Permit _r
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00614
. COMMUNITY DEVELOPMENT DATE ISSUED: 9/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136C B -07200
SITE ADDRESS: 11155 SW 81ST AVE ZONING: R - 4.5
SUBDIVISION: HERB + PEGGY'S PLACE LOT : 011 JURISDICTION: TIG
PROJECT: MULDOON
Project Description: (3) branch circuits for receptacles.
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: 2 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:
MULDOON, MATTHEW J /LESLIE L GARNER ELECTRIC
11155 SW 81ST AVE 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Contact #: PRI 503 - 648 - 4552
FAX 503 - 642 -7925
FEES
Description Date Amount Reg #: ELE 34 -305C
[TAX] 8% State Surcharge 9/4/2007 $4.81 LIC 121159
[ELPRMT] ELC Permit 9/4/2007 $60.15 SUP 3707S
Total $64.96 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -00 • sugh OAR 952 - 001 -0100 eu may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
/ ! '
Issued By • � � ' Permittee Signature: � � l 61
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FDM°:SARNER ELECTRIC FAX NO. : 5036427925 Sep. 04 2007 07:20AM P1
- Tie rical Permit Application . r ol OFFICE USE ONLY
City of Tigard me Received. ed. , O a Partr •
13125 SW Hall Blvd„ Tigard, OR 97r 7 5 L ti� -- 2 —� .
� Plan Review
Phone: 503.639,4171 'Pax: 509.598.1'• �=tpp' n, I 'bnte/I9: OtherPcrmit;
I
Inspection Line; 503,639,4175 C C . P ® ` g 2 fl f J AIL., ., Date Roady/hy.• Jur R1 Soo Pngc T for
Internist: www,ci.ligardor.us Notiflnd/MaLIi 4Supplemental ; ___ - • I - • . Suppl lnformndon
�} ' ij ,�,' �. yr M ,:^)r,,. ,.I , { - ;; },l?'!t ^V�,'P I};,Y+ I yV Y a n+ I 'i , Ui I' Ndl, y , y - ^f n.�� ,. -- ,-- .,- ...��.�.
. , 'i d I r. Il j fl D ` •q i') 4 4 I)l� .$yh 1 170L ^ q' p it 1Va „� a ,1-1', i' i
t'.,�„ 1I� �. ,,1� '!! �� "�" Y',L`''%1 I I l 1L:.I,n' pp I �.�!Ij''. �a,. "� Iv+{� N ,A;,�; .; �.
1 m'L ®w 1 Y�u,�lt � rs 3u_ c r t , LI a 1 i�t,t! rr ,ik�'ll�°� � >x I,>�l' ( , J ,I�;Y�ditis„'�', } al�p���.� ,� :._L._w...—
❑ New construction 0 ! ... • rl :V l it- .likitiMplacement Please check all that apply:
0 Demolition ' • 0 Other: ]Service over.225 amps, cotitm'1 [11-lazardoua location
ai • 6_ " ,. % :•; +. 9 ; , ri p U. i' '�} Z• r "` i,!"tl. ;,Y , �b,;,I..p.11 ,;; QServiec over 320 amps - rating �]J3uildng over 10.000 sq. ft.,
_ �p t t ' ',�,Y n1 b t ; l i' 1?i r �' �', t r ( } ;� �I�i 4�1 Il �i t'. of 1• sand 2- family dwellings a or more new residential
pr +ti H tl P l�„1
►a/ 1- and 2 - family dwelling ❑ Commercial/industrial. ' 0 .Accessory building OSystern over 600 volts nominal units in one structure
■ Multi family ❑ Master builder ❑ Other: ❑Building over three stories ❑eeders, 400 amps or more
t�yy) +' T;n�R pe :r ' pa� , �a }tm, y" KK, K , . .r •p 1 , t ❑Occupant load over 9t9 persons ❑Manufactured structures or
" rialt+ i rW I� 1l�'\'ri. clp t f ' s lj r r . '> �r r' 11 ' rl jtu` : i4, 1f � ❑ p RV park
r. i air.,, ( acv) D 4& r ; r,. 1 i „ ,t •I„ Egress/lighting plan P
Job.no.: Job site address: � I I S i r $rt f}�/�_r ❑Health -care facility ❑ Other:
Submit 2, sets of plans with any of the above.
City /State /ZIP: T r'c 61-1 2.- ,......._„..................„.. Z Tho above are not applicable to temporary construction service. .
Suite /bldg. /apt'. no Project , 1''}tti'l " IMO ' +u ��, ; t,d,�° s '' ' ;" •
..... _ -,_, . - „ Deaertptlon Qtr. j roe. Total -
Cross street/directions to job site: New residential single- or multi - family dwelling unit,
Includes attached garage.
1,(x10 sq. ft. or less _ _ 145,15 _ 4
... ,.- ,.,.,.... no.: __._
•
Subdivision: Lotno. 2a. add'1 500 sq. ft. or portion - 33,40 T__ _r 1
1 Limited energy , residential
Tax 117apl�arcel no.: ,_ Sy crttial 75.00 2 ^ •
I � " t',&, ,i:1 P '; ,- y � ;l , ra nw n,. ° u f o 1 +; pi: •,u t I . , 1 . k4a 3 : L,imitod energy, non - residential _ _ —.. ,.__ -- ,00 �,.2.,
i r',i .. ,��V , , l d�� ' �k -” a � , , , ' 0..u t , I Est 4� `il �`T ,ud: � nl „, , �. j ' } ! . Ea manu or modular
y dwelling, service and/or feeder 90.90 2
0.) C (( . frtt 1Q „^,,, „_.. Services or feeders installation, liberation, and /ur relocation --
200 amps or less 80.30 2
f o a `rP "}5 n C asa . , g �( .G } 1, ; 4' + " n,u '.n 'Fp " 1tY , 201 amps to 400 amps 106.85 Z..,.
1j,' r, , ., ; F, t ,f lk„ . ,, , � ^ ,t id lag i }' {la c _ ° ,f firm:. !r !i. log n 1 ,- t " . tJA ki.(�l tv �l�,lrt,V4tii:!11.11.�'1i�i`: 40 7 .a to f 00 amps ._ _ _. 160.60 ... r 2
Name: ! t' `a IAA (JI Q o 0 601 amps to 1,000 amps ..--- ,,_ 240,60 z
Address: 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
Q .) S D 2 sr FI;X: ( ) relocation
Phone: __ ..
„ � , J r � - 200 amps DI' less 66.85 1
Owner Installation: This installation is being made on property dthat I own which is not 0 ---.. - — ___
201 amps t0 4(N) aril ?1 3 10030 2
inter'ded 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: T � T ,,, ,, y , _ Branch circuits - new, alteration, or extension, per panel
Pit , � �.,. �, ' � - : , F � � f'4,11; � � �. 1 r I �r . 1 ,^G " •': � IIr FA�e' ry ” y t Tt.�) e -, �--.-....,- „..- _,,.,...'._ - °-. e''''' with
'a�” a , x, i > A. Fee fcr hraneh with 1 sT
lj. I.. 11 ∎ 6 ) . rr e hiu tta 3 as4rr1 'il �I " l.f7111 ,,t ,. . a sio ; t n . ,it ,,q
d1,tltV f >. ,. slur ndnl+u,, wt t 1, �V.� ,,:f . .a r . ,v :� ?:.7.n�.. „ ,. nA4: J d ..: „ .�
service or feeder fee, each 6.65 2
Business name: branch circuit —., — .
. B. Fee for branch circuits
Contact. name: - without service or feeder fee, U
46.85 !� 2
s ^ . - ^� v each branch circuit •
Address: __
._...- .__.,., -..__. .....,..__ ..�,M.,....�,,,,,,,,,,,,,,,,,, Each add'' branch circuit 2—• 6.65 /��.� 2
City /State /ZIP: Miscellaneous (servicenr feeder not included)
Pump or irrigation circle 53.40 2
Phone: ) _ �.— ..._....M.._._,... j . F a x : ( ) - ... ___
Sign or outline lighting 53.40 2
E -mail: Signal circilit(s) or limited -
p , � ,,,{ ,'tlIyy,��YY�� , ; , put uw�k ;�t, OEM � , q �m.• � ltj�it , ca,.,; tF ^q.1 + p'p
X411 .1 .1 'iii i9'3Y)J , ' v , i G� 5 9(' a .. , l t{R'� Y d. tt I tt !`t " "C;'' t I , °•dlf'�S energy panel, alteratipn, nr
'Y.srr1 , r - X11,..1.'r JC:'.�,+In .,(1"- "alJ,:'I�Idil
�- extension. Describe: e 2 1
Business name: scn page
• Address: ' C -" '' Each additional Inspection over allowable in any of the above
l- i " '- �>J - `� . C1 . 7 -(� A Lit' - Per inspection 62.50 - -.
City /State /ZIP: (Ai ` (' L-, (j"; - e7 G R_ ( "l / ( - _ Investigation per hour (1 hr min) 62,50 w
,$) ( , % - - � 2..v:-.3— indust plant p er hour 73.75
Phone: ( j �1 H. ,�_ k'alt ) L �_ ... ,.._ R,4 s;,
__ Su , 1 c -= - 3' I0 7 Subtotal " G.'a� ' fi��l ' „ ' t '.. ' lk!L ` �N'��1�;�'M ', !;rt , _
CCB Lie„ t t � /,, n LF arical L.ic,:7 - i►` . Q is”
,
5uprt +. Electrician signature, required: 4 / r _ �_ - Plan review (25% of permit fee) ,.__
- _....,..� , a,. r . �_._ _ State ire o pcnn itfee)
Print name. 5 �� � i /� D
aes} surcharge f g-'
�— _. . �) - 1, R ._,���_._ - C__, Date —. L '. 10
_— .. — TOTAL PERMIT FEE bit 9
A.1dthorized signature: This permit sppggntinn expires ifs permit is nut Obtained within 150
nays after it has been accepted as complete
Print name: Date: • Foe methodology Oct by Trl- County Building Industry Servire Oc erd
•- Number of inspections per permit allowed,
i:t8ugd inn \Prr,,,5 P _c- r4Init4pp.see 17/03 4au.4L14T) /02 /COM/WEB
CITY OF TIGARD 0
I f BUILDING DIVISION --r PERMIT #: ELC2007 -00614
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/4/2007
Phone: (503) 639 -4171 u �hj n��i i� i�l 6 \
Inspection Requests (24 Hrs.): (503) 639 -4175 '� :_ •
INSPECTION WORKSHEET FOR DATE: 9.16/2007 TIME: 7:00PM PAGE: 58
SITE ADDRESS: 11155 SW 81ST AVE CLASS OF WORK:
SUBDIVISION: HERB + PEGGY'S PLACE LOT #: 011 TYPE OF USE:
' PROJECT NAME: MULDOON
DESCRIPTION: ( branch circuits for receptacles.
OWNER: MULDOON, MATTHEW J /LESLIE L PHONE #:
CONTRACTOR: GARNER ELECTRIC PHONE #: 503 - &48 -4552
Inspection Request Scheduled For: Date: 9/€42007 Pour Time:
p q
-- � ,,t? Code # Inspection Description Confirm # Contact # Message tl � />� -
199 Electrical final 055218 -01 503 - 648-4552 N
Corrections /Comments /Instructions:
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1
1
1
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. _
PASS ❑ PARTIAL APPROVAL _ CANCEL NO ACCESS
' FAIL I CALL F''R INSPECTION ❑ ADDITI NAL FEES ASSESSED
/ft / / 1' � (, /�/ / 718-
Inspector: Date: Phone #: (503) 718