Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00580
COMMUNITY DEVELOPMENT DATE ISSUED: 8/20/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104BA -14600
SITE ADDRESS: 13655 SW NORTHVIEW DR ZONING: R -
SUBDIVISION: CASTLE HILL NO. 3 LOT : 176 JURISDICTION: TIG
PROJECT: NG
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:
THOMAS NG JSM ELECTRIC
13655 SW NORTHVIEW DR 7717 SW SKYHAR DR
TIGARD, OR 97223 PORTLAND, OR 97223
Phone: 503 - 524 - 5054 Contact #: PRI 503 - 866 -7304
FAX 503 - 244 -4397
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 8/20/2007 $66.80 LIC 168451
[TAX] 8% State Surcharge 8/20/2007 $5.34 SUP 5104 -S
Total $72.14 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 = • - .an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul -s are set forth •• O - 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain c• - of these rules or direct questions to OUNC at
503.246 •699 or 1.800.33 A .
Issued :y: r I, r * Permittee Sign.° ure: • a d
J
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:
C ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ■ ; DATE: e
LICENSE NO: • 5/o 5
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.
Aug 07 12:47p Jeffrey S. McGinnis 503 -211 1397 p.1
•
h i ECEB�VED
Elect: zeal Permit Applicati rcllz t>rrlcF: I:sr: t>.1.,.
City of Tigard Ana . Received 67 f-Ge. 7�$$0
� 13125 SW Hall Blvd., Tigard, OR 9722Pu u '' 0 2001 i� Pest No.:
• Phone: 503.639.4171 Fax: 503•598J9 y OF TIGARD Date/By Other Permit
www.tig,ard-or.gov l �
Internet Line: 503.639.4175 BUILDING DIVISION I`l0� Ready/By: �/ t � 1 0 See Page
tatInformation
t: gardor.gov
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 1< 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 ID Floating building,.
CO 1 - and 2 - family dwelling ❑ Commercial/industrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ". "E", "1 -2 ", "1-3 ",
Job no.: I lob site address: 13655 SW Northview Drive 100HP or more. occupancy.
❑ Six or mare residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Portland OR 97223 ❑ Healthcare facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Desolation I or.. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. It or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. R.) 75.00 2
Limited energy, multi - family
Four branch circuits residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
I 200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Thomas Ng 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 13655 SW Northview Drive Over 1,000 amps or volts 454.65 2
City/State/2W: Portland OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)524-5054 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 70I. 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 l
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: witho service or feeder fee, 1 46.85 46.85 2
first branch circuit
Address: Each add'l branch circuit 3 6.65 19.95 2
City /State/ZIP' Miscellaneous (service or feeder not included)
Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone:
( ) I 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: JSM Electric
Signal circuit(s) or limited -
energy panel, alteration, or
Address: 7717 SW Skyhar Drive extension. Describe: Page 2 2
City/State/ZIP: Portland OR 97223 Each additional inspection over allowable in any of the above
Phone: (503) 866-7304 I Fax: (503) 244.4397 Per
Invnv estigg iation tion 62.50
per hour (1 hr min) 62.50
CCB Lic.: 168451 I Electrical Lic.: C 18 Suprv. Lic.: 5104S Industrial plant per hour 73.75
2 /�� v ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: �)ff`_ Subtotal: 66.80
Print name: Jeffrey S. McGinnis 1. Date: 08 -18-07 Plan review (25% of permit fee): NA
State surcharge (8% of permit fee): 5.34
Authorized signature: TOTAL PERMIT FEE: S72.14
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
• Number of inspections allowed per permit.
I :MeliairslpamioELGPera 05/23/06 4404615T(11/03/COM/WEB
CITY OF TIGARD <.
BUILDING DIVISION PERMIT #: ELC2007- 00'.80
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8120/2007
Phone: (503) 639 - 4171' ii jll��
Inspection Requests (24 Hrs.): (503) 639 -4175 F ' ..
INSPECTION WORKSHEET FOR DATE: 1/24/ 3008 TIME: 7 :02AM PAGE: 84
SITE ADDRESS: 13055 SW NORTHVIEW DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 3 LOT #: 176 TYPE OF USE:
PROJECT NAME: NG
DESCRIPTION: (4) branch circuits.
OWNER: NG, THOMAS PHONE #: 503 - 524 -5054
CONTRACTOR: JSM ELECTRIC PHONE #: 593.866 -7304
/
Inspection Request Scheduled For: Date: 1/24/2008 Pour Time: /4'
Code # - • - ' • : = iption Confirm # ontact # Message r!-. Q
t.
199 Electrical final 063668-01 503 524 -5054 Y o
Corrections /Comments /Instructions:
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The electrical installatin
/ (0)1711R-- on thire n defects
an ins p0i gall be corn note Pection re
est rngd led and
�alender do l t s Per p within 20
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AR 918- 271 - 0039
PASS G,N�\� 1'1'3 - N � O 1 1-S i S S k)
_ // ❑ PARTI : " ❑ CANCEL ❑ NO ACCESS
21 , IL ❑ C r / FO : r ; TIO ■ ❑ ADDITIO • L FEES A > ESUED
•
Inspector: D / .1` Phone #: 503
pecto . / � ate 2 I ( )
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CITY OF TIGARD 4
BUILDING DIVISION �� PERMIT #: ELC2007 -00580
13125 SW Hall Blvd., Tigard, OR 97223 `' DATE ISSUED: 8/20 /2007
Phone: (503) 639 -4171 itt a�l�
Inspection Requests (24 Hrs.): (503) 639 -4175 F:
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AM PAGE: 57
SITE ADDRESS: 13655 SW NORTHVIEW DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 3 LOT #: 176 TYPE OF USE:
PROJECT NAME: NG
DESCRIPTION: (4) branch circuits.
OWNER: NG, THOMAS PHONE #: 503 - 5245054
CONTRACTOR: JSM ELECTRIC PHONE #: 503 -866 -7304
Inspection Request Scheduled For: Date: 8/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054382 -01 503. 524.5054 Y 33° rU illf-)
I 3
Corrections /Comments /Instructions: Ca, 4,
fitAbz omAir 11 0 4- ( 40x)
z) 5,1 `k4 c o ,.
1 F rz
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL C . LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t► •
Inspector:
01"- Date: ` Phone #: (503) 718-