Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10006
DEVELOPMENT SERVICES DATE ISSUED: 3/1/2006
---�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S105AD -11700
SITE ADDRESS: 14753 SW FERN ST ZONING: R -
SUBDIVISION: HILLSHIRE CREEK ESTATES NO. 3 LOT : 108 JURISDICTION: URB
Project Description: (8) Branch circuits. Job #142,80.
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: 7 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:
STEVE & TA JAYNES BOONES FERRY ELECTRIC INC
14753 SW FERN 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
[UELPMT] ELC Permit 3/31/2006 $93.40 LIC 88482
[UTAX] 8% State Surcha 3/31/2006 $7.47 SUP 49185
Total $100.87 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: sp
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.
CITY OF TIGARD ELECTRICAL PERMIT
BUILDING SERVICES DIVISION
am,a�i 13125 SW Hall Blvd., Tigard, OR 97223 /
503- 639 -4171 www.ci.tigard.or.us PERMIT #: G L,c4930 06 - co g
DATE ISSUED: -- - - - j . ._ --
SITE ADDRESS: / 9 / 7 5 - 3 . 3L � Y v .� - - - - -.- PARCEL #: - - - --
BLDG/STE #: ZONING:
SUBDIVISION: — -- LOT: JURISDICTION: - 1
This is an interim permit issued during computer system maintenance.
Construction work and inspections may proceed under this permit number.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
_._ PROJECT DESCRIPTION j L �art?j�c1 G \S ---- ._ 't! _ q =---.-_._-----
r RESIDENTIAL J ...__ - TEMP SRVC /FEEDERS i 1 MISCELLANEOUS _--
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500 SF: 201 - 400 amp: SIGN/OUTLINE LTG:
LIMITED ENERGY: _ 401 - 600 amp: SIGNAL/PANEL:
MA_NF HM /SVC /FDR: _ _ 60 amps -1000 volts: MINOR LABEL (10):
j SERVICE/FEEDER } i - BRANCH CIRCUITS -? i ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 w/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRANCH CIRC: rj IN PLANT:
601 -1000 amp: 1 PLAN REVIEW SECTION
1000+ amp /volt: >= 4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 amps: CLASS AREA/SPEC OCC:
OWNER l FEES
Name: Permit Fee $ 4 0
. _- ��. -q,_ � C?� �� -..._. _._ G}�
Address: _) 2-( ]_j. 3 y ;_ Plan Review Fee $ _
City /State /Zip: _Ay_;1 six dlO 1L - 3 Surcharge (8 %) $ - -_ t1(1
Phone: Other Fee: $
CONTRACTOR Other Fee:
Name: r' Total Fees: $ a . .
Address: _ 6..Ls.
City/State/Zip: \.34 ∎- U \?_ M. `A10 7 0
Phone: Fax: bf.. = ? q _ -
CCB Lic #:
Elect Lic. #: --1 C„, - _... -._-
Supr. Lic. #. 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -1987 or
1-800-332-2344.
Issued By: T) L Permtttee Signature: S? e.- Sic A
--- -_____ - 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. ELECTRICIAN: DATE:
LICENSE NO.:
Call 503 - 639 -4175 by 7:00 AM for an inspection that business day.
Note: If you cannot schedule an inspection while the system is down, please call 503 - 718 -2433 for assistance.
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.
1: \Building\ Forms\ ManualPermi tForms\ManualELCpermit.doc 12/05/05
EMa 1. 2006. 1.08 BOONES FERRY ELECTRIC No 0123 P. 1
hcauon .`
..a - y' `y'�'
Cit , of Tigard EC a d i' C1Frlr L.IISF ON L1' >r ,
s - „ ,� m
13 iZ Sid/ Hall Blvd., Tigard, OR 97223 Rec dyed 1 - « ' sir.
Phone; 503.639.4171 Pax; 503 .598.1960 Ilk " ,% PermttNo,;l •
Inspection Line: 503 .639.4175 ! . fj r �' plan Revie it
/'if4s:3 j . f Da e Read /B '_U V
Inspection Line: 503. 39A1s ,) _ L J : / t. Daty, Othor Pe:adu -- L is ` I ` :` rt / Noufle ■ . d: H See Page 2 for
� L , 1 ��� s upp lement al Inform
New cons r„ orlon
construction Add " r • Addition/: to ? ' I, >
0 ❑ Demolition Oth t Please check all that apply:
i' .. 3 U i ' '''5 4 . 7 �, _ a,. .' • er PPiy:
DService over 225 atr>ps, co
` v ,•. , I %p , 1 + i , ,....: s tntn 1 ❑Ha7ardou
! , ❑Service over 320 a s location
1 -and 2 - fairly dwelling .1 . Co • ... ° , - , A s li r atin g ❑ o r g over a residential
sq. l
Co mmercial/industrial El Accessory ' � of 1 - and 2-family dwellings 4 volts nominal units in one structure
more new residential
❑ Mulri fatrul rY building ❑System over 600 it
I ❑ Master budder
i tit$ ever thro stories
• - Oth ❑ Buil d'
d.:. ,„ 3 Feeders, 400 a
? E ^ n> >i r r I; 1 I, > h , S r ' ! D ESres nt load over 99 persons ❑ amps or more
no.: X5 e Job site address u ` "' ❑Manufactured structures or
L 7 S • -r, :; ❑ES ressllightingpian RV park
3 S �"�� r ❑Health -care facility ❑Other:
Job
City/State/ZIP: T� Submit 2 sets of plans with any of the above,
a .- 4
Suite/bldgJapt no.:
ii The above are not applicable to P roject name: temporary construction service.
Cross street/directions to job site
! New residential single - or multi - family dwelling unit In a obs - J. tit i II I .._, '.• �t ) lip, � (', l+s'1?` 'r �
peon
••
•
Includes attached garage.
which Subdivision: 1,000 sq, ft. or less �� 4
Tax Map/parcel no Lot no,: E� a 500 sq t 33.40 min dd'15 ft or port -
ti '�t ... 7....,',':,';'..-11.-.1.''/':',4:'. Limited energy, residential 75.00 2
)c$ ���,�, ,..a , ; Lirnitea ev t eztaal 7s.00 _
" r, , D \ e ' Each manufactured or modular 11111 90.90 2
ni» dvellin_ service and/or feeder
:. - ..
services er installation, 5 feeders 90 M
r,� , tailor on site
7:',""f ,7;":'= r� � 311fi tn;', ` ,I tl 200 � ion, and/orrelocatlo n
amps or less
Name: _ L ` ' :! : r Ki f a' .' j r `" l' ;i 201 amps to 400 amps 8030 2
4ddress: i 401 arm 106.85 2
s to 600 amps
601 a 160 -60 2
amps to 1,000 amps 240.60
.:ity/State/ZIP: f Over 1,000 amps or volts 2 2
Phone: ( I. Reconnect only 2 111 1111231.1111 Temporary services or feeders installation, alteration, and/or Owner iastallariott; This installatio is being relocation
g trade on prey that I own ch is n. r zoo amps or lest
intended for sale, lease, tent, or exchange', according o O 2
Owner signature g 4 47, 449, 670, and 701. I
01 amps to 400 amps 1
Owner
401 amps to 600 amps ` 2
Business name: .I, , , ! .. ; `1 - ` ' �i ,S i r lip' r ':) T,• n 4 i _; f � ` , " t Branch C new, alteration, or extension, 2 • {i , ,: A. Fee for branch circuits with ' per panel
�._ • service or feeder fee, each '
Contact rain: branch circuit
B. Pee for branch circuits
6 -65 2
Address:
without service or feeder fee, II
City/State/ZIP: each branch circuit
Each add'1 branch circuit 2
Phone; ( uit v ,
Miscellaneous (service or feeder not included) 2
hr min) E
pump or irrigation circle IIIII t ! Sign or outline lighting
3.40 2
T Si al g 53.40
Business name. B o o rt e a F e r r • t?.! `'il ' ;,: , , g circuits) er fitn / or 2
;; ' energy panel; alteration, or
Address: ec r f I
extension. Describe;
P.Q. kjOX' 628 Page 2
City/State/ZIP: Wilsonville . 6 Each additional inspection over r,llowable of the above
OR 97070 Per inspection
l'hoae; (g 3) 68 2.-4936 Investigation per hour (t _ 62 ,50 any _
CCBL 88482 F ax' (503) 6 82 -7946 s Industrial pnt
_la.r - b2,50
COO Electrician signature, � Supiv. Lc., Lk, i e _ ,,. ? c ir : i 1 hour n.'. ` . r - ,� {. a �
Snature, required: .:, " `t F ? ,r F { ; ; y (
S `� , 3 O
int name: 5 r,y plan review (25% of
HN1�I3Qn Date: Permit fee)
Authorized signature: Z! 04 . ( State surcharge ( ofpermit fee) `7
Print rattle: ToTAL PERK• FEE / 00 i e
This Permit application expires if a permit to not obtained within 180
Date: dale allot it has been ace
l�lflultd 'atBlPe�E1.GFemiulpp.doc 12/03
Fu methodology pted as complete aao eM Neu ibex of ins by permit .Bugg Industry Service Rn..�
9613rtl0/ovrnAM,
"s CITY OF TIGARD 3/31/2006
1 111 1 ' I 13125 SW HaII Blvd. 12:56:24PM
Tigard, Oregon 97223
TIGARD (503) 639 4171
Receipt #: 27200600000000001021
Date: 03/31/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
ELC2006 -10006 [UELPMT] ELC Permit 255- 0000 - 431510 93.40
ELC2006 -10006 [UTAX] 8% State Surcharge 255- 0000 - 207020 7.47
Line Item Total: $100.87
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
CreditCard BOONES FERRY ELECTRIC DER/DLH 211083 In Person 100.87
Payment Total: $100.87
cR ;ceipt.rpt Page 1 of 1
CITY OF TIGARD RECEIPT
DEVELOPMENT SERVICES RECEIPT DATE: 2
I x,, 13125 SW Hall Blvd., Tigard, OR 97223 JURISDICTION.: Lim
- --.c > 503- 639 -4171 www.ci.tigard.or.us CASHIER DATE:
CASHIER RECEIPT #:
LINE ITEMS:
Case No. Fee Description Revenue Acct. No Amount Due
6LC. 706 /0t9
'._ ...._ ,25Y - (2e - 74Z irk 4=/
Total Due: $ ,9
® SEE ATTACHED FEE SCHEDULE.
PAYMENTS:
Payer:
Method Initials Check No Confirm No ' Amount Paid
Total Paid: $ 1 4 D . r
Tidemark- ManualSystem\ManualReceipt.doc 10/3/2005
CITY OF TIGARD CZc
BUILDING DIVISION PERMIT #:a - /1,3 O 6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 44 '�,�,.p� \i�i
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: j CLASS OF WORK:
SUBDIVISION: / LOT #: TYPE OF USE:
PROJECT NAME: I - 753
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -a Y —C c° Pour Time:
Code # Inspection Descri tion Confirm # Contact # Message
CJ�� `Y_ .e 6 8d_ - L{ q 3
/ „2--c) 1 1---(Yt-ek.----
Corrections /Comments/ Instructions:
NI PASS I I PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED t 1/4 6 Inspector: l'-//tP Date. Phone #: (503) 71,7V VI
• CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-10006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005
Phone: (503) 639 -4171 o a k
Inspection Requests (24 Hrs.): (503) 639 -4175 "'' I:,
INSPECTION WORKSHEET FOR DATE: 9/13/2006 TIME: 7 : 02AM PAGE: 61
SITE ADDRESS: 14763 SW FERN ST CLASS OF WORK:
SUBDIVISION: HILLSHIRE CREEK ESTATES NO. 3 LOT #: 108 TYPE OF USE:
PROJECT NAME: JIAYNES
DESCRIPTION: (8) Branch circuits. Job #142,80.
OWNER: JAYNES, STEVE & TAM PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503- 682 -4936
Inspection Request Scheduled For: Date: 9/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 03&425 -01 503 - 682 -4936 N
Corrections /Comments /Instructions:
PASS 1 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: r HiP Date: /3'Oen Phone #: (503) 718- Ze.v7