Permit CITY OI TIGARD ELECTRICAL PERMIT
M ^ TIGARD #: ELC2006 -00475
, DEVELOPMENT SERVICES DATE ISSUED: 8/24/2006
° 'f I± 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 102CD -02000
SITE ADDRESS: 09680 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 010 JURISDICTION: TIG
Project Description: Furnace reconnect.
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:
MARK REILY GENIE ELECTRIC CONSTRUCTION
PO BOX 882 8701 SE 156TH AVENUE
BATTLEGROUND, WA 98604 - PORTLAND, OR 97236
Phone: 360- 904 -8117 _Contact #: PRI 503 - 762 -9296
FEES
Description Date Amount Reg #: ELE 34 -488C
[ELPRMT] ELC Permit 8/24/2006 $46.85 LIC 56639
[TAX] 8% State Surcharge 8/24/2006 $3.75 SUP 45365
Total $50.60 REQUIRED ITEMS AND REPORTS
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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: ...lddi, A , Permittee Signature: d ___242 . _
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.
t H 23 06 03:09p GENIE ELECTRIC 503 -762 9188
1 �, p. l
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1 F7 FOIZ (c1 1 1( 1 1 . O" I.A
Electrical Permit ) d .� Received Q f d If Permit NoA0� Ot7 # / 5
City of Tigard D ate/B y. /J/ i 0 e 1 CLV�
13125 SW Hall Blvd., Tigard, OR 97223 2 c Plan Review Other Ft Permit:
"�plUl7 (� 2UU6 /m,.. - , I Dare/By.
Phone: 5n Line: Fax: 503.598.1 ➢ I Jens: 0 See Page 2 for
Date Notified/Method: Inspection Line: 503.639.4175 s n� 1 - Supplemental Information
Notified/Method:
interact: www.ci.tigard.or.us �'g� ;
�,� � � 'V N � I � '. PLAN REVIEW 7 7C Y!\ Please check all that a apply:
PP Y
❑ New construction ® °Additio` alteration/rePlacement
❑ase check
over 225 amps, comm'1 ❑Hazardous location
❑ Demolition ❑ Other: 0 Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or morc new residential
['System over 600 volts nominal units in one structure
❑ 1 -and 2- family dwelling ❑ Commercial/industrial ❑Accessory building ❑Building over three stories . ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan ❑tabu:
❑Health -care facility
Job no.: I Job site address: 9680 SW °loam ST Submit I. sets of plans with any of the above. .
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldgJapt no.: 1 Project name: Description I Qty. I Fee. I_ Total I ..
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
Ea add'! 500 sq. ft. or portion 33.40 1
Subdivision: I Lot no.:
Limited energy, residential , 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular 2
dwelling, service and/or feeder _ 9
Reconnect Furnace Services or feeders installation, alteration, and/or relocation
• 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
O'PI[OPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2
Name: Mark Reny -
601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: PO Box 882 Reconnect only 66.85 2
City/State/ZIP: Battle Ground, WA 98604 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (360)904 -8117 I Fax: ( ) 200 amps or less 66.85 1 I
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 10 0.30 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
1 ❑ C ONTACT PERSON A. Fee for branch circuits with
❑ APPLICANT service or feeder fce, each 6.65 2
branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee. 1 46.85 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
City /State/ZIP: • Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
• energy panel, alteration, or • CONTRACTOR extension. Describe: Page 2 2
Business name: Genie Electric Construction, Inc. A , '
Each additional inspection over allowable in any of the above
Address: 8701 SE 156"' Ave \ \ � ` per inspection 62.50
Investigation per hour (I hr min) 62:50
l
City /State/ZIP: Portland, R 97236 (1 / 73.75
^ � Industrial plant per hour
Phone: (503) 762 -9296 / - 1 IA I F (503) 762 - 9188 )EI ECTRICAI. PERMIT FEES*
CCB Lie.: 56639 + Electrical Lic.: 34 - 488C I Suprv. Lie.: 4536S Subtotal 46.85
Plan review (25% of permit fee)
Suprv. Electrician signature, required: e l /J �
State surcharge (8% of permit fee) 3. 7 5
Print name: LeRoy White Date: 8/23/06 TOTAL PERMIT FEE 50.60
Authorized signature: .• - - This permit application expires if a permit is not obtained within 180
!ll �� r ����� days after it has been accepted as complete
I Date: 8/23/06 • • Fee methodology set by Tri- County Building Industry Service Board
Print name: LeRoy Whi •• Number of inspections oer permit allowed.
Please fax back permit number. Thank you. Credit card authorization attached
•
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00475
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/24/2006
Phone: (503) 639 -4171 :"0
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:..: -.
INSPECTION WORKSHEET FOR DATE: 8/31/2006 TIME: 7 :00AM PAGE: 2.1
SITE ADDRESS: 09680 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 010 TYPE OF USE:
PROJECT NAME: FRANCIS
DESCRIPTION: Furnace reconnect.
OWNER: REILY, MARK PHONE #: 360 -904 -8117
CONTRACTOR: GENIE ELECTRIC CONSTRUCTION PHONE #: 503-762-9296
Inspection Request Scheduled For: Date: 8/31/2006 Pour Time:
Code # a a - ion Description Confirm # Contact # Message
199 Electrical final 035885-01 503-762 -9296 Y
Corrections/Comments/Instructions:
11\ - O'er: : " •
r , + t''4�
V
S eASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Go - 1 68 L_ Date: i ; 06 Phone #: (503) 718- 2441