Permit ✓ ` CITY OF TIGARD ELECTRICAL PERMIT
i e ° PERMIT #: ELC2009 -00073
COMMUNITY DEVELOPMENT DATE ISSUED: 2/24/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 026 D -01502
SITE ADDRESS: 09815 SW WALNUT PL BLDG H -55-62 ZONING: R -25
SUBDIVISION: WALNUT PLACE APARTMENTS LOT : 001 JURISDICTION: TI G
PROJECT: WALNUT PLACE
Project Description: Installing (2) branch circuits.
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: 1 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:
MARCIENE TERRACE ASSOCIATES JSM ELECTRIC
510 WAVERLY ST 7717 SW SKYHAR DR
PALO ALTO, CA 94301 PORTLAND, OR 97223
Phone: Contact #: PRI 503 - 866 - 7304
FAX 503 - 244 -4397
FEES
Description Date Amount Reg #: ELE C218
[ELPRMT] ELC Permit 2/24/2009 $53.50 LIC 168451
[TAX] 12% State Surchar 2/24/2009 $6.42 SUP 5104 -S
Total $59.92 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.
j �
Issued By: Q (j Q j"" JuA ' 'Permittee Signature: I ) /Eli /.v / / % _, l •
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.
__ , RECEIVED
Electrical Permit Application r ()IZ OHifi l'Sl: ()NI,1
City of Tigard FEB 2 4 2009 Received 2 N' Permit No.: 4 41M 1 . r 1i• 7
Date/11 : a 131 Hall Blvd., Tigard, OR 9722 1., Plan
e O
111 C Phone: 503.639.4171 Fax: 503.598alg a OpTIG� Date/By Other
r I c A r f . Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: --r��° n ® See Page 2 for
. Internet: www.tigard - or.gov Notified/Method: \ 1 `� Supplemental Information
TYPE OF WORK PLAN REVIEW
El New construction ® Addition/alteration/replacement Please check all that apply (submit E sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
to) CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
O`Multi- family ti.5 ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: Job site address: 9815 S.W. Walnut P1. loop or more occupancy
❑ Six or more residential units. ❑ Recreational vehicle panes.
City/State/ZIP: Tigard / OR / 97224 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: Project name: Dryer circuit • .. ! r ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: / `�_ Description FEE SCHEDULE
J I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R)
dryer Limited energy, multi- family
Install d
r3' circuits i ,/t ,/ �e r rp k 8 � residential (with above sq. ft.) 75.00 2
i /- - b f Services or feeders installation, alteration, and/or relocation
LA - N) t Ts 5S _6 .. 200 amps or less 80.30 2
0 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Vin / ( yr L , •t pi / .,_ f /! Q4.� 401 amps to 600 amps 160.60 2
V / l 1 1 Y 601 amps to 1,000 amps 240.60 2
Address: 9815 S.W. Walnut P1.. Over 1,000 amps or volts 454.65 2
City/State/ZIP: Tigard / OR / 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503 )320-4553 Fax: ( ) 200 amps or less 66.85 I
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2
- each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 1 46.85 46.85 2
Contact name: Maria first branch circuit
Address: Each add'I branch circuit "*1 6.65 - 33.25 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 320 -4553 Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: JSM Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 7717 S.W. Skyhar Dr. extension Describe: Page 2 2
City/State/ZIP: Portland / OR / 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 866 -7304 Fax: (503 ) 244 -4397 .
Investigation per hour (1 hr min) 62.50
CCB Lic.: 168451 I Electrical Lic.: C 217 Suprv. Lic.: 5104S Industrial plant per hour 73.75 -
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: • 1 ! - j 4. Subtotal: "89-1 - b3.50
7
Print name: Jeffrey S. McGinnis 1 Date: 02 -25 -2009 Plan review (25% of permit fee):
State surcharge (12% of permit fee): -4.6-1- Co , Li Z
Authorized signature: TOTAL PERMIT FEE: "8T'Tt'
This permit application expires if a permit is not obtained within 180 c
. Print name: Date: ' ' days after it has been accepted as complete. 92
CITY OF TIGARD
CITY
ArEDING DIVISION PERMIT #: EIO2009-00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2,1r1009
Phone: (503) 639-4171 /0/, ti■
Art
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/2612009 TIME: 7:O3AM PAGE: 11
SITE ADDRESS: 09315 SW WALNUT PL BLDG I CLASS OF WORK:
SUBDIVISION: WALNUT PLACE APARTMENTS LOT #: 001 TYPE OF USE:
PROJECT NAME: WALNUT PLACE
DESCRIPTION: installing (2) branch circuit.
OWNER: MARCIENE TERRACE ASSOCIATES, PHONE #:
• CONTRACTOR: JSM ELECTRIC PHONE #: 503-866-7304
----"-
1,ettion Request Scheduled For: Date: 212612009 Pour Time:
Code # Inspection Description 7 ,Ciih Contact # Message
199 Electrical final 080863-03 603-320-4553 N
Corrections /Comments/ Instructions:
I
X PASS E PARTIAL APPROVAL E CANCEL 0 NO ACCESS
fl FAIL fl CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector: 6 7 - ' IN6isL., Date: 2- Phone #: (503) 718- 1A)_____
I. . .
• fil l( OF TIGARD
7 DING DIVISION PERMIT #: EL0009-00073
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2124/2009
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �'. 'I_..
INSPECTION WORKSHEET FOR DATE: 2f25/2009 TIME: 7 :00AM PAGE: 15
SITE ADDRESS: 09015 SW WALNUT 56 -62 CLASS OF WORK:
SUBDIVISION: WALNUT PLACE APARTMENTS LOT #: 001 TYPE OF USE:
PROJECT NAME: WALNUT PLACE
DESCRIPTION: Installing (2) branch circuits.
OWNER: MARCIENE TERRACE ASSOCIATES, PHONE #:
CONTRACTOR: JSM ELECTRIC PHONE #: 503 - 866 -7304
Inspection Request Scheduled For: Date: 2125/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 030025 -02 50:3.320.4553 Y
Corrections /Comments/ Instructions:
Q01) C,OkZ
■Y'it `rE 1\L
CAN Pr4 B `
6 0%N . \--V0 0.6 N11 t?,�_- -
•
)1\FA n PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . }NJ 06 Date: 9-- 2-6 ! Phone #: (503) 718- lqqU