Permit CITY OF TIGA ' ^ `� ELECTRICAL PERMIT
PERMIT #: ELC2006 -00424
DEVELOPMENT SERVICES DATE ISSUED: 8/1/2006
Ail 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2SI11DB 12200
SITE ADDRESS: 15255 SW 94TH AVE ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.12 LOT : 649 JURISDICTION: TIG
Project Description: Panel change.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
FRANCIS JEWELL ALLIANCE ELECTRIC INC
15255 SW 94TH AVE 19590 SW 51ST
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: Contact #: PRI 503 - 691 -2222 •
FAX 503 -6912-9506
FEES
Description Date Amount Reg #: ELE 3 -310C
[ELPRMT] ELC Permit 8/1/2006 $80.30 LIC 78713
[TAX] 8% State Surcharge 8/1/2006 $6.42 SUP 2021S
Total $86.72 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: ; �i % Permittee Signature: � 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.
JUL - 31 -2006 08:05P FROM: ALL I ANCEELECTR I C 5036919506 TO:5035981960 P.1
Electrical Permit Application + 1� FOR OFFICE iii ONEI era City of Tigard ,. � . Dateil3 " '/ ■ - Permit No.: , /6 r
13125 SW Halt Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 {( , Date/B . Other Permit
TIGARD Inspect ionLine: 503.639,4175 �,IiJU 1 2006 DateReody /By: la See Page 2 for
Interne www,tigard -ocgov iJotifiaVivtetleod; Supplemental Information
TYPE OF ,WOIRJUk. I __ .
r g rk" r ir�iir PLAN t '
a -' l' g '' : " ' Please cheek all that apply (submit 2 sets of plans w/items checked below):
❑ New construction �Addition/alte 1� /e' cnt
�T� K ❑Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
k 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder 0 Other: ❑ Fire pump. ❑ installation of 75 KVA or
' ' " JOB SITE INFORMATION AND LOCATION o Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ "A ". "E ", "1 -2•' "1.3"
Job no.: Job site address: 15255 SW 94th 100HP or more. occupancy.
❑ Six or more residential l units. ❑ Recreational vehicle parks.
City / State/ZIP: Tigard 0 R 97224 ❑ Health-care facilities, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no,: Project name: ❑ Serviceorfeeder600ampsormore.
FEE SCHEDULE •
Cross street/directions to job site: L a k e s i d e D r Description I Qtr. i Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no,: 1.000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea, add'] 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R.)
Limited energy, multi- family 75.00 2
Panel change residential (with above sq. R.) _
Services or feeders Installation, alteration, and/or relocation
200 amps or less 1. 80.30 80.3C 2
0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: t 401 amps to 600 amps 160.60 2
' ` ` � C t. ` s., -e • � ` � �
' -' 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) 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
Owner si store Date: Branch circuits - new, alteration or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT • 1 - ❑ CONTACT PERSON " • above service or feeder fee, 6.65 2
each branch circuit -
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add') branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City / State/Z Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) 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: Signal circuit(s) or limited -
Alliance E l e c t r i c energy panel, alteration, or
`O Address. extension. Describe: Paget 2
• 19590 SW 51st Ave
i City / State/ZIP: T u a l a t i n , n R 97062 Each additional Inspection over allowable In any of the above
Per inspection 62.50
� Phone: ( 50 3) 691-2222 Fax: ( 50 3) 691-9506 investigation per hour (I hr min) 62.50
,) CCB Lic.: 78713 Electrical Lic.: 3-310C Suprv. Lic.• 2021 S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES' '
Suprv. Electrician signature, required: Subtotal: R.(1 3 f)
N.
flan review (25% o f permit fee):
Print name: Date: 7- 2 8- 0 6
,1 6 4 3 y t___.-
Authorized signature: TOTAL PERMIT FEE: 8 6 . 72, 7.2_._
Print name• I Date: This permit application expires if a permit la not obtained within ISO
days silenit has been accepted as complete
' Number of inspections allowed per permit.
I \ Building \Pmnita\ELC•PmnitApp.doc 05/23/06 440.4615T1I 1/05 /COM/WEI
CITY OF TIGARD is
BUILDING DIVISION PERMIT #: ELC2006- 00424
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10005
Phone: (503) 639-4171 �ypitii4� l a
Inspection Requests (24 Hrs.): (503) 639 -4175 ± " 411.
INSPECTION WORKSHEET FOR DATE: 9/12/2006 TIME: 7:01Am PAGE: 60
SITE ADDRESS: '15265 SW 94TH AVE CLASS OF WORK: •
SUBDIVISION: SUMMERFIELD NO.12 LOT #: 619 TYPE OF USE:
PROJECT NAME: JE'/IELL
DESCRIPTION: Panel change.
OWNER: JEWELL, FRANCIS PHONE #:
CONTRACTOR: ALUANCE ELECTRIC INC PHONE #: 503-691.3222
Inspection Request Scheduled For: Date: 9/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 036272 -01 503 -598- 3419 Y
Corrections /Comments /Instructions: \ r\N ,
' P p ik___
.............______
. „.....„...,..„._,....„, Al 11.
•
•
Q.
-
......_
\ 4 PASS I PARTIAL APPROVAL ❑ CANCEL I 1 NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .)---' �1A L......
Date: M114.<11 Phone #: (503) 718 - 1.
CITY OF TIGARD
BUILDING DIVISION ` . .. `� PERMIT #: ELC2006- 004214
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1/2006
Phone: (503) 639 -4171 ppothi
Inspection Requests (24 Hrs.): (503) 639 -4175 :..!:
INSPECTION WORKSHEET FOR DATE: 0/22/2006 TIME: 7 :03AM PAGE: 26
SITE ADDRESS: 16265 SW 94TH AVE CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.12 LOT #: 649 TYPE OF USE:
PROJECT NAME: JEWELL
DESCRIPTION: Panel change.
OWNER: JEWELL, FRANCIS PHONE #:
CONTRACTOR: ALLIANCE ELECTRIC INC ci4R.L1 PHONE #: 503
Inspection Request Scheduled For: Date: 8/22 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 035301 -01 503 -691 -2222 Y
Corrections /Comments /Instructions:
> No00
.0 R pl.,th c- ALL 1)k w A P& e C 1.,'e
eANIQ L. kg1 4 0 % 5 _
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 - 271 -0030
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
F AIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: ...--1 N (ila Date: 1 21-=04 Phone #: (503) 718 - 7.4