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Permit
,.- P ' CITY OF TIGARD ° ELECTRICAL PERMIT 1, PERMIT #: ELC2008 00576 COMMUNITY DEVELOPMENT DATE ISSUED: 10/9/2008 , TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 135AA -00905 SITE ADDRESS: 10200 SW 90TH AVE ZONING: R - 4.5 SUBDIVISION: TOWN OF METZGER LOT : 004 JURISDICTION: TIG PROJECT: DENT Project Description: (1) service and (3) branch circuits. Job No. 25692 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 1.00 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: 3 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: MICHAEL DENT MIKE'S ELECTRIC 10200 SW 90TH AVE. 11070 SW ALLEN BLVD TIGARD, OR 97223 BEAVERTON, OR 97005 Phone: 503 - 813 - 6366 Contact #: PRI 503 - 649 - 6991 FAX 503 - 641 -1902 FEES Description Date Amount Reg #: ELE 34 -18c [ELPRMT] ELC Permit 10/9/2008 $100.25 LIC 50209 [TAX] 12% State Surchar 10/9/2008 $12.03 SUP 4230S Total $112.28 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 b- : • e in a c canoe with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more t - 180 days. ATTE •TION: Oregon law requires you to follow rules adopted by the Oregon Utility N ' tion Center. Those rules are set forth in OAR =52- 001 -0010 through e ' - • '2-'41-0100. You may obtain copies of these rules or direct quest' to OUNC at 503.246.6699 or 1.800.332.2344. Iss ed By: ,, _ Ilk 4/ I / Permitt Signature: 4iifOi� — 4 _� s_ 4+ 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: - • NTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _.1 : i ! V -' .� ^ 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. Sent By: MIKE'S ELECTRIC; 591 7847; Oct -9 -08 13:41; Page 1/2 - '7G: T'3ARD At: 5035981960 Electrical Permit A ��I��, FOR of i ii•r: I:sl: ONLY City of Tigard Devi d o 9 p(; X Permit No : ftC f - e 5? i " 11175 SW Hall Rlvd., Tigard, OR 97223 114 8 Plan Review Phone: 503.639.4171 Fax: 503,598 I SET 0 9 20t f Datc/B : Other Permit _..._... 1 I i i n IL I t Inspection Line 503.639.4175 Date Reidy /fay. •• - !tier: Of Si e Page 2 for interne!: www ligatd•or.gov * Notified/Method: / a supplemental Infucmatinn New LO11stnlct10n ©Addition a • l A ig P 4 , S I IV a check all that apply (submit 2 sets of plans w /items checked below): 0 service or theder 400 amps or more ❑ Building over three stones. 0 Demolition Q Other: where the available fault current ❑ Marinas and boatyards. CAigdOtkY 'ot tor4t ,t'C11t:S1. exceeds 10,0u0 amps at 100 volts or ❑ Floating buildings - -. less to ground, or exceeds 14,000 ❑ Commercial -use earicolturni Q] 1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building pimp; for all Cher instullarians. buildings. ] Multi - family ❑ Master builder ❑ Other; ❑ Fire pump. 0 Install/thou of 75 KVA 0 il .. ' S 1NF. ... ..� t r e4 P 1 ' , , f ❑ Emergency system. larger separately derived sy +te,n t + ❑ Addition of new motor load of ❑ "A" "E" "1.2" "1 •,l ", - 1001 or more. occupancy Job nu,. a Job site address: 10200 SW 90th Ave. 256 2 ❑ S or wore residential units. 0 Recreational vehicle parks L'it)(SIUte,'ZIP; Tigard, OR 97223 ❑lleahh•carefacilities. ❑ Supply voltage for more than a Ilmarclous l 600 volts nominal. Suite /bldg. /apt. no.: Protect name: ❑ Service or feeder 600 amps y o y r more. .._., l i. <u t 4. . ''. : •r11.� / YOt yq,(, , (I11 strccf'dirccl ions to job Site: Description 1 Qtr. I Yee. • r Total 1 New residential single- or multl- faintly dwelling oak. Includes attached garage. Subdivision: `Lot no.: 1,000sq. ft, or less 145,15 4 Ea. add'I 500 sq. It or punkin 33.40 1 Tax map /parcel 110.: t imiled energy, residential 75.00 2 DE9 CRT1' TI{1N , OF'TV(11�K (with above sq. ft) Correctin homeowner's wiring and repairs energy, multi- family g $ pairs 15.00 2 residential (will' above N. n.) -f - MST2006 -00247 Services or feeders installation, alteration, and/or relocatio _ 200 amps or less 80 .30 2 • PRO9FR'fY' OWNER Ia TE14A'NT, 201 amps to 400 amps 106.85 ^ 2 Name: Mike Dent 401 amp 160.60 s to 600 amps !6 2 �__ ..,_ 6 ._...,...__._.._.__.... 601 amps to 1,000 amps 240.60 2 Address: 10200 SW 90th Ave. Over 1,000 amps or volts 454.65 2 City /State /7.I P' Tigard , OR 97223 Trery services or feeders inatallatlnn, alteration, e /nr relocation !'hone: ( 503 ) 705.4857 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being mars on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, !case, rent, or exchange, according t0 ORS 447, 449, 670, and 701, 401 amps to 599 amps 133.75 2 Owner signature: Date: A. Fee for branch circuits or extension per panel Branch rcuits - ne .+� uits with p..APFLICAIV C 1 � .. t1 C ;x32 " � l 1{ L It a bove service or feeder fee, 3 6.65 19. 2 each branch circuit Business name: 13, Fec for branch circuits without service or feeder fee. Contact name: first branch circuit 46.85 2 Address: Each edit'! branch circuit 6.65 2 Mtaccllaneuua (service or feeder not included) _ Cily /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( 1 Fax: : ( ) Reconnect only 66,85 . 2 I - : - mail: _ Pump or irrigation circle 53.40 �.2 .. (okt1+ 1k Vt; ' I N ! Sign or outline lighting 53.40 2 Business name: JD Miller Construction DBA Mike's Electric Signal pane a er t limited- o or ,_•,.,_.,_ energy panel, alteration, or Address: 11070 SW Allen Blvd. extension. Describe; Page 2 2 City /State/ZIP: Beaverton, 011 97005 Each additional inspection over allowable in an of the above - - Per inspection 62.50 Phone. M.11649.6991 Fax: (503) 641.1902 Investigation per hour (1 hr min) 62,50 . CCI3 Lic.: 050209 1 Electrical .._- (,.ic.; 34-18C Suprv. Lie.: 4230S Industrial plant per bout 73.75 Suprv. Electrician signature, required: Subtotal. 100. • Print name: Douglas J. Miller Date: Plan review (25% of permit fee): 10.09.08 '--•- -' •- _ _ - State surcharge (12% of permit fee); 12.03 Authorized signature; 4 4146,./..Z TOTAL PERMIT FEE: 11 2.28 Print name: ( Date: This permit application expires if a permit IS not obtained within 1A0 days atter it has been accepted as complete, ' Number of inspections allowed per permit. 1' 1Huddinp ,permilc11-:I.C- E'enni,App (Inc oV211116 440.4615T(11/051COM/WE13 CITY OF TIGARD BUILDING DIVISION PERMIT #: °006•1 13125 SVV_ Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 s' INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS:10SM SW qt AI • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: MI MG EIS a PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: l] PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6-° N06 Date: 3 • f Phone #: (503) 718- 2-441 CITY OF TIGAR D BUILDING DIVISION - - PERMIT #: EI 02008 00576 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/9/2008 Phone: (503) 639 -4171 A �t' Inspection Requests (24 Hrs.): (503) 639 -4175 °1 f I� INSPECTION WORKSHEET FOR DATE: 10117/2008 TIME: 7 :O2AM PAGE: 6 SITE ADDRESS: 10200 SW 9th rl I AVE CLASS OF WORK: SUBDIVISION: TOWN! OF E1 � t7ER LOT #: 004 TYPE OF USE: PROJECT NAME: DENT DESCRIPTION: (1) service and (3) branch circuits. Job No. 25692 OWNER: DENT, MICHAEL PHONE #: 503 -813- 6366 CONTRACTOR: MIKES ELECTRIC PHONE #: 503649,6991 Inspection Request Scheduled For: Date: 10/171 008 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Elect seiviCO 076863.01 503 705-4857 N WI F r.) rik,L.. . Corrections /Comments /Instructions: 1 / 1 -1 11 % kepli 4 f.Luz) .> - 1\1.16 - yt■t\61._. (fit 6sal b cbNN ,Rs U t -LF. 1 � 6 X11 �� t - FO er yvvk1(ss ei 6 4 e N VAN VA 0 11\I 3 ' It c oo4e c r( Mbar ttittitry.ta0 off . Cr, (162)U= ❑ PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL x CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 V6e) l_L Date: 1011 if 61 Phone #: (503) 718 - !J`f"}9 CITY OF TIGARD BUILDING DIVISION P - PERMIT #; .. F=t . t" °:2 00t3 f 0576 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10l91200g3 Phone: (503) 639 -4171 4 14111' Inspection Requests (24 Hrs.): (503) 639 -4175 ,... INSPECTION WORKSHEET FOR DATE: 10/15/2008 TIME: 7:00AM PAGE: 31 SITE ADDRESS: 1I) X00 SW 90TH AVE CLASS OF WORK: SUBDIVISION: TOWN OF MF 1GFR LOT # 004 TYPE OF USE: PROJECT NAME: DENT DESCRIPTION: (1) :service end (3) branch circuit.. Job No. 25692 . OWNER: DENT, MICHAEL PHONE #: f ?:3 -$13 -6366 CONTRACTOR: MIKE'S ELECTRIC PHONE #: 503_649 Inspection Request Scheduled For: Date: 10115/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Elect.iical final 076721 -01 503.649 -699 Y JW Corrections /Comments /Instructions: ` l : diffMlifinWAINTIBRIMPRIffir # 101 IWO ' la_ J'i ,/,&,, , A , g li A g - i A .A Intglin. ' 11 11111.1W i ' % 1 - q s ' Q jr L (-IP—, „- i , e e , r A -- 11 WI 0 i _112 1 A / 1 4 " 1 e 11/16 ( CA-i/051 45 ,ypi.04 '' .• 01( • '''. i 4-4 .-4) . b€,(1) 011 Ugh/ 1.4)-01/k- 0-0 Ai yfi riViftg PASS ❑ PARTIAL APPROVAL ❑ CANCEL ____ NO ACCESS X FAIL ❑ CALL FOR INSPECTION LJ ADDITIONAL FEES ASSESSED Inspector: Orr Date: IV 14 Phone #: (503) 718-