Permit • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00595
DEVELOPMENT SERVICES DATE ISSUED: 8/17/2005
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maraa 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101AB - 01501
SITE ADDRESS: 07555 SW HERMOSO WAY 200 ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT : 021 JURISDICTION: TIG
Project Description: T.I. (5) branch circuits.
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: 4 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: •
LIONEL LLC MIKE'S ELECTRIC
7555 SW HERMOSO WAY 11070 SW ALLEN BLVD
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503 - 620 -5203 Phone: 503 - 649 -6991
FEES Reg #: L1C 50209
Description Date Amount SUP 4230S
ELE 34 -18c
[ELPRMT] ELC Permit 8/17/2005 $73.45
[TAX] 8% State Surcharge 8/17/2005 $5.88 REQUIRED ITEMS AND REPORTS
Total $79.33
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: ]1:p Permittee Signature:
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; Aug -15 -05 13 :43; Page 1/2
o
E lectrical hermit Applic ation= FOR 01 l(r 17SL ()MN City of Tigard ll U Date/8 0 -� D '`J Pert
No.: _ / j 27,9 i f
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Renew Other Permit: i ;..- VEDA
'Phone: 503.639.4171 Fax: 503.598.1950 5 2O O ' '' Datclt{
{ ' Jude: ri See Page 2 for
Inspection
Line: 503.639.4175 „ Aim. � . � _ _ Date Ready/13T g
Internet: www.ct.ttgard.or.us ne 71r.API) ott a e .
I !e
mental information
TV d/lIJ1 � � � ,�
.. .. , c n t a J t� � i t11 ' i�vN r -... ..
— ._: . _ •,•:,,:...'., � ' Please check al� that .:: ' 's..' •
0 New construction ❑ Addition /alteration /replaeetlleflt []Service over 225 amps, ['Hazardous location
['Demolition ❑ Other: 0 s Ruildn fl„
„ ['Service over 320 Drop - rating Q ¢
over 10,000 sq.
• . . :. - ;" • ;;; .1 i - :• •'' .• ' . k M 1' -7 , J. ei l � w n or more ncw residential
+.,: '� : .. ,;1:�: . , i .,l �'� � , LSS 4 i ...,. � r t : :a" � 1 h�del of I - sad 2 d Ili g s • []System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling EX Commercial/industrial C] Accessory building
['Building over three stories C7Ftsadera, 400 amps or more
0 Multi- fatuily ❑ Muster builder ❑ Other: ❑Occupant load over 99 persons []Manufactured structures or •
F . :-,...'..?..',••.„,,•;,-„,..1� ' 1 I .:1 1 i J, • I i ,.;. . RV park
• -, ...4,.: ❑ plan
.. ... . ... _ . ❑Eiealth�aro facility ❑t)ttter:
lob no.: 21908 Job site address: 7555 S W H e r m o s v Way Submit 2 sets of plans with any of the above.
City/ State/ZIP: Tigard, O R. 97223 The above are not applicable to temporary construction service.
,. :.,! R`i . : Y ", s 'K'i : �.i , .,; " :2J7 � • { , t l I '
1_ : f � ) , tl { . f : ri.., � e .F + • '''
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Suite/bldg./apt. no. a(� Project name: c 1wS 'C 1 I S Dwariptiva . Q4• - F«. Total ..
■ Cross street/directions to job site; New residential single. or multi- family dwelling unit.
Ipcludes attached garage.
• 1,000 sq. ft. or less 145.15 4
Subdivision: ' Lot no,: Ea, add'1 sq. ft. or portion 33.40 I •
-- Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential S 75.00 • 2
•1 _ ... :;r :o�:- ' "ir ,.yr., .:�',' \!�_ ',i. ''� modular
� n Be fYlC r rind/or
dwalli a feeder r 90.90 2
Various electrical projects
Services or (ceders installation, alteration, and/or relocation
200 amps or less 80.30 2
- , , � amps amps
'.1 t 1 t '•F.1, ' of �.. t f ; r . . 1 -' 1: g to 600 o„ips 160.64
Name: Minuteman Press of Tigard 601 amps tol,000amps 240.60 z
Address: 7555 S W TI e r m o s o Way aver 1,000 amps or Volta 454.65 2
Reconnect only 66.85 2
City /State/ZIP: T i g a r d, OR. 97223 Temporary services or feeders installation, alteration. and/or
Phone: 0 3) 6 2 0.5 2 0 3 Fax: ( ) ;elgcatlon 200 amps or lass 66.85 1
Owner Installation; This installation is being made on property that I own which is not 20t art>ga to 400 amps 100.30 2
intended for auk, lease, rent, or exchange, according to ORS 4-47, 449, 670, and 701. 401 amps to 600 amps 133 -75 2
Owner signature: Pate: Branch circuits - new, alteration, or extension, per panel
s A. Fee for branch circuits with
in
service or eel fee, each 6 65 2
Business name: branch t B. Fee for branch circuits
Coi tact name: without service or feeder fee, 1 46,85 46.85 2
each branch circuit
Address: Each add'I branch circuit 6.65 2 b . 6 C 2
City /State/ZIP: . Miscellaneous (service or feeder not included)
Pump or irrigation circle 53. 2
Phone: ( ) Fax: _
•
( ) Sign or outline lighting 53.40 z
E -mail: Signal circuit(s) or limited- •
"r` ' i °E : t txttutaton Dca be Page 2 2
energy panel, alteration, or
IBasinessnatne ;Njke's Electric — JD Miller Cons -t. Co - --
Each additional Inspection over allowable in any of the above
Address: 11070 S W All - n Blvd Per inspection 62.50
City /State /ZIP: Be .•_ - t • t a • • Investigation per hour (1 hr rain) 62.50
industrial plant per hour 73.73
- _
Phone: (503) 649 (7991 Fa 641 .., - 5 i:•a1r.,t?f•,ri ta t:ll i t� .x.17,,,A.:.1
CCB Lic.: fl • s • Electrical Lic.: — z Suprv. Lie.: • Subtotal 73. 4 5
Supt,r. Electrician signature, required .t „ —,r` A� -A Y -_
Plan review (25% of permit fee)
State surcharge (8% of permit fee) 5,88
Print name: D o u: l a s J Mil ler � Date: 08.15.05 8. 1 5. 0 5 TOTAL PERMIT FIFE 79 , 3 3 _
Authorized signature: Thu permit appIIest o; exp[res if a permit Is not obtained within 180
days after It has been accepted as complete
Print name: Date: • Fce methodology setby Tr[-County Building industry Service 8u.n1
- -- •• Number of inspections per permit allowed.
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CITY OF TIGARD _
�
BUILDING DIVISION PERMIT #: EI_C2005 0f?55
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8>17/20Q5
Phone: (503) 639 -4171 / �m� NN����,� 11\
Inspection Requests (24 Hrs.): (503) 639 -4175 :.� ":_..
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: PAGE: 6
7 :08AM 97
SITE ADDRESS: 07555 SW HERMOSO WAY 200 CLASS OF WORK:
SUBDIVISION: HERMOSO PARK 6�6 LOT #: 021 TYPE OF USE:
PROJECT NAME: NW GRASSROOTS
DESCRIPTION: T I (5) branch circuits.
OWNER: LIONEL LLC, PHONE #: 503 -620
CONTRACTOR: MIKE'S ELECTRIC PHONE #: 503 - 649 - 6991
Inspection Request Scheduled For: Date: 0)2912005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1( Electrical final 016951 -01 503-649 -6991 Y
Corrections /Comments /Instructions:
c r .-_-
)Lq ...„
. .
PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: v`✓y'�� "�
p r6_ Date: Phone #: (503) 718 -