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Permit Y � CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC206 -00596 DEVELOPMENT SERVICES DATE ISSUED: 10/20/2 44- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S134CA -06700 SITE ADDRESS: 11810 SW BURLCREST DR ZONING: R -4.5 SUBDIVISION: BURLWOOD NO. 2 LOT : 007 JURISDICTION: TIG Project Description: (1) 100amp sub - panel, (6) 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: 1 W /SERVICE OR FEEDER: 6 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: ROD CALLAHAN JSM ELECTRIC 11810 SW BURLCREST DR 7717 SW SKYHAR DR TIGARD, OR 97223 PORTLAND, OR 97223 Phone: 503 - 407 -3409 Contact #: PRI 503 - 866 -7304 FEES Description Date Amount Reg #: ELE C218 [TAX] 8% State Surcharge 10/20/200( $9.62 LIC 168451 [ELPRMT] ELC Permit 10/20/200( $120.20 SUP 5104 -S Total $129.82 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: Permittee Signature: c e p. 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. Oct 14,06 09:47p Jeffrey S. McGinnis 503 - 244 -4397 p.1 Electrical Permit I Application_ FOR OFFICE t: Sl .c? r_1 City of Tigard M tU ld V E D A Received _ 4, _ e 6 DatuB - .., 13125 SW Ha11 Blvd.. Tigard, OR 97113 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 O C T 2 0 2006 ^s* qu \ DatuB : Other Permit. - J I Inspection Line: 503.639.4175 .. - 'ri: , •r � � y Date RcadylBy: Ju @ ris: See Page 2 for Internet: www.c i.tigard.or.us CITY OF TIGARU - Notifie :Method: Supplemental Information no roe nonin ntt/[Ciriat TYPE Of WORK - PLAN REVIEW Q New construction Addition/alteration /replacement Please check all that apply: ['Service over 225 amps, comm'I ❑Hazardous location ❑ Demolition Q Other: ['Service over 320 amps - rating DBuildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential 1- and 2- family dwelling Ell ❑ Accessory building CI System over 600 volts nominal units in one structure ['Building over three stories [Weeders, 400 amps or more El Multi family 0 Master builder Q Other: ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park y ❑Health facility ❑Other Job no.: `Job site address: ,.5 , 0 5 C.,3 � 1 k. , < \ C r e 3 ) Submit 2 sets of plans with any of the above. City/State/ZIP: - 1 , The above are not applicable to temporary construction service. ! FEE* SCHEDULE Suite/bldg./apt- Pro Pct name: �� � (\,,,,,„___// _ rN no.: Project 1 \ \ \ ( �` \ h.t - Seripfion 1 Q. ` Fee. ' Total L •• Cross street/directions to job site: New residential single- or multi- family dwelling unit_ Includes attached garage_ 1,000 sq. ft. or less I 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 DESCRIPTION OF WORK Each manufactured or modular 1 C dwelling, service and/or feeder 90.90 2 .5 /66A _<, : ,b , -1 , I ;4 -97,9" Services or feeders installation, alteration, and/or relocation M /^ G. <f ' . :i 2 C., ��� 141/6. & " � � �� } �/ � �s" PVC � D�y, r' 201 amps to 400 amps 106.85 1 200 amps or less X 80.30 1 i • 2 El PROPERTY OWNER I ❑TENANT 401 amps to 600 amps 160.60 2 Name: R Od '/ 0.--k & I I 601 amps to 1,000 amps 240.60 2 Address: ii e 0 S, L'`,, .- .'- I c fes-1- JD-- Over 1,000 amps or volts 454.65 2 i Reconnect only 66.85 2 City/State /ZIP: t 4' G�r"U' ©/ 1 ei 7 Temporary services or feeders installation, alteration, and/or _ relocation Phone: (59) Li 7 '- 314 ©4 Fax: ( ) 200 amps or less 66.85 l l 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel X APPLICANT ❑ CONTACT PERSON - A. Fee for branch circuits with ' /` service or feeder fee, each (� 6.65 .0 2 Business name: al /eG r-j G branch circuit V 11 B. Fee for branch circuits Contact name: , L'' 'e t'i L 6 t 01 / 3 n without service or feeder fee, 46.85 2 � 7 7 5 . W 5 t `- y h r (J� each branch circuit Address: iv ' Each add'l branch circuit 6.65 2 ` i' Miscel laneous (service or feeder not included) 1 0 r":1" ! j 6 R7 2 .-i 3 ( ) / �/ [� r� Pump or irrigation circle 53.40 2 Phone: ( s�3 ) �CJ - 73 Fes: (' ) L /(f Q / Signor outlinelighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 , 2 Business name: .T,S t fe - L v /1 Each additional inspection over allowable in any of the above Address: 1 `7 / 7 S • l y 5 /C. -,> h .12 Per inspection 62.50 City /State /ZIP: /9»-&I 1 8 9. ct ' � Z',--3 Investigation per hour (I hr min) 62.50 Industrial plant per hour 73.75 Phone: ( 3) �6 6- 730'1 Fax: ) ELECTRICAL PERMIT FEES* CCB Lie.:I fj0 51 Electrical Lic.: / / e Suprv. Lie.: S Subtotal LO , 2- Suprv. Electrician signature, required: f /I/a D Plan review (25% of permit fee) !J State surcharge (8% of permit fee) eq •- ` 4_ Print name: Ll L � CM 6-(‘I• 3r �'� �d TOTAL PERMIT FEE 1 r9A Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Hoard •• Number of inspections per permit allowed. is Building \PermilslELC- PermitApp.dac 12/03 4.0- 3615T(101021COM/WEa CITY OF TIGARD i� - ' °'BUILDING DIVISION PERMIT #: ELC2006- 00596 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2006 Phone: (503) 639 -4171 N Atb, Inspection Requests (24 Hrs.): (503) 639 -4175 111111 '' �.. INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: 1 SITE ADDRESS: 11810 SW BURLCREST DR CLASS OF WORK: SUBDIVISION: BURLWOOD NO. 2 LOT #: 007 TYPE OF USE: PROJECT NAME: CALLAHAN DESCRIPTION: (1) 100amp sub- panel, (6) branch circuits. OWNER: CALLAHAN, ROD PHONE #: 503-407-3409 CONTRACTOR: JSM ELECTRIC PHONE #: 503. 8667304 Inspection Request Scheduled For: Date: 3/29/2007 Pour Time: Code # Inspection Description Confirm Contact # Message 199 Electrical final 045700-01 503- 407 -3409 N Corrections /Comments /Instructions: \\\ \ c � • \ S ,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: t l Date: 3 2' of) Phone #: (503) 718- -114i0 CITY OF TIGARD �- 0,6_ 7,0616- O GQ BUILDING DIVISION 1. `' PERMIT #: • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4/4104i Inspection Requests (24 Hrs.): (503) 639 -4175 'f INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: I t c I 0 A-/V S • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Sch -. - • •r: Date: (R d S Pour Time: Code • Inspection Description Confirm # Contact # Message J l " Ele.4 - . 6-.4. ItoilL 4- '7q leati) Co ns /C m�en /Instructions: • �` I: 'ASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS WI FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G A tA vJ Date: 1 . v ' 01 () Phone #: (503) 718- 244/0 CITY OF TIGARD 6LC20o BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: b1Z�� bb Phone: (503) 639 -4171 1II j�i'i Inspection Requests (24 Hrs.): (503) 639 -4175 .� / � INSPECTION WORKSHEET FOR DATE: 1420i c/o,. TIME: PAGE: SITE ADDRESS: f t j 0 15 A..cair CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 168 vt•itnxbolz, thhn Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ' fV Date: 11v tb Phone #: (503) 718- 2,14'