Permit CITY OF TIGARD ELECTRICAL PERMIT
:1111i " PERMIT #: ELC2007 -00446
COMMUNITY DEVELOPMENT DATE ISSUED: 6/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104 B B -09800
SITE ADDRESS: 14119 SW WALNUT CREEK WY ZONING: R -25
SUBDIVISION: WALNUT CREEK LOT : 015 JURISDICTION: TIG
PROJECT: WALNUT CREEK
Project Description: Service and branch circuit for lighting at entry.
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: 1 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:
MATRIX DEVELOPMENT CORP. TODDS LIGHTING & ELECTRICAL
12755 SW 69TH #106 19579 SW KARI ANN CT.
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 620 -8080 Contact #: PRI 503 - 913 -2144
FAX 503 - 742 -1900
FEES
Description Date Amount Reg #: ELE 3 -510C
[ELPRMT] ELC Permit 6/29/2007 $86.95 LIC 146666
[TAX] 8% State Surcharge 6/29/2007 $6.96 SUP 4434S
Total $93.91 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: 44144,44,. Permittee Signature: xGu
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.
JUN 29,2007 10:30A 5037921900 page 2
•
Electrical Permit p 1 by 101: ill l R I I ,I. t 1\I .1
City of Tigard 6� DekaB `e ,,..t 0 BO A 13125 SW I hilt Blvd., I lgard OR 97223. Piaui Renew ..10,97. DO
Phone: 503 639.4171 Pax: 503.598 19 1'.� w 200 '/`" ,,, I ftatnt Other Perim.
Inspection Line: 503 639.4175 ! . 1 I Date Ready/By
gym++ ! RI See P age 2 for
Internet; www.ci,ltgordur.lIO 4iI Y U I I IUPtii t�^-�y�,� Nut'lied /Method: '/ Supplemental Information
BUfIbE�tt t�P�1 i0t`t PLAN REVIEW
'New construction -❑ Addition/alteration/replacement Please check all that apply:
ID Demolition Other. fiIC eefr.sof /i{`4,fn9 `11Ri9uf/q,, ❑Scrvlccover amps,comm'I ['Hazardous location
J ❑Ser vice over 320 amps -ruling ❑Buildng over 10,000 eq. ft.,
CATEGORY OF CONRTRIUCTION oft- and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi-family ❑Master builder ❑Ruilding over three stories ❑ Feeders, 400 amps or more
❑ Other:
JOB SITE INFORMATION' Altib' QCATION ❑g rs
anl load over 99 peons ❑Rnu achtred structures or
❑kgressress/lighting plan park
['Health - cam facility ❑Other
Job no.: Job site address: /5/// q Oa 4 r' CS eerie jt,at Submit 2 acts of plans with any of the above.
City /StutcJZIP: 1 -4s. A- /723' The above arc not applicable to temporary construction service,
J
FEE' SCHEDULE
Suite/hldg. /upl- no.: Project name: 1hbe,l _ 6C . rt{T y Dampam spy. I vet• I ran I ••
Cross street/directions to job sitc: u ^ $ r -1 t Ne wr esidenllal single -or multi- family dwelling unit.
/ Includes attached garage-
/)tell ('�'� Gx wt. t fil 1,000 .sq. IL or less 145.15 d
Subdivision: W d.( n� f. CT et. h Lot no.: /j F.a, add'l 500 sq. ft, or portion 33.40 I
Limited atergy, residential 75.00 2
Tux map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
L- dwelling, service and/or feeder 90,90 2
Sax U // t L:-t ' Co A 0 6; #ry Services or feeders inefallation, alteration. and/or relocation
ZA op f`/ Dt o t J`' r 1 4-1 -1' o h Co "fro AS' 200 amps or less / 80.30 /50. 2
PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
r / 401 amps to 600 amps 160.60 2
Name: ]"'C x D f p L l 61 ' (,01 amps to 1,000 amps 240.60 2
Address: SL.) i o ci'r—' — of T Over 1,000 amps or volts 454.65 2
f � — Reconnect only 66.85 2
Ci ly /Stute/71P: ' _0 4 9 z e1 ) Temporary services or feeders Installation, alteration, and/or
Phone: (S °j) 624 z o0o a am _ gof c , rFat:( ) 2o
or toss 66,83 I
Owner installation: This installation is being made on property that l own which is not 201 amps 61400 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
❑ APPLICANT D CONTACT PERSON _ A. pee for branch circuits with
Business name: bran LW feeder fee, each 6.65 6,65 2
R, Fee for brand circuits
Contact name: 7 h / f Oce .C� , - — without service or feeder fee,
46.83 2
Address:
first branch circuit
Foch udd'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) fax:: ( ) Pump or imganon circle 53.40 2
Sign or outline lighting 53 40 2
E -mail: Signal mew t(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Pagc 2 2
Business name; e L A0 "/ C2— ( LLC _
a � ,,// Each additional Inspection over allowable in any of the above
Address: f gs7 1 S /
, —C►r/ All pa C • Per inspection 62.50
C ity /Stat eJZll': - re, d0 D1 (.' 4-Y / A. '7 f %' Investigation per hour (I hr min) 62.50
Phone: ( 5 ) f r Fax: ( 0.7 ) 7 2 -moo Industrial plant per hour 73.75
`� - u ELECTRICAL PERMIT FEES
CCB Lie.: /yd66C E lectrical I. ,.,'i Op f eZprr_ I.ic. �y111 Subtotal - Is Suprv. Electrician sign lure, required: d: IO ' I ' (77 Plan review (25% of permit fee)
Print name: � State surcharge (8% of permit fee) 6% ge
17 ,,,,, e. 4 5 , I Date: d /L /�
TOTAL PERMIT FEE 4/3_ I
Authorized signature; t
gTlaturi: ( This permit application aspires if a permit is net Obtained within ISO
days after It leas been accepted as complete
Print name: � a I Date; 1 t t • I•ee methodology set by Tnd:ounty men ding Industry Serving none
•• Nuutbut Of inpetuna pin ;annul :Ahmed.
, \RU iki-1 ('- rmoltAlm dm, 12/03 44t- 4OIST(InR11/(OMM'FA
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00146
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/2007 •
Phone: (503) 639 -4171 Vit Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 7/18/2007 TIME: 7:01AM PAGE: 29
SITE ADDRESS: 14119 SW WALNUT CREEK WY CLASS OF WORK:
SUBDIVISION: WALNUT CREEK LOT #: 016 TYPE OF USE:
PROJECT NAME: WALNUT CREEK
DESCRIPTION: Sorvice and branch circuit for lighting at entry.
OWNER: MATRIX DEVELOPMENT CORP., PHONE #: 503. 620 -8080
CONTRACTOR: TODDS LIGHTING & ELECTRICAL ' PHONE #: 503 913 - 2144
Inspection Request Scheduled For: Date: 7/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 052249 -01 503- 913.2144 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,. , • Inspector: � •�� Date: 7 ` I Phone #: (503) 718-
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00446
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/2007
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 F.
INSPECTION WORKSHEET FOR DATE: 7/2/2007 TIME: 7:02AM PAGE: 13
SITE ADDRESS: 14119 SW WALNUT CREEK WY CLASS OF WORK:
SUBDIVISION: WALNUT CREEK LOT #: 015 TYPE OF USE:
PROJECT NAME: WALNUT CREEK
DESCRIPTION: Service and branch circuit for lighting at entry.
OWNER: MATRIX DEVELOPMENT CORP., PHONE #: 503-620.0000
CONTRACTOR: TODDS LIGHTING & ELECTRICAL ' a� PHONE #: 503- 913 -2144
Inspection Request Scheduled For: Date: - 7/212007 Pour Time:
Code # Inspection Description C.nfirm # Contact # Message
105 Underground/slab cover 051294 -01 503913.2144 Y
Corrections /Comments /Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G .-- kbe Date: I O") . Phone #: (503) 718- 2-1-01)