Permit p i
A CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
r.. DEVELOPMENT SERVICES PERMIT #: ELR2006 -00203
__441: i ll DATE ISSUED: 8/28/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1 S125DD - 05500
SITE ADDRESS: 09860 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 063 JURISDICTION: TIG
Project Description: Low voltage all encompassing.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS:
Owner: Contractor:
MCLELLARN, ROBERT W /PALMIRA B A & 0 TRINITY WIRING
9860 SW VENTURA CT 21785 SW TUALATIN VALLEY HWY.
TIGARD, OR 97223 ALOHA, OR 97006
Phone: Contact #: PRI 503- 643 -6723
FEES Reg #: ELE 34 -577
LIC 159676
Description Date Amount
[ELPRMT] ELR Permit 8/28/2006 $75.00
[TAX] 8% State Surcha 8/28/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 m. obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699. (\ /
Issued By: E oA „ , 1 P ermittee 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.
r; 0 ..
Edect*iical Permit Ap a-t4 i 1 EU CI OR UrF IC u s1 ONLY
City of Tigard Date/B a . ! ✓ Pem ,
ut No, L . „ Oa, ,3
13125 SW Hall Blvd., Tigard, OR 97223 -
AUG Plan Revie
_
lO,wr y ✓#
Phone: 503.639.4171 Fax: 503.598.1960 U 2 ,tj 2UUl ,�, � , Date/By Other Permit
Inspection Line: 503.639.4175 I I � Date Ready/By 1 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method 1 Supplemental Information
f1TEET9F e WRK;,'� T;Tta Tr? PLAN REVIEW
El �
New construction 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 I- and 2- family dwellings 4 or more new residential
—NO- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
0 Building over three stones ❑Feeders, 400 amps or more
❑ Multi -family ❑ Master builder ❑ Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting RV park
n ❑Health -care facility ❑mar:
Job no.: gL Op / Job site address: q 8 ( 0 , f IA) ire /(J .h u y � Cf . Submit 2 sets of plans with any of the above.
City / State/ZIP: 1 (6 i4g t7 I 6 R The above are not applicable to temporary construction service.
Suite /bldg. /apt.no.: Project name: 02, 13„-( FEE* SCHEDULE
Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: 04 Ve..ikYt . dL ixs 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. ft. 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
A 1i ® 1-% ire 4 1 p� 1' N � , dwelling, service and/or feeder 90.90 2
L+C! Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
i 0 PROPERTY OWNER 201 amps to 400 amps 106.85 2
❑ TENANT
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
Phone: ( ) Fax: ( ) relocation
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 ❑ 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,
Address:
first branch circuit 46.85 2
Each add'l 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
_ extension. Describe: 1 Page 2 7 51 r 2
B usiness name: A i c) 771 (a 1 , f l I� i aft A s (, 4, L6
Address: 1 -? U 5 S V I yfO Each additional inspection over allowable in any of the above
e' , Per inspection 62.50
n
V City/State/ZIP: 1 vl Pr G 1 7 tD C t w o Investigation per hour (1 hr mm) 62.50
/ ) n Phone: (501) ( L ' 3_6,^7 2 Fax. (5 b3) 1 -- 7(psf/ Industrial plant per hour 73.75
1 v - CCB Lic.: 15C c c g Electrical Lic.: 3 4_ 7 Suprv. Lic.. G ELECTRICAL PERMIT FEES*
3 5 1� �. � E, Subtotal , cS ,
Suprv. Electrician signature, required: C L' -- Plan review (25% of permit fee)
Print name: ` —• ,\ ),)..5-)("c, State surcharge (8% of permit fee) s A v U1 � T1 S Date: qs
TOTAL PERMIT FEE
g ` .t
Authorized signature :� This permit application expires if a permit is not obtained within 180
Print name:
days after it has been accepted as comp
) Date. �- 6 1 O * Fee m ethodolo set b Tn -Coun Buildin Indus Service Board
A ir i S � J tl� �r y ty g try
'CITY OF TIGARD . '
BUILDING DIVISION PERMIT #: EI -00203
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/20/200€
Phone: (503) 639 -4171 :44j�l ,
Inspection Requests (24 Hrs.): (503) 639 -4175 , ' °__..
INSPECTION WORKSHEET FOR DATE: 8/31/2006 TIME: 7:00AM PAGE: 68
SITE ADDRESS: 09860 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 063 TYPE OF USE:
PROJECT NAME: MCLELLARN
DESCRIPTION: L voltage all encompassing. V t 1
OWNER: MCLELLARN, ROBERT Md /PALMIRA B, PHONE #:
CONTRACTOR. A & 0 TRINITY WIRING vilb : PHONE #: 503-643.8723
Inspection Request Scheduled For: Date: 8/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 • .+. voltage 035839 -01 503- 5446076 Y
f'e
a - ..ns /Comment A• uctions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL fI NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G— • N6 Date: O ��b i1 f Phone #: (503) 718 - Mgt,