Permit t^ {e- CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
► PERMIT #: ELR2006 -00094
� DEVELOPMENT SERVICES DATE ISSUED: 4/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S125CD -08900
SITE ADDRESS: 07524 SW RED CEDAR WAY ZONING: R -4.5
SUBDIVISION: 'JACKSON WOODS LOT: 004 JURISDICTION: TIG
Project Description: All encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ALL ENCOMP X
TOTAL # OF SYSTEMS:
Owner: Contractor:
BRENT & AU LAWSON OWNER
9990 SW LAUNDAU PL
TIGARD, OR 97223 •
Phone: 503- 260 -6366 Contact #:
Reg #:
FEES
Description Date Amount
12? gi o
Total REQUIRED ITEMS AND REPORTS
Vie _ , F Itt "" /A-An Da " 61- 9 00 5 - 004 -7
•
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 dir- ..: ions to OUNC at 503 - 246 -6699.
Issued y: � �r; Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own ich i of intended for sale, lease, or rent.
OWNER'S SIGNATURE: „„vie / DATE: L4 -2-5 'O6
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 FOIR of i ic,i•: list: O\I.Y
City of Tigard Rimed y Permit No.: i s �,.,
II q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 • Date/B . Other Permit: •
f I G n It D Inspection Line: 503.639 Date Ready/By. . •
Notified/Method:
Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION oft- 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
❑ Multi - family ❑Master builder ['Building over three stories ❑Feeders, 400 amps or more
❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
Job no.: Job site address: "f j a,// / / ❑Health -care facility ❑der:
h. . P) ` / = l J 6gwe Submit 2 sets of plans with any of the above.
City/State/ZIP: 64. 2 7) 0(2_ / The above are not applicable to temporary construction service. .
` ji _ FEE* SCHEDULE
Suite/bldg /apt no.: Project name: t O t, , 0 � 612) De Siphon I Qty. I Fee. I Total 1 ••
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'1500 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
(/��-�i ) A -( N( J P s/ 1 ^ k� Joe_r-ine- dwelling, service and/or feeder 90.90 2 fTw I Q 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
� � 1, 401 amps to 600 amps 160.60 2
Name: . 7- - A91 ( 601 amps to 1,000 amps 240.60 2
Address' 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: ( ) I Fax: ( ) relocation
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
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 _ 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 •
Business name: (,� �l U, \
p� EC_ extension. Describe: Page 2 2
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Investigation per hour (1 hr min) 62.50 .
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal: 75—a'
Suprv. Electrician signature, required: Plan review (25% of permit fee):
State surcharge (8% of permit fee): C(� • . •
Print name: '.--' Date:
/ 1/8- TOTAL PERMIT FEE g/, Store
Authorized si : � r J�G / , 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:\ Building \Permiis\ELC- PennitApp.doc 03/23/06 44044615T(11/05/COM/WEB
•
Electrical Permit Application - City of Tigard
Page - Supplemental Information
LIMITED ENERGY PERMIT FEES:
1 RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and, Air Conditioning System*
❑ Vacuum Systems*
❑ Other
COMMERCIAL WORK ONLY:
Fee for each commercial . • $75.00
. system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
..❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ - Intercom and Paging Systems
❑ Landscape Irrigation Control*
El. Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling .
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
•
for all other installations
•
I :BuiIding\Pamits ELC- PcmitApp.doc 03/23/06 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006 -00094
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2006
Phone: (503) 639 -4171 i l �h i
Inspection Requests (24 Hrs.): (503) 639 -4175 ^__..
INSPECTION WORKSHEET FOR DATE: 6/3012006 TIME: 7:01AM PAGE: 10
SITE ADDRESS: 07524 SW RED CEDAR WAY CLASS OF WORK:
SUBDIVISION: JACKSON WOODS LOT #: 004 TYPE OF USE:
PROJECT NAME: JACKSON WOODS
DESCRIPTION: All encompassing low voltage.
OWNER: LAWSON, BRENT & AUTUMN PHONE #: 503-260 -6366
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/30/2006 Pour Time:
Inspection Description Confirm # Contact # Message
199 Electrical final 032516 -04 603-914-8434 N
C ions /Comments /Instructions:
.:-
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 "c8 Date: 6 31 64 Phone #: (503) 718- /A$( /
CITY OF TIGARD if
BUILDING DIVISION - PERMIT #: ELR2006 -G0094
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/200e
Phone: (503) 639 -4171 a t'
Inspection Requests (24 Hrs.): (503) 639 -4175 F '! (—
INSPECTION WORKSHEET FOR DATE: 502006 TIME: 7:07AM PAGE: 16
SITE ADDRESS: 07524 SW RED CEDAR WAY CLASS OF WORK:
SUBDIVISION: JACKSON WOODS LOT #: 004 TYPE OF USE:
PROJECT NAME: JACKSON WOODS
DESCRIPTION: All encompassing low voltage.
OWNER: LAWSON, BRENT & AUTUMN PHONE #: 503 -260 -6366
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 I..ow voltage 029472 -03 503 - 914 -8434 N
Corrections /Comments /Instructions:
X , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 : A r1 ti Date: 4 l` 0 b Phone #: (503) 718- 2-
4