Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00388
DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102BB 01300
.‘" SITE ADDRESS: 09980 SW JOHNSON ST ZONING: R - 4.5
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT : 016 JURISDICTION: TIG
Project Description: (2) branch circuits. Moving outlets, add exterior light.
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: 1 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:
EMMETT & E SHEARER OWNER
9980 SW JOHNSON
TIGARD, OR 97223
Phone: Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 7/14/2006 $53.50
[TAX] 8% State Surcharge 7/14/2006 $4.28
Total $57,78 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 OUN at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature:
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 ApplicationRECElVE FOR o =FILE USE ONLY .
�, Ci of Tigard JUL 1 4 20(1 fi Received ' /t� d‘ „.....o__
Permit No.: GCoZ v 6' 63.75.
13125 SW Hall Blvd Tigard, OR 97223 Plan Review
;l - - III ” Phone: 503.639.4171 Fax: 503.598.19 Other Permit: Date/B :
OF TIGARD
•‘TI-6ARIY Inspection Line: 503.639.4175 Date Rea d y By: H See Page 2 for
/ Internet: www.tigard or.gov BUILDING DIVISI Notified/Me Supplemental Information
TYPE OF WORK ' - ,PLAN REVIEW
0 New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition AV Other: where the available fault current ❑ Marinas and boatyards.
- - _ ` - - _ ` CATEGORY OF 'CONSTRUCTION ° . M•n ' a_ : ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
[7 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
.' - JOB SITE INFORMATION: AND `,LOCA ❑ Emergency system. larger separately derived system.
. , _ _ . . ❑ Addition of new motor load of ❑ "A ", `3 ", "1 -2 ", "1 -3 ",
100HP or more. occupancy.
Job no.: Job site address: 9fi.7 �� h 1 ❑ Six or more residential units. 0 Recreational vehicle parks.
— ❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP:
L�a r`' ` ( ! q °� ') ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE. SCHEDULE ' °
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single - or multi - family dwelling unit.
a rel. nom' Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
._. _ „ _
"• _•.. `.M - DE SC R I P TION OF, , WORK � (with above sq. ft.)
�� o Limited energy, multi - family 75.00 2
rn 0 V) 47 fJGC 7 41 ad, / j . A '1-- residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
. 7 PROPERTY° OWNER - ' , _ ❑'TENANT- ; , 201 amps to 400 amps 106.85 2
Name: . �m yy e 34-- 5 ke.41. -�
( 401 amps to 600 amps 160.60 2
r � 601 amps to 1,000 amps 240.60 2
Address: qv , / ) V r� tin S b Over 1,000 amps or volts 454.65 2
City/ State/ZIP: / " q rcf� D .. a:3 OR ' 7 a Temporary services or feeders installation, alteration, and /or
JJ relocation
Phone: (g) _ 3 1 . 4 D Fax: (S7-.).3) (Q a a -5 d 200 amps or less 66.85 1
Owner installation: Th ". d i tallatio r .eing made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, I -,. s:•,: , or e .%. !e, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
,." �� � �� a Branch circuits — new, alteration, or ex tension, per panel
Owner signature' f Date: A. Fee for branch circuits with
_ ' „ ❑ °API'L 'ANT < - „ . ❑ CONTACT ,P „ ` ' , above service or feeder fee,
each branch circuit 6.65 2
Business name: O6-0 Ke r- B. Fee for branch circuits fj
Contact name: without service or feeder fee, / 46.85 2
first branch circuit
Address: Each add'l branch circuit / 6.65 - 2
Miscellaneous (service or feeder not included)
City /State/ZIP: 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
Signal circuit(s) or limited -
Business name:
01,...t) "Le...)-- . energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
'EL ECTRICA L PERMIT FEES
Suprv. Electrician signature, required: Subtotal: .3 ,5
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 7
Authorized signature: TOTAL PERMIT FEE: 1 . 2 4
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615TO1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information •�
LIMITED ENERGY PERMIT FEES:
FNRESID,ENTIAL,WORK ONLY:.
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:
COMMERCIAL WORK ONLY:,._W_ >. ;_..__._.
Fee for each commercial $75.00
system
(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*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC - PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2006-00388
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1412006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/1812006 TIME: 7:03AM PAGE: 67
SITE ADDRESS: 09900 SW JOHNSON ST CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 016 TYPE OF USE:
PROJECT NAME: SHEARER
DESCRIPTION: (2) branch circuits. Moving outlets, add exterior light.
OWNER: SHEARER, EMME I I & ELISE PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: W18/2006 Pour Time:
Code # Description Confirm # Contact # Message
120 Electrical rough-in 035206-01 503-620-3140
Cor tions/Comments/Instructions:
kRck F■No,L:
\--=5 v Ai \A 'ELL LOO'
NkiztvE -iIi1
•
FA PASS I PARTIAL APPROVAL El CANCEL I I NO ACCESS
I FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: ste Date: s- vb Phone #: (503) 718- 7.-+%