Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00489
.� DEVELOPMENT SERVICES DATE ISSUED: 8/31/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S125DD -05500
SITE ADDRESS: 09860 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 063 JURI cTION: LIG
Project Description: (3) branch circuits for kitchen & bath remodel. Job # A7292. �XP �s ®® ®® E®
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 WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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:
MCLELLARN, 9 60 SW VENTURA CT W /PALMIRA B O MCCOY BOX 42428 ELECTRIC CO INC EXPIRE.,
TIGARD, OR 97223 PORTLAND, OR 97242 /CI, ti 6... it
Phone: Contact #: PRI 503 - 234 -7521
FAX 503 - 234 -9473
FEES
Description Date Amount Reg #: ELE 26 - 82C
[ELPRT] ELC Permit 8/31/2006 $66.80 LIC 8277
NI
[TAX] 8% State Surcharge 8/31/2006 $5.34 SUP 2175S i
0
Total $72.14 REQUIRED ITEMS AND REPORTS
;i
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: f j r ,2,4: \ Permittee Signature: .R • _
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: ELC2006 -00489 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description 1 PASS Date By ✓ Code I Inspection Description I PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing X 120 Electrical rough -in
805 MFG - Structure grading/footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough-in
998 Alarm final g
322 Shower pan
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building\Inspection Cards \Forms \AOP- InspCard- Blank.doc 12/09/2005
: ELECTRICAL PERMIT
CITY OF TIGARD -
PERMIT #: ELC2006 -00489
DEVELOPMENT SERVICES DATE ISSUED: 8/31/2006
s s 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S125DD-05500
SITE ADDRESS: 09860 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 063 JURISDICTION: TIG
Project Description: (3) branch circuits for kitchen & bath remodel. Job # A7292.
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: 3 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:
MCLELLARN, ROBERT W /PALMIRA B MCCOY ELECTRIC CO INC
9860 SW VENTURA CT PO BOX 42428
TIGARD, OR 97223 PORTLAND, OR 97242
Phone: Contact #: PRI 503 - 234 -7521
FAX 503 - 234 -9473
FEES
Description Date Amount Reg #: ELE 26 -82C
[ELPRMT] ELC Permit 8/31/2006 $66.80 LIC 8277
[TAX] 8% State Surcharge 8/31/2006 $5.34 SUP 2175S
Total $72.14 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 B y: �,( n ^ L / � Permittee Signature: tL
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.
' V
_
- Electrical Permit - ! L.' . '1 1.014 011:1C17. USE ONLY
I, ; j r ',
City of Tigard'. - E ti R......,..,„ _....., 4 ...■
nar.n3 . A -5 . ik. Permit N '''' (-d CX.. 9 0 t -
13125 SW Hall Blvd., Tigard, OR 972 3 1 2 0 0 6 pip, aoiew
Phone: 503.639.4171 Far 503.5983U Other Permit
Inspection Line: 501 D
639.4175 a ': - 1
!.. ___ ata Ready/By: Mil 65 See Pagel tor
Internet: www.ci.tigard.or.us CITY OF TIGARD -- Notified/Method: Supplemental information
. BUILDING DIVISION
. _
0 New construction El Addition/alteration/replacement Please check all that apply:
' . D Demolition 1215ther: °Service over 225 amps, comrn'l IDHazardous location
- - °Service over 320 amps - rating OBuildng ova 10,000 sq. IL,
' ...". 2.: • . •• '', ....":: • .,;.
CATEGORY: OF CONSTRUCTION : . , ...7 . .: • ::.-7 of I- and 2-family dwellings 4 or more new residential
ford 2-family dwelling 0 commercial/industrial 0 Accessory building Dsystern over 600 volts nominal units in one structure
EIBuilding over three stories ElFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
DOmapant load over 99 persons 1:Manufactured structures or
-
• • .• - ' ::' •• : .:•-•• JOB SUE INFOR,MATIOWAND tOCATIOg ' .:' : .. . • ...... . " .. LIEgeseliglaing plan RV park
Job no. A 3-vi 2., Job site address: 86.0 c w , vt(fv Cr °Health-care leaky 00ther.
Submit 2 sets of plans with any of the above.
City/State/ZIP: - W s - 4.1.1040 d (C._ , Tbe above are not applicable to temporary construction service.
_
'tili,.:47% ; • .1.: ••'1 .. FEE sancouLt;
Suite/bldg./apt. no.: I Ilroject name: /Y1C L r.,..
Description I QtA I Fm I lreol I ..
Cross street/dire:dims to job site: New residential single- or multi-family dwelling unit.
Inch:ides attached garage.
1.000 sq. it or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy. residential 75.00 2
Tax 'nap/parcel no.:
• Limited energy. non-residential 75.00 2
. "; '...; . .:„.• ....:::..::-.. r :: '..; '...:'!.'"'....':' ;.`• ".:...• '......;EIESCRIPTI . ON; OF WORK :: :!..:r . .......',..':.;'.'.i.:: . ;;'........ 1 '.: Egth manufactured or modular
- . dwelling, service and/or feeder 90.90 2
r V■i9 kt...--/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80,30 2
'.... • !':,..2.':7.0 PROPER:It:4:444A :'.•:.: .';':,':: '.•:..;;;:`:;.:.'Y,',:.::::" ; .. 2 ------------------- 01 amps to 400 amps 10615 2
401 amps to 600 amps 160,60 2
•
Name: .
601 amps to 1,000 amps . 240.60 2
Address: . Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) • ' Fax: ( )
200 amps or less 66.85 1
Owner installation: 'This installation is being made on property that Iowa which is not ----- amps to 40o 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
:.,..: .: ..i . :.; ::: CI •Aiiii,ICAtor::/.:;::':;:.:A.:::::•:• ::::7.,;:',.53.frc'oNikey..olis kFee for branch circuita with
service or feeder tbe, each
6.65 2
Business name: U. (Lo _.
1 .4 L C..) branch circuit
B. Pee for branch circuits '
C name: & LL -L US i without service or feeder fee, I 46,85 it6
KJ 2
each brunch circuit
Address: 26 1,4„4 5 ,6- . ct w _... A..-ic-
Each adel brEnch circuit - 3 6.65 i i 2
City/State/ZIP: pOdn-L at_ ¶ Z.- I (t Miscellaneous (service or feeder not included) .
J i _
Pump or irrigation circle 53.40 2
Phone: (3 )234-- qr z ) I Fax: 05 ) .g5q-ci ki. q-.3 Sign or ontline lighting 53.40 2
_ E-mail: Signal circuit(s) or limited
CONTRACTOR ____ energy peed, altera±ion, or
extension. Describe: Page 2 2
Business name: o tc r xsi, ge , mt ..
Address:
Each additional Inspection over allowable in any of the above
z t s _ 6LI
Per inspection . 62.50 - City/State/ZIP: - 1,07%.80 OA-- ca 4
o.1
./
Investigation per hour (1 hr min)
62.50
Phone: .1) )23 '4- 4.-S- a_ % Fax: (3 )D SY-- 9 Y72 Industrial plant per hour 73.75 ,
7 - • ELM PERMIT FEES* -
CCB Lie.: 62..q-p- Electrical Lic.:Ve Suprv. Lic.: 401455
Subtotal ( e a
140 t
Suprv. Electrician signature, required: g. gai,...____ Plan review (25% of permit fee)
State surcharge (8% of pennit fee)
Print name: .20 62 1 k,...... Date: 6(s tics 6
- TOTAL PERMIT FEE C
Authorized signature:
. Th Permit application aspirea it a Walk is out obtained within la
days after it has been accepted as complete
Print name: Datc: • Fee methodology set by Tri-Conoty Baficing Industry Service Board
• '" Ntenher of impactions per permit allowed.
lAnuafingwerroltal.C-PermitApp.soe 1=3 4404613T00/02/COMMEB
6 'cl 69E6 . °N 01E031] A00 OW . IAN l S :L 9006 "lE 1n
' . CITY OF TIGARD -•
BUILDING DIVISION PERMI #: ELC2006 -00489
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/31/2006
Phone: (503) 639 - 4171 ,, 11 � I
Inspection Requests (24 Hrs.): (503) 639 -4175 ,'!'i "'��
INSPECTION WORKSHEET FOR DATE: 9/1/2006 TIME 7:01AM PAGE: 65
SITE ADDRESS: 09660 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 063 TYPE OF USE:
PROJECT NAME: MCLELLARN
DESCRIPTION: (3).branch circuits for kitchen &bath remodel. Job # A7292.
OWNER: MCLELLARN, ROBERT W /PALMIRA B, PHONE #:
CONTRACTOR: MCCOY ELECTRIC CO INC PHONE #: 503 -234 -7521
Inspection Request Scheduled For: Date: 9/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 035916 -01 503-234-7521 N
Corrections /Comments /Instructions:
- 1`30 -2J .
140 (50 d tk6tAX
1
l'Ao 14 IC `'i o mva . 1Aooc� O N L' y 9
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL
)k10 ACCESS
\ RIAIL )CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr • W Date: 1
NW V L.{ - V 64) Phone #: (503) 718-