Permit (.
ELECTRICAL PERMIT
CITY.,OF TIGARD
PERMIT #: ELC2006 -10074
4I, DEVELOPMENT SERVICES DATE ISSUED: 3/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S125DA -10000
SITE ADDRESS: 06606 SW WALNUT TERR ZONING: R -4.5
SUBDIVISION: PP1993 - 011 LOT : 001 JURISDICTION: TIG
Project Description: Reconnect Only - Ground Rods. Job #6 - 374.
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JAY & MICH GILBERT ABC ELECTRIC
6606 SW WALNUT TERR 135 NE 9TH AVE
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503 - 977 - 9229 Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: ELE 161501
[ELPRMT] ELC Permit 4/5/2006 $66.85 LIC 26 -1226C
[TAX] 8% State Surcharge 4/5/2006 $5.35 SUP 50965
Total $72.20 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: am Permittee Signature: 4_,
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.
MAR -25 04:57A FROM: T0:81P5035981960 P.1
Electrical Permit Ap tt ,o ��` FOR OFFICE: L!S1: ONI
City Tigard of Ti and ���� V F Received
Date/I3 . ...2 v D , / v per mit No.: G / ,_ l DQ7
' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 �n . ,p /t 1;: t Date/B
Inspection Line: 503.639.4175 MAR C 20L.. _I _ Date Ready/By: Juris: 55 See Page 2 for
Internet• www.ci.tigartLnr us V,/ � p Notified/Method: Supplemental information
6F llkitJf t 'PLAN REVIEW
❑ New construction dditicalggition/ rep ae `dell l ' 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
15 I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family 0 Master builder 0 Other:
❑ Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons 0 Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
Job no.: iy • 3 q Job site address: Lais)0(D '� 00 t ,� Db Health-care facility ❑Other:
/. sets of plans with any of the above.
City/ State/ZIP: i, 0 A Lt ,' ( � `Y (� The above are not applicable to temporary construction service.
FEE* SCr1EbdLE.
Suite/bldg. /apt. no.: Project name: ^
C' 1 1 1 L1X J w ` Description I Qry• I Fen I Mal ' 1 ••
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 I 4
Subdivision: Lot no.: Ea. add'I 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
. �'( . ���COcQ S
dwelling, service feeder 90.90 2
Services es or feeders rs Installation, alteration, and/or relocation
200 amps or less 80.30 ' 2
7 201 amps to 400 amps 106.85 2
,,, �RUPERI'Y ',. ❑ TENANT 401 amps to 600 amps 160.60 2
Name: ` �, i 1 ( '1. 1 1� 601 amps to 1,000 amps 240.60 2
Address: J"' ' 1 S q9.QUin - Over 1,000 amps or volts 454.65 2
`� Reconnect only ' 66.85 10kS5
City/State/ZIP: -CSC': , 0 l -7 p � 3 Temporary services or feeders installation, alteration, and/or
' � 1 relocation
Phone: ( ) 7 o i --- DO Fax: ( ) 200 amps or less 1 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 1 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
, 0 'APPLICANT, . .. - I , , : • El CONTACT PERSON ` A. Fee for branch circuits with
=' 1 service or feeder fee, each 6.65 2
IN
Business name: -G \ l t , C _ branch circuit _
B. Fee for branch circuits
Contact name: ub J without service or fader fee, 46.85 2
each branch circuit
Address: Each add') branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not Included)
_ Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Descr Page 2 2
Business name: Ate..., k 1 Q �t f �.
Each additional Inspection over allowable in any of the above
Address:
5 5 ki E. k` I Y111. Q Per inspection 62.50
City/State/ZIP: �� \C1,n(A 1 ) Investigation per hour (1 hr min) 62.50
Induslriul p 73.75
Phone: (535 �5 :. I f C1 � . Fax: (!� 53 7� 5� 'ant per hour
ELECTRICAL PERMIT FEES!
CCB Lie.: /6 /J () 1 I Electrical Lic.�6) _/�6, Suprv. Lic. Q C , S Subtotal 6 P6 u ! /
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) -
Print name (n 71,
�Q �A�/� �/ (/'L/ 1 /7 Date: �y `f -
' TOTAL PERMIT FEE 7.�
• Authorized signature: ^ III This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete
Print name: C �• - Ne it 1. Sri skn Date: •� y 0 • Fee methodology set by Tri- (:aunty Building Industry Service Bouni
•• Number of inspections per permit allowed.
i'. IIu,IdingV'anI91ELC-Pa,mRApp.dec 12/03 44046151(I WO /COM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200 10074
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2212006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 F '- --
INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7 :01AM PAGE: 86
SITE ADDRESS: 06606 SW WALNUT TERR CLASS OF WORK:
SUBDIVISION: PP 1993 -011 LOT #: 001 TYPE OF USE:
PROJECT NAME: GILBERT
DESCRIPTION: Reconnect Only - Ground Rods. Job #£ -374.
OWNER: GILBERT, JAY & MICHELLE PHONE #: 503 - 977 - 9229
CONTRACTOR: ABC ELECTRIC PHONE #: 503 233 - 7551
Inspection Request Scheduled For: Date: 10/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 038477 -01 503-701 -2600 N
Corrections /Comments /Instructions:
E.L( .•oS� o oq 23
•vim X 62 S� •
FP % L f ►NtL e415
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C - " (14 Gg LE Date: to 1 2-01o6 Phone #: (503) 718- Z