Permit C I T`' OF TIGARD ELECTRICAL PERMIT
PERMIT #:
r � l � DEVELOPMENT SERVICES DATE ISSUED: 2/2/2005 00055
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC -04700
SITE ADDRESS: 13635 SW STEVEN CT
SUBDIVISION: BEREA ZONING: R -4.5
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Misc. wiring in garage & house.
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: 4 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:
MCC RAY, SCOTT TICE ELECTRIC
13635 SW STEVEN CT PO BOX 15009
TIGARD, OR 97223 2139 SE BELMONT ST
PORTLAND, OR 97293 -5009
Phone: 503- 620 -7854 Phone: 503 - 233 -8801
Reg #: LIC 166
SUP 2586S
FEES ELE 26 -126C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/2/2005 $73.45
[TAX] 8% State Surcharge 2/2/2005 $5 Electrical rough -
Electrical final
Total $79.33
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- 3332 -2344.
Issued By: may Permit Signature: Siut, p,
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 639 -4175 by 7:00pm for an inspection the next business day
02/02/2005 11:01 503 - 872 - 8 (� TICE ELECT.SERV.DEPT PAGE 01
EJPGtlica1. P- e� �i &t° n FOR OFFICE USE ONLY
„ t om Received / 9 Electrical •
• Date/By: O f ,!/�/ Permit No.: 6 , L e / 9 $ � i 5 5 5
•
City of :Tigard FEB 02 2005 Planning Approval Pe
Date/By: Permit No.:
13125 SW Hall Blvd. . Plan Review Other •
.Tigard; Oregon 97223 • CITY OF TIGARD Date/By: Permit No.:
• Phone; 503 - 639- 417 8UT> x ED s'I �'' i Post- Review Land Use
OP,,,,, ''h: c0
Date/By: Case No.:
Internet: wwvv.ci.tigard.or.us • � 141.•;i114 ; l Contact JuJr s.: IN See Page 2 for
• 24-hour Inspection Request; 503- 6394175 • • " Name/Metho j (� Supplemental In formation.
•
TYPE : OF . , ; , : . : • y PLAN REVIEW (Please check all that apply)
•
' New construction 0 Demolition ❑ Service over 225 amps - )_] Health -care facility
commercial .❑ Hazardous location
Addition/alteration/replacement 0 Other: ❑ Service over 320 amps - rating of ' ❑ Building over 10,000 square feet,
• CATEGORY OF'CONSTIkt3CTITON I & 2 family dwellings four or more residential units in
IN 1 & 2- Family dwellii • Commercial/Industrial ❑ System over 600 volts nominal one structure
0 Building over three stories (] Feeders, 400 amps or more
0 Accessory 'Building . • Multi - Family ❑ Occupant load over 99 persons 0 Manufactured structures or RV park
• . JD Master Builder Q Other: 0 Egress/lighting plan 0 Other:
r Submit sets of plans with any of the above.
JOB SITE IN)Fd,
• Job site address: 1363 SW c,teven et :,. The above are not a�r� ry construction service.
• Suite #: • Bld ./A t. #: Number of inspections per permit allowed
. Project Name: Scott MoCray • • Description Qty Pee (ea.) Total
job Site:: . • dwelling ingd unit. Includes or multi-family street/Directions to ara per j
� dwelling wait, rndudes attached garage.
• . •. Service Included:
. • 1000 sq. ft. or less _ 145.15 4 • . Each additional 500 sq, ft. or portion thereof 33.40 1 •
Subdivision: I Lot #:. Limited energy, residential 75.00 _ , 2
Limited energy, non residential 75.00 2 ,
. TaX map /parcel #: • . • . Each manufactured home or modular dwelling
I)ESCRIPTIONiOF WORK • :`:;;; <''! :.,! : � service and/or feeder 90.90 2
. Services or feeders - Installation,
Misc wiring in garage. and house alteration or relocation:
200 amps or less _ 80.30 2
--
r... 201 amen to 400 amps 106.85 2
. . • 401 amps to 600 amps 160.60 2
• s s : * , , • 6 amps to 1000 amps 240.60 2
arROPRRTY:OWIVER'' . %1 3.0.00 a .' •; ittf+44?;v 454.65 z
Over 1000 amps or volts
• Name: Scott MCCray. • . Reconnect Only 66.85 2
Address: 13635 SW Steven Ct; Temporary services or feeders - Installation,
Ti 0 27 97ZZ3 alteration, or relocation;
City /State /Zip; 200 amps or lass .. 66.85 I
• Phone: 503 -- 620 -7854' Fax:
ax • • . 201 amps to 400 amps 100.30 2
. 401 to 600 amps 133.75 2
NI I APPVCANT • . ' III ' :ON? O4C,T %�,lE l ' _ U '' Branch circuits - new, alteration, or
Name: extension per panel:
A. Fec for branch circuits with purchase of
Address: servi or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 1 46.85 46.85 2
• I Phone: Fax: . • Each additional branch Circuit 4 _ 6.65 ?_rt Fib 2
E-mail: Misc.(Service or feeder not included):
•
Ea pump or irrigation circle • 53.40 2 •
i:i:: '`:Cs-Q• N iO' ,i•1 •. ,,r„: ; ' , ,_;,,.. .•� ••,* • Each sign or outline lighting 53,40 2 '
Job .No: 99.9597 Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name:. Tice Electric Co, Description; •
• Address: . PO. Box 15009. . • -
!—�•
'or ' OR • ' • ' - 1 1 • ' Each additional Inspection over the allowable in any of the above; • City /state /Zip: Per inspection per hour (min, I hot, 62,50
Phone: 503- 233 -8801 _ Fax: 503 -872 -8290 Investigation fee:
other:
#:_ '166 Lic. #: z6. -126C . ;':: - ` R �_:,,;:�-, • . . .. .
CCB Lie. •
_
`,.:' � . , . - :.. EI�'tk'Isal,���eraaait,�.�S:
Supervising electrician -''' " . l Subtotal S ' ' 73.45
' si • •ature I.e. wired: � � 2/2/05 Plan Review (25% of Permit Fee) S
Print Name: John ,T M1 nnay
Lic.. #:. 2 State Surchar•e 8% of Permit Fee $
• TOTAL PERMIT FEE $ 7c)13
• Authorized • — Notice: This permit application expires if a permit is not obta within
• ' Signature; • hate: 180 days after It has been accepted as complete.
• 'Fee methodology set by Tri -County Building Industry Service Board.
• (Please print name) .
•
is \DstsWermit Foerns\ElcPermitA'pp.doc 01/03 •
•
CITY OF TIGARD • ,i
BUILDING DIVISION PERMIT #: E Le200'.'i3O005
13125 SW Hall Blvd., Tigard, OR 97223 �l DATE ISSUED: 7 12J2OO
Phone: (503) 639 -4171 �4.I�l
Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: 44/2O0b TIME: 'i :11AM PAGE: 'r'1
SITE ADDRESS: ",1 = /r• '1 i:VLi i:; i CLASS OF WORK:
SUBDIVISION: FFLRL A LOT #: U00 TYPE OF USE:
PROJECT NAME: IVIs; :C RAY
DESCRIPTION: Mi5 . tairiiig in garago & hoi. w.
OWNER: MCCRA °(, SCJ7 I PHONE #: 50; 620 -7854
CONTRACTOR: 144.;x=. ELECTRIC PHONE #: 03 2313801
Inspection Request Scheduled For: Date: 414L2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 ) Ple - mica! final 00 50:3 7322 11
J Corrections /Comments /Instructions:
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❑ PASS E] PARTIAL --- R
\ i: / l///
TIAL TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
k AIL L � CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESS
Inspector: ji /"' " Date: 9' L / os Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E & O -DOU
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE _ 3-- 05 TIME: PAGE:
SITE ADDRESS: / 360 3 S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
•
OWNER: PHONE #:
CONTRACTOR:7 , PHONE #:
Inspection Request Scheduled For: Date: 3 —S= o 5 Pour Time:
Code # Inspection Description Confirm # ontact # Message
00 3 7 L1'1 2 33 -
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7 - D ` f ° Phone #: (503) 718-