Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00362
DEVELOPMENT SERVICES DATE ISSUED: 10/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DC - 03800
SITE ADDRESS: 07190 SW SANDBURG ST 10 ZONING: I - P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Voice /Data. Job #61669.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MCCORMACK, WILLIAM L + DARLENE T NEW TECH ELECTRIC
7415 FAIRWAY LOOP 13970 SW 72ND AVE •
WILSONVILLE, OR 97070 PORTLAND, OR 97224
Phone: Phone: 503- 648 -1900
Reg #: LIC 41868
SUP 3849S
FEES ELE 26 -418c
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/20/200f. $75.00
[TAX] 8% State Surcha 10/20/200° $6.00
Total $81.00
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.
Issued By: 7) if_z_ 1 Permittee Signature: _ c Qj \O
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.
10/20/05 THU 09:13 FAX 503 648 3131 NEW TECH ELEC ftj001
11, ; 2-'
4. Electrical Permit A► lie >r c EI role O ITICI: USE OLY
City of Tigard iieQived _ � � �� y �
13125 SW Hall Blvd, OR 97223 Dam • / 0 f vf-- Permit No.: QQ - 03 c.
Phone 503.639.4171 Parc 503.598.1960 Plan Review
Inspection Line: 503.639.4175 OCT 20 ;�.' L L . �OadyBy Other Permit
Internet: www.ci.tigard.or.ns No W
Method: A S bee P 2 for
�j� ornuon
Supplemental Iat w
Addii .'s wA irkl, 7. • • • e .- .. - 111 :'ail I .4.
` LS I ''
❑ New construction
. ., • • .r : u,. en Please check all that apply:
❑ Demolition ID Other: ❑Service over 225 n
y " i ail II � n,: u m � ; 1 ,I c ,n � � �t�, - , . , ['Service over 120 �n Hurldn lora gover 10.000 sq, ft,
amps rating ❑
` , ' : of - and 2- family dwellings 4 or more new residmnal
❑ 1• and 2- family dwelling % Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps more
El Multi- family ❑ Master builder 0 Other:
- 'rF k d !. /Ill �a i rl ' L'} i� , �,�i .— . ILIU,LJ }� l{ Ir .. O an load persona ❑Manufaoured structures or
S
gt
........._ ,.. , . , ;.;- 0 � tghting plan � RV park
q� �� ❑Health -care facility ❑Other. .
Yob no.: - Job site address:
City /State: — P "'" 4 " /' Submit 2 sets of plans with any of the above.
L 1 The above are not applicable to temporary construction service.
Suite/blligJapt. no Project name: 4.1..00-044e-If- r4 . '. 1 L l h r up i + ,.:. _,. rp 1 i'
Q T Total "
Cross street/directions to job site: New residential single- or multi-ramify 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
11111 11 t
�.... ...._ ItI,,UIi'I, t 1VL .- nu fare red or modular
1 75.00 �� 2
red
Each manufactured or modular
`1.0t dwelling, service and/or feeder 90.90 2
D l « . i _11 , C ` Services or feeders installation, alteration, and/or relocation
200 arms or less
t i 1 { ,) • , I e a I .! yin, ,
' 2
. J _ - S _[:._ �'`i -' '... --... i . I I r{ �i 1 I j 201 ampsto400amps 106.65 2
Nom; 1 MGLD�•`� 401 amps to 600 amps 160.60
2
601 amps to 1,000 amps 240,60 2
Address: , e G : - _ W' Ow 1,000 amps or volts
454.65 1
City/Stste/ZYP: Reconnect only 66.85
Temporary services or feeders Installation, alteration, and/or
Phone: ( ) relocation
1 `, ' 200 amps or leas
Owner installation: This installation is being made on property that I own which is not f 6 '� 1
intended for sale, lease, rent• or exchange, according to ORS 447, 449, 670, and 701.
201 amps to 400 amps 1 00,30 2
signature: 401 amps to 600 amps 133 2
Owner._ fir,
I p r Y Date: Branch circuits — new, alteration, or extension, per panel
rL- ` t j 11ir , I 1. I ",- 6� t1'i.l
L..' - 1i i if , . , let, - - •: 2 .._. ..L h _ ,11im_ I �1i4 , UlN p l 1 'L: I ,L I al i y {i 2 w 1 ! 1 'I A.tee forbtan hC1xcuit
Business name: service or feeder fee, each
branch circuit 6.65 2
Contact name; B. Fee for branch circuits
without service or feeder fee.
Address: each branch circuit 46.25 .2
Esch add' l branch circuit 6.65 2
City/Starer Miscellaneous (so - ice or feeder not included)
Phone: ( ) Fax :: ( ) Pump or irrigation circle 1 53.40 l 2
E-mail: Sign or outline lighting 53.40 2
7 �rr Signal circuit(s) or limited-
; , 3" LI4, F�...f 7 7, 1 I CL 1`171 V t lrf4 4 1 L n 1 .( ,. . T i . l l r.. l . ...
-� -1: ..., ... r1y n'- -i .ILA,T ..,. T 1 ,... ';h� ; `! energy Panel. ahentioa or ,
Business name: New Tech Electric extension. Describe; Paget 2
Address: 13970 SW 72nd Ave Each t
additional inspection over allowable in any of the above
cit PO rt 1 and , OR • Pa inspection _ 62.50
Investigation per hour (1 hr min) 62.50
Phone: (5 0 3) 648-1900 Fax: 603 )6 4 8.3131 Industrial Pmt per hour
_ _ 73.75
41868 zit+ a ,''31irI rr.,r 'ly'1,,,
Electrical Lic.: 26-4182 Suprv. Lic.: 3 84 ( S 1 - Gl ;l: + ` ,'?',
CCB Lic.:
Subtotal
Suprv. Electrician signature, required: l 4 - .61111111111 Plan review (25% of permit fee)
Print name: f
La. Date: i b IA la State surcharge (8% of permit fee) le.
Authorized signature: TOTAL PERMIT FEB 01 .
This permit application expires if a permit is not obtained within ISO
print name: Dater days shat It has been accepted as complete
• Pee methodology set by T - County Building Industry Service nand
c�aulWLey�pe*avylp,C,p tp��n 11/03 • • Number of inspections per perish allowed.
ea0Je1Sr(Ion2/COmiwn
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: ELR2005 -00362
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639- 4171 gj
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' . ^__..
INSPECTION, FOR DATE: 10/27/2005 TIME: 7 :16AM PAGE: 87
SITE ADDRESS: \ 7190 SW SANDBURG ST 10 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCGORMAt K BUILDING
DESCRIPTION: Voice/I a. Job #61669.
OWNER: MCCORMA WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: NEW TECH EL' . TRIG PHONE #: 503 -64 &1900
Inspection Request Scheduled For: Date: 10/27/2005 Pour Time:
Code # Inspection Description - . ° ' —s: Contact # Message
135 Low voltage 119513-01 503-969-1711 Y
Corrections /Comments /Instructions: .• (Z_
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &[ N614)1 Lt • Date: 14 4 4. 0( Phone #: (503) 718- 2'41go