Permit C ITY 0 TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00313
�� DEVELOPMENT SERVICES DATE ISSUED: 5/11/2005
jr ijj, 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111AC-04300
SITE ADDRESS: 14955 SW 92ND AVE ZONING: R -4.5
SUBDIVISION: LAUNALYNDA PARK LOT : 011 JURISDICTION: TIG
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Project Description: Installation of A/C unit.
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: 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:
MARSHALL, JAMES H. SR. - OWNER
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14955 SW 92ND AVE
TIGARD, OR 97224 -5725
Phone: 503 - 624 -6402 Phone:
FEES Reg #:
Description Date Amount
[ELPRMT] ELC Permit 5/11/2005 $46.85
[TAX] 8% State Surcharge 5/11/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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 am 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: 7, ���
_. „6 Permittee Signature. . , nn7 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. 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.
Electrical Permit A ti.
EuEIVEDA ',.,-4, . • . -:- FOR OFFICE USE ONLY . ,'-' :, i. , . • . -
City of Tigard Received ..,..- .... .....
0 l ■:" Date/B Permit No.:
: ..) L..... —.. 05'ali...7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 MAY 1 1 2005 _.„,4M„i Date/B : Other Permit:
Inspection Line: 503.639.4175 —.11-110P; Date Ready/By: RI See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGAR: I ... Notified/Method: Supplemental Information
te'.,,,,, g :' .
-irtuoi..`",4:::k.444-,..:P..ix .;,44, . 46 ,: ::._,,,,,,...,....,-. -. ,
E] New construction 0 Addition/alteration/replacement Please check all that apply:
EService over 225 amps, comm'l OHazardous location
0 Demolition 0 Other:
, CService over 320 amps - rating OBuildng over 10,000 sq. ft.,
W ' ''' .111 r: ..': ''Vrigg M
of 1- and 2-family dwellings 4 or more new residential
tfgar..1._ •` ".', '-- '7thr..,.4.:_.0 ..-,.....,,,, - . al, rz-.r.
Ell and 2-family dwelling El CommerciaUindustrial D Accessory building ElSystem over 600 volts nominal units in one structure
0Building over three stories OFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
DOccupant load over 99 persons ElManufactured structures or
t1 9..#0,17:MP 0 — R MA T YIA A VAK9 § ''' 0EgessAighting Plan RV park
0Health-care facility 00ther:
Job no.: Job site address:
Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: tei-S :.'..: VACTiaftWiF§RiteFtYr:. ,'
Description 1 Qty. Fee. Total *11
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 4
Subdivision: Lot no.: Ea. add'l 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
AW:,:tr JIM= r 'Ale;,4Y,$.,',WW'fr_cKrcgDr„,cr„ggitdMrASRNgZV, Each manufactured or modular
dwelling, service and/or feeder . 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps . 106•85 2
rt .11 P.PNVIAVO4V ' 44
401 amps to 600 amps 160.60 2
_—
Name: -,-. --J an4 .e 17, M et rg l, a (I ,7S • 601 amps to 1,000 amps 240.60 2
Address: j `1` ..-,1"cjei ',.._:.---- d A-0-e. , Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 7-7 - ,---x / ,91-2 9 2 c7 Temporary services or feeders installation, alteration, and/or
Phone: (E,93 ) 6, p_ . _ 6', cze .. Fax: („ 6 ..2 y _ 6 v , _
relocation
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 100.30 2
intended for sale, le. e, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: 11 1- - .....:., 4 , 4110, ,,,/40, Date: ,,,, 4 0 Branch circuits - new, alteration, or extension, per panel
- , ;`'0 : i:',...':;- ,:fraly4N ',.M,SMVETIONMACAVOTAW A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: e 4, GC) A branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, .
each branch circuit / 46.85 2
Address:
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
a~-b :' piff1RNW.N.VIS . energy panel, alteration, or
extension. Descnbe: Page 2 2
Business name: et) .e... .
Address: Each additional inspection over allowable in any of the above
Per inspection 62 50
City/State/ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) Fax ( ) Industrial plant per hour 73.75
. V.Z.5'4 iggEPErtV.C.AMMIIIMMT.77
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal v4
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) .
Print name: Date:
TOTAL PERMIT FEE ) -- - 9,..e C)
_
Authorized signature: This permit application expires if a permit is not obtained within I SO
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed.
iABuildirig \Permits \ELC-PermitApp doe 12/03 440-461 57(10/02/CO3,1/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
4 fa ., r F uY '£ 9 ai ",i iSi`� «W y < v. L '.^'.. ;." .::'dam
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
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❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
•
for all other installations
i \ Building \Perauts\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL 0200 - 003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1'i /20Off
Phone: (503) 639- 4171 �n�0tp�l ;�
Inspection Requests (24 Hrs.): (503) 639 -4175 J : I I ..
INSPECTION WORKSHEET FOR DATE: 2/9/2006 TIME: 7 :01AM PAGE: 58
SITE ADDRESS: 14955 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: LAUNALYNDA PARK LOT #: 011 TYPE OF USE:
PROJECT NAME: MARSHALL
DESCRIPTION: Installation of NC unit.
OWNER: MARSHALL, JAMES H SR PHONE #: 603.6` 4 -6402
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7Ja/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 026370-02 603-624-6402 V
Corrections /Comments/ Instructions:
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AOATMINI
r/112 WI
I NIIIII IIPP—
J PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL / Oa FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �-�_ ��"' Date: Z Phone #: (503) 718 -