Permit CITY OF TIGARD f .^ 3 O -/ ELECTRICAL PERMIT
D' ' r ✓ {{ PERMIT #: ELC2007 -00005
COMMUNITY DEVELOPMENT DATE ISSUED: 1/3/2007
TIGARD • 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S114BA - 01400
SITE ADDRESS: 16185 SW GRIMSON CT ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.2 LOT : 125 JURISDICTION: TIG
Project Description: (1) branch circuit for bathroom remodel. Job No. 15296
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: 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:
JEFF GREENE BOONES FERRY ELECTRIC INC
16185 SW GRIMSON CT PO BOX 628
TIGARD, OR 97224 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 682 - 4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 1/3/2007 $46.85 LIC 88482
[TAX] 8% State Surcharge 1/3/2007 $3.74 SUP 4918S
Total $50.59 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
susp ed for mo - han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Th a rules are set fo ' in e • - 95 - 001 -0010 through OAR 952 -001 -0100. You may obtain copie - se rules or direct questions to OUNC at
5 3.246.6699 or 1.800.3: +.23• .
I ued By: / / / � Permittee Sign ure:
-
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:
• CTOR INST • LATION ONLY
SIGNATURE OF SUPR. ELEC'N: �Z����I - DATE:
LICENSE NO: l 0
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.
EJan. 3. 2007112:07PMplici-BOONES FERRY ELECTRIC No. 5408 P. 1
FOR OFFICE . . ,l V
� r , . - i ty of Tigard
1 ii t' � EL-C j ?-D
` 13125 5W Hall Blvd., Tigard, OR 4 2 - ^ . . . Per No.:
C ' Phone: 503.639.4171 Fax: 503.598.196 ' rr li
Other Permit:
f1 Inspection Line: 5036394175
-.. Internet www.tigard JAi 7 Date Ready/By:
:
20 07 Notlfted/Metho ® see Page for
k , -� „� ��' � , � t fl , � { �.�, ,� , � , � 1 Supplwcntal 'Ihtarmation
• 'di1� ..L..,usrh{ .:YJthSlr:. :, �ihl;'wl r211k! "il + ytli'} -i' r'_ 4j 4 r E ".i�' , �',J 7iS }; j+ xt t
7 ter �r t ht z
_r?a.I ";I ... .o ! ' "l•:w. �t� 6 IL L, J j� -. 1 i�, ,L 1,ir i!1�. i' �1 L�' IP a/. t ^ ii } { '^(�a
-+ k ' ur �.- .t . .r. ,•_ all i ap l ._ (a -mit 1. u'., 1�' ..�.ecke'1` i,�
❑ New construction Addition/alt .1 RI d ",1 ! . Please check all ihat apply (submit Z eels of 0=1;W/items checked below):
❑ Demolition Other: �1 #T Tyr 1 ❑ Service or feeder 400 am or more
i w e f r A/ s R�' ca ❑ M r ings over three stories.
SI j ���11,!� ! i h �'�-i J 1 h '�; -g^'" �-"{(, "0. F.� `� �t•� '� � :t� - i , -,,,,, where the available faun cement ❑Marinas and boatyards.
u 1 L 1 R r.t� I.,r ,{ :,�,, . r tl �' �� ' �r i!,i H ¢ p I� f • �,� 1 T ii ' I' i . • exceeds 10,000 amps m 150 volts or
:�'+ � L, -: t. ,+ ❑ Floating buildings.
® 1 and 2 dwelling C le ss to ground, or exceeds 14,000
Y g ❑ Commercial/industrial ❑ Accessory building 1=1 Commercial -use agricultural
amps for an other installations. buildings.
❑ Multi -family
❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or
i ii r a l 14 _, °!,,,�!i� r I1 ��1•+a {7 L � _ �i3s�; t 1 C t fkzP k l:3 r,;6 i �tl i r ' ^ I . 1 Y lager seprate deved
1 z`�a,,, 19 Addition 0f nY ew motor load of Q qr^ + a
g� +1_Z+ ly +1.ri3 > system.
�
Job no.; 15296 Job site address: 16185 SW Crimson Ct or more. occupancy.
CI Six ix or or more residential limits. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard OR 97229 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg.apt_ no.: I Project name: Green ❑ Service or feeder 600 amps or more.
�; , r
Cross street/directions to job site: R E i J, `F T ` f 3, , uhf i , !�: r • r ; i l n
nacriplloe �'' Fee. p ' ; H's
• - Qty. Fe Toler. •
New residential single- or multifamily dwelling unit.
Includes attached garage.
Subdivision: `Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no Es. add'1 500 sq. ft. or portion 33.40 1
Ti + 1 map/parcel i t t y '. L
�•�. }ir,.e�e fl l P b� „. q ,`+ ,� q- 1 f+ t f ,-tit Lu (with a ovesc residential
:sue r.. , t J 5 ., ei !
_, _, i,,, ... hn., .F� ?�_ .._ „5., _.,,[.',�il_- � „f��:, (wilh abovesq,t) 75.00 2
Bathroom Remodel Limited energy, multi - family
residential Leh above sq. A.) 75.00 2
Services or feeders installation and/or relocation '
r ^ y ¢� 1 z 200 amps or less
�4�.'.4h�7�I � 1 tit r }' � �� 1,r 11 ��', �fi�' k�( � i ;fe1 t .�' �� ,r- 80.30
li i� 1 .ms.1, :�i#'.r ' �,U�,��f .! l = g { ;+ 1\ tit +11L `ACC 1^�:. 2
!�t.l,- .k:.;t , ., _, .. „ _ I ,., ,,.1I 201 amps to 400 amps 106.85 2
Name: Jeff Greem 401 amps to 600 amps 160.60 2
Address SAA 601 amps to 1,000 amps 240.60 2
•
Over 1,000 amps or volts 454.65 2
City /State /ZIP; SAA Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I 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 1 100.30 1 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature Date: Branch circuits - new, alteration, or extension per panel
{ }V1�r °'' 1 €I t k� -r- ;1� -'I {. ,cur+ � + ss- A, Fee for branch circuits with
p
.F. u rlstl._,.L " iKi t t iFT4 ~trl�... TI �l3{ -•---- � ~ ii-t service or feed
�. w _7, m t. s . . ,l�l 1 a f , 1 ...... above or fee,
Business name: each branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85
first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
City / State/ZIP: • Miscellaneous (service or feeder not induced)
Each manufactured or modular
Phone: ( ) I I dwelling, service and/or feeder 90.90 2
)E -mail: Fax: : ( ) _ Reconnect only 66.85 2
yµy�, Pump or irrigation 53.40 2
i FAZ l�• �r r '.i � � �,� + � � r {: t> =. � , �• P gation circle
- �_ T1t,r,11i ,+t R 1 1:1�!il rt,k l r�,(`.9 Ell�dht t c-, ' 1 -+ a I ki �� "rt.. y °'T r f :,f
� - ,,.te _ �1�:�+. .f,:�l.�� ^: Sign ar outline lighting 53.40 2
Business name: Booties Ferry Electric INC Signal circuit(s) or limited
Address: P.O. Box 628 _ energy panel, alteration, or
extens Describe: Page 2 • 2
City / State/ZIP: Wilsonville OR 97070 Each additional Inspection over allowable in any of the above
Phone: (503) 682 -4936 l Fax: (503) 682 -7946 Per inspection 62.50 •
Investigation per hour (I hr min) 62.50
CCB Lie.: 88482 I Electrical Lic.: 3 -223C 1 Suprv. Lie.: 4918S Industrial plant per hour 73.75
Suprv. Electrician signature, required: �l I `. 1 5 r J ; t� : ` C ; I i� t j I fi g 7 ;:i l ;`
Subtotal 46.85
Print name: Stan Hon r Date; , / / • Plan review (25%ofpermit fee):
Authorized signature: I 7 . State surcharge (8% of permit fee):
-
TOTAL PERMIT FEE: 50.59
Print name: Data:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I: tnuildiaglPennaslEtC _permilAOp.doc 05123/06 ' Number of inspections allowed per permit.
440.461 Sr(1 r/n5/COM/Wt;a