Permit -
4 CITY OF TIGARD ELECTRICAL PERMIT
. t PERMIT #: ELC2006 -00404
-,,,, All DEVELOPMENT SERVICES DATE ISSUED: 7/25!2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 14 BB -20100
SITE ADDRESS: 16571 SW 103RD AVE ZONING: R -7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT : 045 JURISDICTION: TIG
Project Description: (2) branch circuits for kiln & sprinkler control.
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:
SANDRA JONES MIKE'S ELECTRIC
16571 SW 103RD AVE 11070 SW ALLEN BLVD
TIGARD, OR 97224 BEAVERTON, OR 97005
Phone: 503 - 781 -0581 Contact #: PRI 503 - 649 -6991
FAX 503 - 641 -1902
FEES
Description Date Amount Reg #: ELE 34 -18c
[ELPRMT] ELC Permit 7/25/2006 $53.50 LIC 50209
[TAX] 8% State Surcharge 7/25/2006 $4.28 SUP 4230S
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 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: 7):- �� � Permittee Signature: R, a
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.
Sent By: MIKE'S ELECTRIC; 591 7847;
Jul-24-06 12:55; Page 1/2
Tt7: TIGARD l c lg 1 Fr \.
Electrical Permit ,Applicati rt)ItOI:IICE. USE. ONLY
JUL 2 2006 D e - - -0 1 Permit j -7j /
City of Tigard Dates
13125 SW Hall Blvd., Tigard, OR 97223 . plan Review ether Pernuu
Phone; 503.639.4171 Fax: 5 3. -' - l Date/B ' ' ®9a. Page 2 for
�7C 1 b M .. T� 1.� _ a , 11 Date Ready/By: : g
Inspection Line: 5igard..41 7 / I Supplemental information
ci.ti ard.or.t' T f TI (r d �J J; Ia ot1B cWMet1w d:
Internet: r. ' g „ �.
'
.• ; iu ,i ; - t. .I, lie .. m 'f' •I' Zl .'14+7..
Please check all that apply:
El New construction ❑ Addition/alteration/replacement
• ❑Service over 225 amps, comm'l ❑Hazardous loesuon
❑ Demolition ❑ Other; s ..Service over 320 rating u r 10,000 sq. fi ,
.._,,..,., ... „..:. ...,_,..,•.:.. . „„ yl . ❑ B
Damps - rains n¢ov
c 5 • . , 1 Y � 7 3 4 � : 1 t . e i.I��' ii i . /rE ,t '14, of 1 -and 2- family dwelling� 0? structure
['Building residential
_..,. __.._... 1 ..... dSy�temover 600 volts norm units in one
® 1 - and 2-family dwelling ❑ Commercial/industrial ❑ Accet3soty building ❑Building over three stories ❑Feeders, 400 amps or more
D Multi- family ❑ Master builder ❑ Other ❑Occupant load over 99 persons QManufactured structures or
r ; , ;:j i !' . ❑Egress/lighting in RV park • a,.•; r .:a.
� � . I . •� (]Health -care facility ❑Other:
Job no 23022 Job site address. 16571 SW 103rd Ave . Submit sets of plans with any of the above.
e temp orary construction service.
d OR. 97224 The above are not applicable to constr service
City/State/ZIP: Tigard, :1 : ^ . .:a: 1 i 3 ;,ri':ii < ; w ::... .
Suite/bldg. /apt, no.: Project name: .eseriptlea Qtr. F... Teter ..
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
Ea. a dd'l 500 sq. ft. or portion ! 33.40 l
Suhdivislon: Lot no_:
Limited energy, residential 75.00 2 2
Tax lnap/parcel n0.: Limited en ergy, non-residential 75.00 2
d w mode
. ' '.!..' . . ' . ..: ' .4 .,. ...
;,;:' ; �, e : !" ' �: ....._ .., ' Ea manufacturemodular 2 •
... �, .. ' • ... �, :.�: - '..:. :...._... r wellin . service and/or feeder 90.90 d _
Two circuits for kiln and sprinkler control. Services or feeders l.nta1Iatlon, alteration, and/or rlocatto
200 amps or less 80.30 2 _
201 s to 400 amps 1 06 85
'ti: >. v °v .' ' ',; a mp
� t a ( ?:. 160 -60
` ' ,... ... R•... ........ •. ...... .......,. ... 401 amps to 600 ara>ps
Name: Sandra Jones : 601 amps to 1,000 amps 240.60 2
16571 SW 103rd Ave. Over 1,000 arts or volts 454.65 2
Address: ,,, Reconnect only 66.85 2
City /State/ZIP; Tigard , OR . 97224 Temporary services or feeders instillation, alteration, a
relocation
Phone: ( 503 )781 .0581 Fax: ( ) 200 amps or less 66.85 1 - Owner installation: This installation is being made on property that I own which is not 401 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, R er panel
::-. rbranch circuitb wft
fee, each
feeder h
.:, .._. ..._ . service or .65
Business name: branch circuit
E3. Fee for branch circuit
Contact name: without service or feeder fee, 1 46 -85 46.85 2
zilch branch circuit
Address: Each add'l branch circuit 1 6.65 6.65 2
City/State/ZIP: Miscetlaneoua (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting
53,40 2
E -mail: Signal c1
,...
circuit (s) or limited-
•:'`: energy anal, alteration, or
:,.•,. . ;,,; " i.....= : ..i.. Pa e 2 2 •
<., ; .. ,.. .., •: - .: r • ................ extension, D scnbc s
. :...c.. , .., :............ ..:. e
Business name; mike 1 s Electric JD Miller Const . G
Each additions! Inspection over allowable In any of the above
Address: 1107 0 W - - n : ._ s per inspection IMI 62.50
City/State/ZIP: .
ity /State/ZIP: _ Investigation per hour (1 hr nun) II 62.50 • - s ft • 11
Industrial plant per hour 73.75 •
plttnte -(503) .. 649.5991 Fax: ( 5o3) 641.1. i .. ;: .,' .lt_..,..: +:...y:°'.'t::ii, .....4--.
K ,'" ,y`.
CM; Lic.: 05 e _ 0 • Electrical Lie.: - Suprv. Lic.: • g Subtotal 53.50
Suprv. Electrician signature, required' I f ,� . Plan review (25% of permit fax)
,0 .0
State stlrcharyc (8% of permit fee) 4.2$
Print name: Do u 1 a a J Mill r t° Date: 07.24.06 TOTAL PERMIT FEE 57.78
Authorized signature: This permit application expires If a permit le sot obtained within 100
days after It has been accepted as complete
Print name: Date: • Poo methodology set by Tri County Building Industry Service Board
•• Nutuher of inspections per permit allowed_
tv3othh .+8‘eerteitatiBLC-a.- mk.pp.dee 12/O] 440 - 461 sr( 10 /a2fCOMlwoa
datraf-OF TIGARD
BUILDING DIVISION J PERMIT #: ELC2006-00404
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2006
Phone: (503) 639 -4171 kaidt
Inspection Requests (24 Hrs.): (503) 639 -4175 = ' L .
INSPECTION WORKSHEET FOR DATE: 11/27/2006 TIME: 7 :05AM PAGE: 36
SITE ADDRESS: 16571 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: RIVERVIEV11 ESTATES NO. 2 LOT #: 045 TYPE OF USE:
PROJECT NAME: JONES
DESCRIPTION: (2) branch circuits for kiln & sprinkler control.
OWNER: JONES, SANDRA PHONE #: C503 -781 -0501)
CONTRACTOR: MIKE'S ELECTRIC m� sl D PHONE #: `: 0 b49-b'��1
Inspection Request Scheduled For: Date: 11/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040222 -01 503- 649-6991 Y
Corrections /Comments /Instructions: MM^^
�Irl
NI b LAB
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' • W O Q Date: L
2,9 - Phone #: (503) 718- 2.4q(0