Permit ® ELECTRICAL PERMIT
CITY OF TIGARD
" - PERMIT #: ELC2007 -00175
COMMUNITY DEVELOPMENT DATE ISSUED: 3/22/2007
TIG'ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S104BB -08400
SITE ADDRESS: 14297 SW WALNUT CREEK CT ZONING: R -25
SUBDIVISION: WALNUT CREEK LOT : 001 JURISDICTION: TIG
PROJECT: LEGEND HOMES
Project Description: Temporary power to job trailer.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
LEGEND HOMES GARNER ELECTRIC
12755 SW 69TH AVE. #100 2920 SW 247TH AVE #A
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 681 -8820 Contact #: PRI 503 - 648 -4552
FAX 503 - 642 -7925
FEES
Description Date Amount Reg #: ELE 34 -305C
[ELPRMT] ELC Permit 3/22/2007 $66.85 LIC 121 159
[TAX] 8% State Surcharge 3/22/2007 $5.35 SUP 3707S
Total $72.20 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: A Permittee Signature: aye � .4) CUrbi
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.
M Ws :GARNER ELECTRIC FAX N0. :5036427925 Mar. 21 2007 02:48PM P1
ctr g .e Application FOR OFFICE 11SE 0 \.L:IV
City of Tigatrd n o/B� - 2 7
Imo O/
13125 SW Hall)31vd., Tigard, OR 97223 . il% a 0 pi...„. a < %rno�lw •" 1 +. Llnte/9v: Other Permit:
Phone: 503.639.4171 Fax: 503. r hw'c''
Inspection Line: 503.639.4175 `' '' I Dee Ready/fly: form; 116 See Page Z tar
Internet: www ci.tigard.Or.US c) ) oOl Nnnfied/Medtod Sum:demeote' lniarmation
n '.:�'•l� . "� ' ' 4 91'{�,;q +1�`,iir + t �1,���� . p�r��l]�1 tr � ���'iiy,,�ji�'a�, i6+4. � ��h'�� 'P1(!r i,� iir ! ���� {ir�� . � „�� � .: �!, 7 r � a ,; ;:, �fi.�in•�''1, I; ' 1 r` � '' ...,
4 iRJ!ilLi�t:¢siY� 7 9i�E u l�'�a rt�llRTI • ^,uL�dSS'!d': ��tirY�azsS'v1*i ZNI +',..' I�I':r +� ! as I iih
0 New construction ❑ Al l #t r t t�q{Y iicement _ Please check all that apply:
e QServicc over 225 amps, eomm'1 . Q iazaidous location
[] Demolition 1"� � � � - iy{ " � ❑Service over 320 amps - rating ❑Bulldog over 10,000 so. ft„
pQ 1� { � t � tt ,,_�� r IS. ( ! ������ h + u p1 ra pt' �tp ��7� � 1 Ffe f r6vir yl' t<7 ��i� c ' r I • L . r • �
r � of 1- and 2 dwellings 4 nr more new residential
Y7rfL�W�Ni;I'iN'117��N� ]�.'ih�'�.47C'll�r'� '
Mr � �i� �.4� , 1�i'LL4J8;� �.33�1d'�� e• I � �'��r � LL � � � �l } r � � ,� y g
ystem over 600 volts nominal units in one structure
1 and 2- family dwelling ❑ Commercial/industrial ❑S
ndustrial Accessory building
❑ Multi Q Master builder ► ❑Feeders, 400 amps or more
�13mldmg over three stories
� Other: ❑Occupant load over 99 persons []Manufactured structures or
k t , ;t rnngrt t t U !k+ r r' 7 y tr J r,' r` �� f �T „ F i M "r 1 -'' 0 Ro � RV park „a .,n ,.w t:a... ,. „,,..,' $ICI!'., 1''j , Li. P `1 ., ,- ;1 ' S J ? s ,b(r nil ,, ;1i ; a it - t -1-1C j rIla ❑Egress/lighting plan
U,Leti 1�. « =ur iY: i i.... A i1;r,A C,.. ,� nt,.r, ..1F.0 �TSr�S�i lli 1• .t S7 }.L r ,t t i El Other: —
`�� ❑Health -care facility
Job no.: fob site address: f g 7 W Q (Vlld�” P�.><G �� Submit sets of plans with any of the above.
City /S tato/ZIP: ( y i 9 2Z The above arc not applicable to temporary construction service.
`e�r g_rt 17+ i'??`' u.1- {°�r1"17. , - F a i „
��'��i'rAd!k��i: !.!' i i� T �i�if ^ + ..i . CIS ;FI' rr • , ., t,
�,(( 1u1J1. FA�s
Suite/bldg./apt. no.: Project name. Dascoyttan Qty, Rea i 'coat
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 —
Lot no.: F. add'l 500 sq. ft, ar portion 33.40 1
Subdivision: II 75.00 2
-
- Limited energy, residential
Tax map /parcel no.: v � Limited energy, non- residendal 75.00 2
g j'fs,(i r/}'`?� Ff''"> r "'f�� u, aJ���t1 n rl�•i3 e, pq�Vi' ' }f�� ,`1'r'''1 I1,''1 li,y
�i.'i} EIME'F a':idt'I9,1: BEF.ir'.t 4��td.s {LT. t it'1tT�� u 1'ESt' lMFR `5 ,�• i +t 5'w i.1, r A �'.t . 1�' r'•I Each manufactured or modular
I , dwelling, service and/or feeder 90 90 2
'� ae.Ante L '.. .4 , A a fit, I, I- " Services or feeders installation, alteration, and /nr relocation
- 200 amps or less 80 30 2
It t y714R l 201 amps to 400 amps .. 10 2
p� TrR: a' 11 tt A
ilJ tL1 2' e 1 ry' r �' t 1 ' C , ASA v m i 3�1 tt,' 10p� rw 1 �1 .e. ;a4 . + � II A01 amps to 600 amps 1 P
� r�.t !h ti ��ir�sP� r �i�q a t! , k L �L., r .,,,• �,4„1N'� t.�'•rH. I�aC , •tl 0,60 2
Name: MP AA ' _- N 601 amps to 1,000 am 2 40,60 2
C Over 1,000 amps or volts _ 454.65 _ 2
Address: d W /al • Reconnect only 66.85 2
City/State/ZIP: c ' 7J) 3 Temporary services or feeders installation, alteration, and/or
I �t� relocation
Phone: ( a,) 1p $ g o�V Fax: ( ) 66.85 t
_ relation
amp less
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 ennel -_
r• r �] "tee 'r m• 1 �,� � / i :Inn - 11 { 2t , TI 'r pa r r 5 !� t' 1 i '� A. Fee for branch circuits with
6.15; ('f 1 + ' 1 1i } i a�! f) � e [ �f'dlf' r V l ,f wjll U a SJf r, a l It %'•,1J�41_ G S ' �' t ' : .! r
b. l• .. t L a i, am.s r: it r ' �y s serv or feeder fee, cas 6.65 2
Business name: branch circuit W
j3. Fee for branch circuits
Contact name: without service or feeder fee, 46.65 2
_ each branch circuit
Address: r Each Adel branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service nr feeder not Included)
_ Pump or irrigation circle 53.40 2
Pbane:( ) _
__
FAX:: ( ) Sign or outline lighting 5 3.40 2
- 0.: cttcu or limi ted- r---
E-mail: t • r ir ++ �. " energy panel alteration, or
{� �,� � t n + 'c W " r : +,' �" x1.�'' �� � 1 " 'Wi BY p
NE W &"� r "i , u U`�1i.$ t+yS��t ?) {. +. r. Page 2 2
�'i , ', 6 t, u fit aalil{'IdtirJt, t -N0< extension. Describe;
Business name: (7-1 - 6 J'`} i 8L'; -L- r 1 L.-
Each additional inspection over allowable i n any of the above
Address. Ll -.„?...e.:.> > (/l l r 2, - l'i 1 - Y� I Per inspectlan - 62.50
ty 1 �_ : - � C i_ Investigation per hr r hour (1 min) 62.50
City/State/ZIP: l ( 1_, v R- 1 6 A 3 � 4 _ b, es tn aj plan t r hour (I 73.50
-
-
Phone: (r' �) v (-(i ,.. P , I ) (v �4-1 7 ' 4 ..Mil a..r rls . ,. . ;Li I ., 1 , 1, A 1-k`;:; ti; .,,.,.. r •
CCB Lie.. (L ! ( -� Electrical Lic._'l p i. S ' • C. - 3 -Jr:, I -5. _ Subtotal bb ,' -
5upry Electrician - aired: //1/ , Plan review (25% of permit fe Electrician signature, cal /y _ - -- S
- _ - State surcharge (5% of permit fee) 5- 3—
- Prior name: 7 i 1 •]ate: ,z FEE
__ _ ('; '( ' ^i�� l� { , �:� TOTAL PEItM1T 7c . 3d _
Authorized signature' . This permit application expire' s if a perrn Is nor obtained within 190
days after it has been accepted u complete
Print name: Date: • Fee methodology eel byTri- CUunty Building Indus y Service board
__.,• -- Number or iu4prrtinns pc, permit a110wed.
isle, tildioePermde \P.1-C- PQnvtApp,doc 12/03 440- 4619T(10/02/COM/WEB
. CITY' OF. TIGARD
r
BUILDIN.G - D1VISION PERMIT #: ELC2007 -00175
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 3/28/2007 TIME: 7:00AM PAGE: 52
SITE ADDRESS: 14297 SW WALNUT CREEK CT CLASS OF WORK:
SUBDIVISION: WALNUT CREEK LOT #: 001 TYPE OF USE:
PROJECT NAME: LEGEND HOMES
DESCRIPTION: Temporary power to job trailer.
OWNER: LEGEND HOMES. PHONE #: 503-681 -8820
CONTRACTOR: GARNER ELECTRIC PHONE #: 503 -648 -4552
Inspection Request Scheduled For: Date: 3/28 /2007 ' Pour Time:
Code # Inspection Description - • . • • Contact # Message
110 Temporary electrical service 045562 -01 503 - 648.4552 N
VA ►NFL
- - eeffections/Co e11Ts /Instructions: -
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • IV fili Le
Date: 31 . 2.i on Phone #: (503) 718- Ziiikp
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