Permit w
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005-00381
lra DEVELOPMENT SERVICES DATE ISSUED: 6/6/2005
A 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 101 DC -03800
SITE ADDRESS: 07190 SW SANDBURG ST 20 ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 12 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: SIGNAUPANEL:
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: 11 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 L H MORRIS ELECTRIC INC
7415 FAIRWAY LOOP 7051 SW SANDBURG ST, #100
WILSONVILLE, OR 97070 TIGARD, OR 97223
Phone: Phone: 503 - 639 -2334
FEES Reg #: LIC 1838
ELE 20 -39C
Description Date Amount SUP 3006S
[ELPRMT] ELC Permit 6/6/2005 $120.00
[TAX] 8% State Surcharge 6/6/2005 $9.60 REQUIRED ITEMS AND REPORTS
Total $129.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 AR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 246 -6699 or p00-3V-2344.
Issued By: Permittee Signature: - ( ,
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.
•
71101
Electrical Per t•'., onlication FOR OFFICE USE ONLY
City of Tigard �+'I Date/B 4 O �I _ - 6 -- vv3S'1
13125 SW Hall Blvd., Tigard, R 97223 Plan Review
t^
Phone: 503.639.4171 Fax: 8 6960 A A Date/By: Other Permit:
Inspection Line: 503.639.4175 e ' 1005 „ _�_ n' I� Date Ready/By: t { " " ""���� ICJ See Page 2 for
Internet: www.ci.tigard.or § x Notified/Method: Supplemental Information
pp r 7,
BUIL jp #% 4Rf ' WORK • . PLAN REVIEW
❑ New construction ddignalleration /replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 - 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 ❑Other: ❑Building over three stories OFeeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: 71101 Job site address: 7190 SW SANDBURG ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above.
City/State /ZIP: T IGARD OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: PERLO MCCORMACK PACIFI FEE* SCHEDULE
Deserlptlon I Qty. I Fee. I Total I ••
Cross street/directions to job site: 72ND AVE 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. R. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
. dwelling, service and /or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
OFFICE REMODEL 200 amps or less 80.30 2
❑ PROPERTY OWNER , ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 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
relocation
Phone: ( ) Fax: ( )
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: 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: L.H. MORRIS ELECTRIC INC branch circuit
B. Fee for branch circuits
Contact name: SCOTT CARLSON without service or feeder fee, 1 46.85 46.85 2
Address: each branch circuit
Each add'l branch circuit 1 1 6.65 73 „ 1 5 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: (503) 631 -2334 Fax: : ( ) Pump or irrigation circle 53.40 2 • Sign or outline lighting 53.40 2
E -mail: _ Signal circuit(s) or limited -
vcvcx vcmnVCX ?f /W energy panel, alteration, or
extension. Describe: Page 2 2
Business name: L.H. MORRIS ELECTRIC INC
Address: 7051 SW SANDBURG ST #100 Each additional inspection over allowable in any of the above
Per inspection 62.50 120.00
City/State/ZIP: TIGARD OR 97223 Investigation per hour (I hr min) 62.50
Phone: (503) 631 -2334 Fax: (503) 620 - 7405 Industrial plant per hour 73.75 9 . 60
ELECTRICAL PERMIT FEES* 1 L • (DI)
CCB Lic.: 1838 Electrical Lic.: 20 -39C Suprv. Lic.: 3006S Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Dat� �I State surcharge (8% of permit fee)
GARY EOPLES 5
TOTAL PERMIT FEE
Authorized signatur : / f tt )� 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 \Permits\ELC- PermitApp.doc 12/03 440.4615T( I0 /02/COM/WEB
CITY' OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 003$1
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/6/2005
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: i
A
SITE ADDRESS: 07190 SW SANDBURG ST 20 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
I, DESCRIPTION: 12 branch circuits.
OWNER: MCCORMACK, WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: L H MORRIS ELECTRIC INC zv1A PHONE #: 503
Inspection Request Scheduled For: Date: $/2005 Pour Time:
Code # Inspection Description .. C. it • Contact # Message
195 - 'on 01 • , i 503-830 -1599 Y
\q°1 F',tJ`0.\
= - e • - - : - ructions:
II
cv PEA eP EL e- Zoe — 6c - s `S "c?--tz.%4\6
co \)3 NSA- a _.Q.V ► ll.Gl `1 IIC .. L1 \i'\1. t
4, ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
3DASS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r n1 p ILVA b-
Inspector: C� 1` Date: % VI Phone #: (503) 718 -