Permit • ` CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00289
m, �k ' l l n DEVELOPMENT SERVICES DATE ISSUED: 4/29/2005
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: Install (3) receptacles.
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: 2 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:
MCCORMACK, WILLIAM L + DARLENE T NEW TECH ELECTRIC
7415 FAIRWAY LOOP 20811 NW CORNELL RD #400
WILSONVILLE, OR 97070 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 - 1900
FEES Reg #: LIC 41868
3849S
Description Date Amount SUP 26
ELE 26 - 418c
[ELPRMT] ELC Permit 4/29/2005 $60.15
[TAX] 8% State Surcharge 4/29/2005 $4.81 REQUIRED ITEMS AND REPORTS
Total $64.96
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: �? .2 L , Permittee Signature: sc
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.
04/29/05 FRI 09:19 FAX 503 648 3131 NEW TECH ELEC 0 001
Electrical Permit ApplicafiCEIVED
fort (*Flo:, USl•: ()Nix
City of Tigard
13125 SW Hall Blvd., Tigard, OR 97223 PR 2 20 i . - )� j
Permit No_: _9_ / 0 (/a •
Phone: 503.639.4171 Fax: 503 598.1960 . ,-, ; Plea Review
la9ptxtionLane: 503.639.4175 i '`` - '1 . ; >Jii�{�' DnalB . Other Permit:
Bonnet: ww 503.63or.us CITY OF TI r:_! _:� nerelee9ayray hale DING DIVISION Noo�dtmemnd: ®SeePaCe2t
r.'.Jtjl r,;.
p d Information
El New construct . - ...:.... 1 '''e-: �`i,'. ' i,; ..�:.,� "J-
on/alte apply:
4 _ ,
� AdtitG rauon/replat:ement Please check all - - .. ..r, . • , -;•. _�:,'J
❑ Demolition
_.. ❑ Other ['Service that app
ova 225 mops, y
;:i � ; i , - (' ovcr320 co
_..... I of 1- and 2 -femIy
cps �� ❑ 13aildngover 10,000 an,. ft,
O 1 - and 2- family dwelling L2rComnaercial/industrial - o Accessory building dwellings 4 or more new residential
El Multi family ❑ Accesso bulldin ❑Syerem over 600 volts nominal amiss in one structure
Master builder over three
Mai ❑Other
['Building a stories ❑Fete err,
11' 1 ? iiSi; "ri ;i;+F,j : - is -L i i; i i 'f !.1i . ' '•v ' " - _. -- ❑O load over 99 400 amps or more
, 2) ... :. ,.. ......._:__. ,,,• ,i.,I ,:. '-i persons ['Manufactured par structures or
j ❑Bgre�/tighting plan RV k urrd
lob no.: 1 - r. )0 Job site address: facility r
'7141 0 SAN .: J • , R olimlrh. sets of n o sbo er:
Submit 3,. sets of plans with any of the stave. _
City/State/ZIP:
1 j 4,AW 0g^ 6 1 - 31-2-77 ' I O The above are not applicable to c
Suite/bldgJapt_ no.. Project a�'P rary construction service.
ectname: i � - N h `K -
- 11:6:11 , -':'1 N.: tIitin oi' r : } 1
Cross sheet/directions to job site: nmsetio
Qtr. Yee Tani
New residential single- or multi - family dwelling unit.
Includes attached garage -
Subdivision:
1,000 sq. ft. or less ] 145.15 1 4 �
Lot no.: Ba. add'I 500 sq. ft. or portion
Limited energy, residential 75.00 2 MI_ ]nap/parctl no.: , 33A0 1 -
.._.. •. �ti'2llli .i'fL.. _!'p Limited lr•P ,� . non
_.. .L�.: -.: 1' ": 'v Emil manufactured ".:..�. Or modular
■ L-L� -L Pr e4 LES dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation or
-- - - -... . , . . . ., .. , :1���. ,,. . , - r'.li1 _ ;:=-° I 201 amps tod00arnps
• � " 106.85 _
2
Name: 1 . M L�A4ti�fAG� t�ev a01 amp to 601 amps 10 1,0 00 amps amps 160.60 2 -
Name: Address: mps 2x0.60' -
Over 1.000 _
( 6 2
' ' ■ amps or volts 454.65 2
City /StatrJZ>p; -/-0.0.4e,43, le- � Reconnect only 66.85 2
Phone; (sods) services or feeders Itastallation, alteration, and/or
G,2 yoy0 Fax: ( relocation
Owner i nstallation: This installation is being made on property that I owes which is no[ - 201 amps or less 66.80 1 400 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - of craps to 600 scrips
100.30 2
Owner signature: Date , 401 amps m 600 amps 133.75
L II v e-1 i , :,‘-',''-• r i f 1 Branch circuits - new, alteration, or extension, per panel
._— - '•" ' ',:, _ 4 • ' i � - i ` : c � . i " ^ .. ,-...‘'..1.- v 4 - 1 ! � _' � I . , 1 A. Fee for branch circuits with
Business name: cervix 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 I 46_115 Lit , � 2
CiryfS tart ILIA: Each add' I branch circuit z.- _ _ 6.65 _ 1 3.3 0 2
miscellaneous (service or feeder hot included)
Pump or irrigation circle 53.40
Phone: ( ) Fax :: ( ) 2
E outline li ghting -
Sign or outli
- , ,, ,�,...,-771',-, _ 53.40 2
.. • -, , ,r. !'•:, - , - -.T • I'. Signal none! S O
C'lr ;Y i - r c - r . - " ; inr. or limited-
;.;:1 ".,.L.-:: r: '[:: :,ca - .._ " _ . .., �1 ;1.1L a2,..,• �ln.. ±: _, j!_ ,.,,.0.:n„._, . },, ; tivr�� _ rGd�
=i!.. ,. _� }, - '- . 1 ? . etlergy panel alteration or
B .CSS name: TECH ELECTRIC, INC wt tens ioa. Describe: , Paget 2
Address: 20811 NW CORNELL RD STE 400 Each additional Inspection over allowable in soy of the above
City /StatelLlp: fi ILLSAORO OR 9 71 2 4 _ Per inspection 62.50
_ Iavcstigadon per hour (i in. rein) 62.50
Phone: ( ) 503. 6 4 8. 1 9 0 0 Fax: ( ) 503.648.3131 Industi� plant per hour 73.75
CCE Lic.: 41 8 6 8 Electrical Lic.: 6 :5 y'bs` -g uy 'catad�i ,1(IC,2' n;,, 7 T coq
-41 8C Suprv. Lic.: 3849S ''.�:1� �i����i, } .a,i�',nr::
Suprv. Electrician signature, required `/ Subtotal ( - / 5
: 0.4,44:110„.. Plan review (25% of permit fee)
Print name: -
PHIL HANSON Dare: it - 2.1-0s- _ State surcharge (
, Authorized signature: TOTAL pE T FEE Lt /// r
This permit application expires If a permit Is not obtained within 180
Print name:
Date: days after It has been accepted a9 cemptete
• Fee methodology set by Tri- County Building !Maury Berme Board
I:utulwmgWettttdeuE11Z -P ,y,p,doa tZ/os '• Number of inspectloru per permit sn
t Te�1ST r-- *�+dlsrtlomnca
1
CITY OF TIGARD *
= BUILDING DIVISION . . PERMIT #: r~LC2005•O0289
13125 SW Hall Blvd., Tigard, OR 97223 i DATE ISSUED: 4/29/2005
Phone: (503) 639- 4171 °'�a�� �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 1.38
,
SITE ADDRESS: 07100 SW SANDBURG ST 10 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE: -
PROJECT NAME: MCCORMACI . BUILDING
DESCRIPTION: Install (3) receptacles.
OWNER: MC(X3RMACK, VALLIAM L. & DARLENE T PHONE #:
CONTRACTOR: NEW TECH El EC URIC PHONE #: 503648 -1900
Inspection Request Scheduled For: Date: 10i31/200g4 Pour Time:
Code # Inspection Description Confirm # Contact # Message G
'199 Elects' al final 0197t14 -01 W3-969-9441
369.9441 N
Corrections/Comments/Instructions:
•
•
•
•
0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
N Inspector: Il J Date /O 3- O f Phone #: (503) 718 -