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Permit
CITY OF TIGARD '` ELECTRICAL PERMIT PERMIT #: ELC2007 -00200 COMMUNITY DEVELOPMENT DATE ISSUED: TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 102 C D -02001 SITE ADDRESS: 09630 SW O'MARA ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT : 020 JURISDICTION: TIG PROJECT: MCDILL Project Description: 2 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: 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: MCDILL, STEVEN J + KIMBERLY C BENTLEY ELECTRIC INC 9630 SW O'MARA ST 41330 SW EDNA LANE TIGARD, OR 97223 GASTON, OR 97229 -9625 Phone: 503 - 936 -0647 Contact #: PRI 503 - 985 -9500 FEES Description Date Amount Reg #: ELE 2 -20C [ELPRMT] ELC Permit 4/4/2007 $53.50 LIC 44467 [TAX] 8% State Surcharge 4/4/2007 $4.28 SUP 36355 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 otification 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 OUNC at 5 . 46.::'9 or 1.800.332. 44. Issued By: 44,4.44...A__ Permittee Signature' N • 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 Applicati � E ECEIVED. FOR OFFICE USE ONLY � St Recei � Ci o f Ti an d a J Permit No.: a 13125 SW Hall lvd., Tigard, OR 97A R 4 2007 Date Review /,� 7 "— {�j 6 049,7a, 1111 C . Phone: 503.639.4171 Fax: 503.598 1 Date/By: Other Permit: • T I G n R D Inspection Line: 503.639.4175 la I T OFT{(AFID Date Ready/By: rarix,..1 la See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ 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. El 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 VI 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 LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ", Job no.: Job site address: q (0 3 Q S ( 0 R_4 f Six or or o more residential R occupancy. ❑ Six or more residential units. ❑Recreational vehicle parks. City/State /ZIP: i ( ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: me 0 ILL ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: (M j JA ct) - OtAftikv24 Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. 4- 'Y1 `E t caFw e.a_ C Ge, Q i sco 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 DESCRIPTION OF WORK (with above sq. ft.) M;C� Limited energy, multi - family 75.00 2 543 LT TO 3 - tirE_ J stcll, GI (STS residential (with above sq. ft.) f 1 Services or feeders installation, alteration, on, and/or relocation P � - It S[' Cyr (' S 1 I — 4 1 - 6 .t 200 amps or less 80.30 ' 2 c lip PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 . Name: ,5 tJ jJ (MG U t U— 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 _ Address: q ( Q StAi © h AAA gar Over 1,000 amps or volts 454.65 2 City/State /ZIP: ^i (yL� , Temporary services or feeders installation, alteration, and/or relocation • Phone: (WS ) `l3 i — Q gt "1 Fax: ( ) 200 amps or less 66.85 1 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 Branch circuits - new, alteration, or extension, per panel _ Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ 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, r ' 46.85 2 first branch circuit ` ��/� Address: Each add'I branch circuit I 6.65 G, i 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 Business name: $ S� E. G c . - Signal circuita e r limited- t o or . `°- 1 energy panel, alteration, or Address: y ( 30 F E....DAJ t ,4 LA extension. Describe: Page 2 2 City/State /ZIP: Y t 9l ( ( q Each additional inspection over allowable in any of the above ( 3) 84 ^ 7 c( (�) ? 5'-9 j'q Per inspection 62.50 Phone: SO � Fax: Investigation per hour (I hr min) 62.50 CCB Lic.: y'-(, 7 Electrical Lic.: Z -'L G Suprv. Lic.: 3b 3 5-s Industrial plant per hour 73.75 (� ELECTRICAL PERMIT FEES Suprv. Electric an signature, required: q K Q0_ , Subtotal: .5 , 50 Print name: huitEr Po WELL Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): /7 4 r. Authorized si nature: TOTAL PERMIT FEE: . 7 g Print name: Date: T�s permit application expires if a permit is not obtain within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\BuildingWermits C- PermitApp.doc 05/23/06 ^ 1 0q 440-4615T(1 I/0 /COM/WEB (� I I 7�0 7 1 D/I /o 1 Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information ' LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ H ealing, Ventilation and Air Conditioning System* ❑ V acuum Systems* ,.. ❑ Other: t COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) • t Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls . ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC i ❑ 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 11BuildingWermits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00200 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 - 4175 W- ":.. INSPECTION WORKSHEET FOR DATE: 4/10/2007 TIME: 7:00AM PAGE: 41 SITE ADDRESS: 09630 SW O'MARA ST CLASS OF WORK: SUBDIVISION: EDGEWOOD LOT #: 020 TYPE OF USE: PROJECT NAME: MCDILL DESCRIPTION: 2 branch circuits. • OWNER: MCDILL, STEVEN J + KIMBERLY C, PHONE #: 503-936 -0647 CONTRACTOR: BENTLEY ELECTRIC INC PHONE #: 503985 -9500 Inspection Request Scheduled For: Date: 4/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 046247 -01 503 -936 -6047 N Corrections /Comments /Instructions: ci PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ►� � Inspector: Date: Phone #: (503) 718 - CITY OF TIGARD - BUILDING DIVISION PERMIT #: ELC2007 -00200 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2007 • Phone: (503) 639 -4171 , m 1 � Inspection Requests (24 Hrs.): (503) 639 -4175 _..'!4i I �� INSPECTION WORKSHEET FOR DATE: 4/9/2007 TIME: 7:01AM PAGE: 1 SITE ADDRESS: 09630 SW O'MARA ST CLASS OF WORK: SUBDIVISION: EDGEWOOD LOT #: 020 TYPE OF USE: PROJECT NAME: MCDILL DESCRIPTION: 2 branch circuits. OWNER: MCDILL, STEVEN J + KIMBERLY C, • PHONE #: 503- 936 -0647 CONTRACTOR: BENTLEY ELECTRIC INC ( \::J - ' f\ PHONE #: 503 - 985.9500 • Inspection Request Scheduled For: Date: 4/9/2007 Pour Time: 'Thl, 1- 11.3, 1 j Code # Inspection Description Confirm # Contact # Message 199 Electrical final 046201 -01 503 - 936-6047 Y Corrections /Comments /Instructions: —f 57 \rU\) ¥ :1' _ \ c) A :v- p FYI 0 - p Nz vib AttetF 4- 0 6F cbc\\b \il ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS X FAIL C ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED , Inspector: r N Q4 L Date: 1 4 l ®') Phone #: (503) 718-1-44