Permit f CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00274
° . COMMUNITY DEVELOPMENT
DATE ISSUED: 4/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136AB -03400
SITE ADDRESS: 07111 SW LOCUST ST ZONING: R-4.5
SUBDIVISION: LOCUST TERRACE LOT : 001 JURISDICTION: TIG
PROJECT: YAKE
Project Description: Job No 23885 Panel change
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: 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: •
SHANNON YAKE MIKE'S ELECTRIC
7111 SW LOCUST ST 11070 SW ALLEN BLVD
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503 - 244 - 7728 Contact #: PRI 503 -649 -6991
FAX 503 -641 -1902
FEES
Description Date Amount Reg #: ELE 34 - 18c
[ELPRMT] ELC Permit 4/26/2007 $80.30 LIC 50209
[TAX] 8% State Surcharge 4/26/2007 $6.42 SUP 4230S
Total $86.72 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: r Permittee Signature: / t � �s / - - �, �.
' I '
OWNER TALLATION 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.
t By: MIKE'S ELECTRIC; 591 7847; Apr -25 -07 7:59; Page 1/2
. TIGARD At: 5035981960
f
Electrical Permit A, p lication . -L -
P�. 1 OFFICE USE ()NIX
City of Tigard 1 � PmtNo•:
r 0 Do - 00 a • 13125 SW Hall Blvd., Tigard, OR 97223 '� 'E°CE°`� p�lteview
Phone: 903.639.4171 Fax: 503.598.1960 1 1 p Other Permit:
inspection Lin: 503.639.4175 ! l J / i (
APR 2 5 :... Cute Ready J ® see Pogo 2 far
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Internet: ww.¢].tigard.or.us Nodded/Method! Supplemental Information
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❑ New construction ❑ Additi : N a i 1 '. " Please check all that apply:
El Demolition ❑ Other: ['Service over 225 amps, com i'l ❑]iazardous location
'' t{u,.; ;, ,74 _ ., -T.: v 7 •- r ,,,, CI Service over 320 amps – rating ❑ Buildna nver 10,000 sq. ft.,
` 4t . of 1- and 2-family dwellings 4 or more new residential
G] 1- and 2- family dwelling ❑ CorruneTCial/industrial ❑ Accessory building _ .. ['System ov4 600 volts nominal units in one structure
❑ Multi- family • [] Master builder ❑ Other: v Feed 4
o . ( pan l o Stn dm over three stories ['Feeders, 00 amps or more
- - ❑Occu t load over 99 persons ❑Manufactured structures or
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. .. . ... ...... .,. ... '•- ::;�...,..;�::... .<_::: i:,..:.:•,�. ❑6greas/lighting
plan
Job no.: 23885 Job site address: 7111 SW Locust S t:. ❑Realtb -care facility
Submit 3 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above ere not applicable to temporary construction service.
Suite/bldg. /apt no- PT roject naine: 9 I a +, _-, 5 . {, -
. Dearrlpdos Qty. Bee. Tete, ME
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
Subdivision: l Lot no.: Ea. addl 500 sq. R. or portion 33.40 1
Tax map/pyre.] no.: Limited en - _i , residential 75.00 2
.... ......... { .,...._..... : 75.00 • 2
_...
: Limited energy, non-residential
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Panel change dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
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, " ' '' ' „ ' 1 „ I , 'r � r X } .. i_ �\ t ` r k_ I � ; . 201 snips to 400 amps 1 06.85 2
401 amps to 600 amps 160.60 2
Name: Shannon Yake 601
amps to 1,000 crops 240.60 2
Address: 7111 SW Locust St. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /StatelZIP: Tigard, OR 97223 Temporary aervicea or feeders installation, alteration, and/or
Phone: ( 503) 244 .7728 I Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being Made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sate, 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
1 ::C,e ':, .',' 'I' .' . •y, .9. - r - ,I: :: "' A.Fee for branch circuits with
-- -
....,.. , c.' . . .... ... ...... .'.' servvice or feeder fee, each 645 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46 2
Address:
Each add'1 branch cittiuit 6.65 2
_
City /State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) I Fax: : ( Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: Signal circuits) or limited -
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.,•,....::_ -•• • +�, .;�.: ;:� , � alteration, o r
extension
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Business name: Mike's Electric — JD Miller Const. Co -
Address: Each additional inspection over allowable in any of the above
110 7 0 S W Al 1 P n B X, X.d __ - . _ . _ _ Per inspection 62.50
City /State/ZIP: Beaverton OR ,97003 Investi per hour (1 to min) 62.50
industrial lent
Phone: (5 0 3) 649 . 6 9 91 I Fax: (5 0 3) 641 .19 0 2 es Hour 73 7s
y ' - •.r.
CCl3 Lic.: 0 5 0 209 [Electrical Lie.: 3 4 —1 Sc 1 Suprv. Lic.: 4 3 () S . Subtotal 80.30
Suprv. Electrician signature, required• . k �
,- Plan review (25% of permit fee)
Date: Print naII7e: la State surcharge (8% of permit fee) 6.42
Douglas J Miller 04.2.5.07 TOTni. PERMIT FEE
86.72
Authorized signature: This permit application expires if a permit is net obtained within 180
days after It has been accepted as complete
Print name: b • Pee methodology set byTri- County Building Industry Service Boani
• • Number of inspections per permit allowed
1Buadingtromutalst.c.t+ermi pp.doc 121123 e40- 46tsrt1amicowwe9
CITY OF TIGARD
BUILDING DIVISION . - PERMIT #: ELC2007-00274
.A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 , I ..
INSPECTION WORKSHEET FOR DATE: 5/4 /2007 TIME: 7:00AM PAGE: 63
SITE ADDRESS: 07111 SW LOCUST ST CLASS OF WORK:
SUBDIVISION: LOCUST TERRACE LOT #: 001 TYPE OF USE:
PROJECT NAME: YAKE
DESCRIPTION: Job No 23885 Panel change 5,0
OWNER: SHANNON YAKE, eM gai ' kflig PHONE #: 503. 244 -7728
CONTRACTOR: MIKE'S ELECTRIC PHONE #: 503 6449 69914
Inspection Request Scheduled For: Date: 5/4 /2007 Pour Time.
Code # Inspection Description Confirm # C ntact # Message
199 Electrical final 047607 -01 503. 649.6991 Y / c
Corrections /Comments /Instructions:
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ASS II] PARTIAL APPROVAL ❑ CANCEL [1] NO ACCESS
F AIL ❑ C F. - NSP - •N ❑ ADDITIONAL FEES ASSESSED
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Inspector:
/ Date: S/ A Phone #: (503) 718 - --2"7/