Permit •
CITY OF TIGARD r ELECTRICAL PERMIT
PERMIT #: ELC2006 -00598
� DEVELOPMENT SERVICES DATE ISSUED: 10/20/2006
°=-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2 S 103AB -01100
SITE ADDRESS: 11100 SW WALNUT ST ZONING: R - 4.5
SUBDIVISION: ECHO HEIGHTS LOT : 007 JURISDICTION: TIG
Project Description: (4) branch circuits. Job #103506.
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: 3 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:
KEN KAHN BOONES FERRY ELECTRIC INC
11100 SW WALNUT ST PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 682 -4936
FAX 503 - 682 -7946
• FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 10/20/200( $66.80 LIC 88482
[TAX] 8% State Surcharge 10/20/200( $5.34 SUP 4918S
Total $72.14 REQUIRED ITEMS AND REPORTS
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: � Permittee Signature: -24N f
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.
Electrical Permit Application - -
FOR OFFICE USE ONLY
City of Tigard Received AA -,) i/)
B f
Date : / Va q� Z. Permit No.: c �\
�^
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review -' V
Phone: 503.639.4171 Fax: 503.598.1960 �"dd4 i i i Date/B : Other Permit.
Inspection Line: 503.639.4175 cL1 Date Ready/By: Iliffii ® See Page 2 for
temet: www.ci.tigard.or.us Notified/Method• Supplemental Information
:,; 1- , °ae T,', '.c :4 'x. ± T YPE FS%VOR ° ,x t + , f 3,n�, . . , ;u' t `. -f . .-'t'
' � � �_ O ,:. �„ :. r '+�t. � 1� a -� k' �. `. '., ' rpL�►�- ����y �h`'` ,"+�, =��+•s,i % •
❑ New construction Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location
El Demolition ❑Other:
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
.' N. , . 'CATEGORY - O F O STS U CON >� , - of 1- and 2-family dwellings � - � - ,:.,1-.. > F . , � ,� ,,, � y 4 or more new residential
X 0.1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
*' ��� sat; , JOB �- - -- �- . - � DOccupant load over 99 persons :Manufactured structures or
pz ,i ;sue ST�I'E INFORMAT)EOICA D;I ," 't park
RV
-�- .� � � ..t , x =�rt -u�,: .^•_� �, x,�;� ��� ❑Egress/lighting plan P
Job no.: O 3 S0 6 a Job site address: I ) j v 0 S y WA hi S ❑Health -care facility ❑Other
Submit 2 sets of plans with any of the above.
City/State /ZIP: T'1 ya , d 0 k The above are not applicable to temporary construction service.
n / .).:.' •.a ., z- `,FEE* IEDI)LE , x
° . ,, 1 r
g p . Pro j ect name:
Suite/bldg./apt. o.
Descriptio 1 Qty I Fee. �� I Total I � Description
"
Cross street/directions to job site: 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'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
,�,,r ; �- i r- , y, ; . „ Limited energy, non - residential 75.00 2
.. �.� : ] `` .t. inikilIPTCONi60F.!'VURI ,. i' ',, ' a " ,
, *`, - .:. „:; i, a , 4 , -,_o - ; ' r . Each manufactured or modular
dwelling, service and/or feeder 90.90 2
k¢ P-ko Ci el Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
t.-4,;,14,-,: `r ]: PROPERTY; O - - 6 "' v,' 9 .t T '" ` ;• ' ,;° 201 amps to 400 amps 106.85 2
Name:
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
idress: 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
;; 4i; �
I v �" �' -. `° t ® ;/1PPT;'ftA1VT * a , �, • pi R3(- A. Fee for branch circuits with
± service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, )
Address:
first branch circuit 46.85 2
Each add'l branch circuit .3 6.65 ) 9 , q 5 - 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax. ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
'' 7'4' .r. .,';; ''-' '; 4 ` ' TOR °.- . r- t..b: n t . ,.'..`; energy anel, alteration, or
Business name: Boones Ferry Electric
extension. Describe: Page 2 2
Address: P.O. Box 628 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Wilsonville OR 97070 Investigation per hour (1 hr min) 62.50
Phone: (503) 682 -4936 Fax: (503) 682 -7946 Industrial plant per hour 73.75
.. i •z ELECTRICAL PERMIT FEES *2 ,.':_ . ;;
CCB Lic.: 88482 Electrical ic.: 3 -223C ( Suprv. Lic.: 3 ) 3 65
Subtotal I, 6.
Suprv. Electrician signature, require \: - . 1 Plan review (25% of permit fee) _
tint name: ' Date: State surcharge (8% of permit fee) S. 3 y.
TOTAL PERMIT FEE 7 2 . /4
Authorized signature: 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- PermttApp doc 12103 440-4615T(10 /02/COM/wEB
•
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: ELC2006 -00598
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F. ..
INSPECTION WORKSHEET FOR DATE: 11/28/2006 TIME: 7:03AM PAGE: 28
•
SITE ADDRESS: 1 1 100 SW WALNU f ST CLASS OF WORK:
SUBDIVISION: ECHO HEIGHTS LOT #: 007 TYPE OF USE:
• PROJECT NAME: KAHN •
DESCRIPTION: (4) branch circuits. Job #103506.
OWNER: KAHN, KEN PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503.682-4936
Inspection Re • _ - Scheduled For: Date: 11/28/2006 Pour Time:
'ode # Inspection Descrip • n Confirm # Contact # Message
199 Electrical final 040323 -01 503- 682 -4936 N
• rections /Commes _ • ons:
I :1 Y` [ — t!
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS '
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ti `v V` l � 1` •2i -(,�(
pector: v Date: { VO Phone #: (503) 718- 21441
CITY OF TIGARD .. o 4 ..r_. •
44,
BUILDING DIVISION PERMIT #: ELC2006.00598 .
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: '' 10/20/2006
Phone: (503) 639 -4171 ''`zon4 � , *IA
Inspection Requests (24 Hrs.): (503) 639 -4175 "' �.. •
INSPECTION WORKSHEET FOR DATE: 10/2412006 • TIME: 7:02AM PAGE: 32
SITE ADDRESS: 11100 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: ECHO HEIGHTS LOT #: 007 .TYPE OF USE:
PROJECT NAME: KAHN
'DESCRIPTION: (4) branch circuits. Job #103506. • .
•
•
OWNER: KAHN, KEN PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503-682 -4936
-
Inspection Request Scheduled For: • Date: 10/24/2006 • Pour Time:
Code # Inspection Desc • • ' • n Confirm # Contact # Message
120 Electrical. rough -in 038750 -01 503-682-4936 N
• - • . - • - nstructi • •
� tiz cf3 -
•
•
•
•
•
•
•
•
►ui PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS'
❑ FAIL ❑, CALL FOR INSPECTION , ❑ ADDITIONAL FEES ASSESSED -
'Inspector: ' Le
. Dater __ Phone #: (503) 718 - ,
•