . !, .....Y: ,.., q*C.IECTROJACPEEMMBEES. , ........, -. ..... , ,'
CCI3 Lic.: 1 44 L4g El ' 4 .. - Lic.: , :•• .• 4, Suprv. Lie,; Licqi
Subtotal C9). 5
Suprv. Electrician signature, require \ ' Plan review (25% of permit fee)
di .........., A
State surcharge (8% of permit fee) ,..1 .11
Print name: Date: ( j rt.
• TOTAL PERMIT FEE 9 '
Authorized signature: Nt
This permit application expires it a permit Is not obtained Milan 180
_ ...
days atter it has been accepted as complete
Print name; I Date: • Fee methodology set by Tri-Couaty Building Industry Service Board
- •• Number of inspections per permit allowed,
iMuildinglPenniWELC-PennitApp.ders 17/03 440-461stawavcomAvEa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006.00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611412006
Phone: (503) 639 -4171 / ito
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7:05AM PAGE: 53
O
SITE ADDRESS: 09735 SW NACIRA LN CLASS OF WORK:
SUBDIVISION: NACIRA PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: HOLMAN
DESCRIPTION: . 2 br. circuits to AC and GFI
OWNER: HOLMAN, BRIAN PHONE #: 503-639 -91162
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503 - 439 - 9666
Inspection Request Scheduled For: Date: 7/1212006 Pour Time:
Code # Inspection Description Confirm # Contact # sag
199 Electrical final 032930 -02 503-538-2953 Y
i 1 1
Corrections /Comments /Instructions: V- /
Am?"' eie__ e__, F/Ptie ____/
____Ille' Ft&L e__ brse 0A, e-_,c
4- I 0 ,ti r ti Cl. -E_
di sib
I% PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e_ IL/1 Date: 7 l z_'a 6 Phone #: (503) 718- z6 Y9'