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Permit CITY OF TIGARD ELECTRICAL PERMIT ,:- • TIGARD PERMIT #: ELC2006 -00224 ` I hi DEVELOPMENT SERVICES DATE ISSUED: 4/26/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134CB -12400 SITE ADDRESS: 12212 SW MILLVIEW CT ZONING: R -4.5 SUBDIVISION: MILLVIEW LOT : 024 JURISDICTION: TIG Project Description: (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: JENNIFER SIMER OREGON INTERGRATED CONTRACTING INC 12212 SW MILLVIEW CT 19239 MERCANT PL. TIGARD, OR 97223 OREGON CITY, OR 97045 • Phone: 503 - 317 -9582 Contact #: PRI 503 - 880 -8649 . FEES Description Date Amount Reg #: ELE 3 -534C [ELPRMT] ELC Permit 4/26/2006 $73.45 LIC 158482 [TAX] 8% State Surcharge 4/26/2006 $5.88 • SUP 38535 Total $79.33 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: 32_,�r-ie_f - -. Permittee Signature: _40,1, d. 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. Electrical Permit Appliccat FOR OFFICE ESE ONLY '' - , .� 2006 City of Tigard �. Received e : - ► 7r. Permit No.:L, _ `_A.. 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.19616TV OF TIGARD i'^',4 apt I I ` Date/By: Other Permit: Inspection Line: 503.639.4175 BUILDING DI VISIO _ - ' I I1 DateReadyBy: 1mis: 0 SeePage2for Internet: www.ci.tigard.or.us Notified/Method: / ) Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: ['Service ['Hazardous over 225 amps, com'l Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park ❑Health - care facility ❑Other: Job no.: knt 0601 Job site address: 12212 sw millview et Submit 2 sets of plans with any of the above. City/State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service. Suite/bldg. /apt no.: Project name: FEE* SCHEDULE Description I Qty. I Fee. I Total 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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular addition dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 '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 I own which is not 201 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, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 5.4 2 Address: first branch circuit Each add'I branch circuit 6.65 4. 7e'. 6 U 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: OIC Address: 19239 Merchant pl Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Oregon City, OR 97045 Investigation per hour (1 hr min) 62.50 Phone: (503) 880 -8649 Fax: (000) 0000000 Industrial plant per hour 73.75 - ELECTRICAL PERMIT FEES* CCB Lic.: 158482 Electrical Lic.: 3 -534c Suprv. Lic.: 3853s Subtotal 71 415 / Suprv. Electrician signature, required: ' Plan review (25% of permit fee) State surcharge (8% of permit fee) 5 ,AI Print name: _.5--4.------. G-. /f'f0/e /� /S- Date: 4 -26-06 TOTAL PERMIT FEE .-7 9 , 3 3 Authorized signature: This permit application expires if a permit is not obtained within 180 — days after it has been accepted as complete Print name: Date: 4 - 26 - 06 • Fee methodology set by Tri -County Building Industry Service Board 7 lir • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006.00224 13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED: • 4/26/2006 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/28/2006 TIME: 7:02AM PAGE: 68 SITE ADDRESS: 12212 SW MIL [MEW CT CLASS OF WORK: SUBDIVISION: MILLVIEW LOT #: 024 TYPE OF USE: PROJECT NAME: SIMER DESCRIPTION: (5) branch circuits. OWNER: SIMER, JENNIFER PHONE #: 503- 317 -95112 CONTRACTOR: OREGON INTERGRATED CONTRACTING INC PHONE #: 503 - 880 8E49 Inspection Request Scheduled For: Date: 4/28/2006 Pour Time: Code # Inspection Description Confirm # .contact # Message 120 Electrical rough -in 028936-02 503.936.0736 Y — Corrections /Comments /Instructions: WC, V/ /5 0 2 1 ( S ©Wt ct0 2 UkpASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6-r' iF Date: � Z8- c6 Phone #: (503) 718- Yr