Permit ..r'
•
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00691
DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103CC -06400
SITE ADDRESS: 13795 SW 124TH AVE ZONING: R -4.5
SUBDIVISION: WHISTLER'S WALK LOT: 011 JURISDICTION: TIG
Project Description: (3) 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: 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:
TODD ERICSON GARNER ELECTRIC
13795 SW 124TH PL 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 698 -6767 Phone: 503 - 591 -1320
FEES Reg #: LIC 121 159
Description Date Amount SUP 3707S
ELE 34 -304-30
5C
[ELPRMT] ELC Permit 9/19/2005 $60.15
[TAX] 8% State Surcharge 9/19/2005 $4.81 REQUIRED ITEMS AND REPORTS
Total $64.96
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: • � -� (�q
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.
. FROI 1 4 :GARNER ELECTRIC FAX NO. : 5036427925 Sep. 16 2005 06 : 33AM P1
...
Electrical Permit A lication ED • • A
. imille ====.
City of Tigard r.Z l ei ----Fermiti.b.6 1
13125 SW Hall Blvd., Tigard, 0137g , . Plan Review
Phone 503.639.4171 Fax: 503.598.1960 / el! 1 ? q , ..r . i /'s DatiBy e Other Permit
• Inspection Line: 503,639.4175 2 431 .11H. 1111 ,
SEP 1 6 005 ..- 412. Date Readyy: ' lurk; la gee page 2, for
IPternet: www.ci,t 1 D
igard.or.us NotifieeVhSeihod: -T- 1 ( r Sopptemental information
:
liriv ircW.14RP,IN'.niir'ORIMR,,I,F,U;'illswM,4-‘41,7.,Ygg,11T,palMetipigNiraide,( 1 ,,, !,,,‘ .,,, , ; Aii,, •',.',,
0, le V.:.',4a,V,AL9.04q,' ,W, ,:.3:.01. 0.).1., .6 vz:ai, . , 't2 L I , .1 :V ■ .1 114.- v , L 1 , .., ,,,,,. . 1 ., ' . 4 1
0 New construction ' I . rrtio alteration/replaceMent please check all that apply:
°Service over 225 amp, corrun'l 0 Hazardous location
Ej Demolition IN Other: • , , • , OSeriice over 320 amps - rating °Buildng over 10,000
vm,;),,RIN,.,nrz WPM of 1- and 2-family dwellings 4 or more new iisidcntial
1,&:,,,;t1 ,!, s:., , :it , Id:',;1,u■lieq: WM& '.Y.E. ■ U11. , u !!, 11, o _
LISystem over 600 volts nominal units in one structure
IN . - and 2-family dwelling 0 dommercial/industrial 1.] Accessory building
EIBuilding over three stories • PFeeders, 400 amps or more
• MUM-family ' D MaStar i4ii builder 0 Other: IDOccupant load over 99 persons Divianufacturcd structures or
pfaViril,:ipl:kg.:RINRC*;;Aarfl ['Egress/lighting plan RV park
11.f '441,641 or, 1, ,7,2, ,l'i;pik,,, JC• at , q 71 A. PII; L;J C Y .; Ili! Al t .Sr. • .%.'., Y.I.I , 4..1 T.' ' OP.` ,' g'. . . .
Job no,: Job site address: 1 3 7 5 .5%.A./ 1 I. v't...)e, EiFfeaM-aare facilitY 1:10ther
•
_ Submit 2 sets of plans with any of the above. .
City/State/ZIP: l C f.."7tIVC q -1 2..2,2 _ The above are not applicable to temporary construction service, .
_
Suite/bldg./apt. no.: Project name: Description ' . Qty. ier. I Tatal I **
. .
Cross Street/directions to job site: New residential single- or multi-family dwelling unit.
aragIncludes attached ge.
• _
1,000 sq, ft. or leas 145.15 4
- .
•
Subdivision: L otto.: Ea. add'l 500 sq, ft. or portion 33.40 1
_
Limited energy, residential 75.00 2
Tax map/pareel no.: • -residential • 75.00 2
f ,. ... t ;Tr . ,.,:,,, ,,) ,,:, „ , . , ,, , .,,, , ;1/444 ,,,,•,w ,v r,,...9)1, „..lrhillTA '4 k 'ii '".i. l ,
Pjlilinr? I i ', ' " i W i y 1 -',■', 1 1 ',,`4, , , 1; i c'ek. 1 ,1 It r tt r,y, 41' tt 1 i ..\ , \f 0 , '( ,) tai . ( ,,, q, .4 - i 1 .); 1.. t,. . , +!,,„IPE?
1:'„Iia i ,IV,Ii.1.4■ALL.LAI L ,, i ■1:.'.7N ..tt,takl al. !. ..11L6A4 6 tR . , ;i, IL ;;■( . Jii,,,, ,A.11Au I I, ..0Wk:ik id t,. M Each manufactured Or ThadUlar
dvicilin service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or leas 80,30 2
.....
rpiN70 2°1 amit's t° 4°° ImPs
),er ., ,(+■CA41:01 '.. l''-dl ' ' 401. s to 600 amPs 160,60 2
Name: - ro dot Uir irc,v 0 tl 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts
—. 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 0177 - / 3 Temporary services or feeders installation, alteration, and/or
Phone: ( ) • OP ; r ( relocation
p , Fax: ( ) •
20 amps or less 66.85
1 .
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Owner Installation: This installation i 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 600 amps 133.75 2
Owner signature: • Date: . Breach circuits - new, alteration, or extension, per panel ,
Iii;10j7.PWIrb:!'/PVi'SIFilt•Fi'll'i',1'40V+PRII)TiM;••"•,,,ni,'•,Nk'qgfeltilrsiiFINtiAclireilf;FIZiaiVII0;4: A. Fee tr traria circuits with ,
?flu ', ,! ■-%1 'ha AN'!"■\ :(EU! '=',. V. 4, : ', '' .1 A '',,,, tta ' \ ' "?''',,,,,, A ' " '' ' '' ." k '1 .`"' service or feeder foc, each 6,65 2
Business name: . branch circuit
_ a, Fee for branch circuits
Contact name: wititoia service or feeder fee, (
46.35 (.4.LS5
cac 2
h brench circuit
Address: laaa__2:
Each add'l branch circuit a 6.65
_
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:( ) I Fax: : ( ) . Sign or outline lighting III 53,40 2
_—
E S Signal circuit(s) or limited-
nor 0;•?!).•.,.,;1;tiMei::31171 Willrigr ener P anel ' alteration' or
, a ..` ,L$.6Va .4 (, mlnikanorN;noni. :) , A71-1 .1 Ilf ) .,.% :4.41‘. .1: .- , , 0111" 0 .1. , S 1, . J , 16 extension, Describe. Page 2 2
Business came: C.".-y-1- Eiji ›. E I r k , i c
Address: 2- : W ,2_ - 0 Ave , Each additional Inspection over allowable in any of the above
-- ' 7 _ j 4,' . `; L - 1 ,2 1 4 ie
_ i' — Per inspection 62.50
City/State/ZIP: 1,..1- k ( .,--) tc, 0 ,-0 () R c■ -/ I 2._ "...i?, Investigation per hour (1 la min) 62.50
.- AIIIIMOMIIMIllin. Industrial plant per hour 73.75
Phone: (' ) (42 C A ...../ 9 4.. .2-7 rfflifirAngliivrAMIllill .v;,1m,nowl,i .,,., ni-rvz,; l'a.Tli V 7 ""''''4''. 61t ' A '
'.t;0
11122=1= Electrical Lie.:: ArAIS . .. ic.: - 3 - • .,,
Sublotol j 1"N.
' / / •
11=W7.a./140f./././ Plan review (25% of permit fee) —
r. C State surcharge (8% of permit fee)
Print name; f(3 e.,--. cz ( ---.,..-,..-- (..-:_ Date: evi us ....., . -
TOTAL. PERMIT FEE , 4 Ak_.,
- ..`
Authorized signature: , S This permit application expires It permit is not obtained within
,—.-------*-••■-.^. days after Is has been accepted as noniptete
Print name: _ Date: • Fee methodology set by TA-County 13 tkittling Industry SerViea Board
• * Number of inspections per permit anemia.
•
1:■BuildinsWemtitslet.C.PermitApp.eac
I/03 . 440.461sT(10/02/COM/WEB
CITY OF TIGARD • =• •
BUILDING DIVISION ` PERMIT #: ELC2005- 011691
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 Ni; �il
�
Inspection Requests (24 Hrs.): (503) 639 -4175 _.! l ��� i `__..
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AIVI PAGE: 129
SITE ADDRESS: ' 13795 SW 124TH AVE CLASS OF WORK:
SUBDIVISION: WHISTLEFVS WALK LOT #: 011 TYPE OF USE:
PROJECT NAME: ERICSON
DESCRIPTION: (3) branch circuits.
OWNER: ERICSON, TODD PHONE #: ‘) - 6913 -67
CONTRACTOR: GARNER ELECTRIC PHONE #: 5091 -1320
Inspection Request Scheduled For: Date: 10/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017767 -01 503-64B-4552 N
Corrections /Comments /Instructions:
0 `fi e ecci &/ pc di 4),.
U i •^e 4 3 +M I` oIAL . c , _ Or /'C'. l cam?
• L0 c - (04 2 -r 1 e_ IA e-- (
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1
Inspector: A . 1.../14 ._.4 Date: (® -- f 0 OS Phone #: (503) 718-
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