Permit CITY OF TQIA R D ELECTRICAL PERMIT
PERMIT #: E 22/200 -00351
COMMUNITY DEVELOPMENT
DATE ISSUED: 5/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134CB-13500
SITE ADDRESS: 12398 SW MILLVIEW CT ZONING: R -4.5
SUBDIVISION: MILLVIEW LOT : 035 JURISDICTION: TIG
PROJECT: SMITH
Project Description: (4) Branch circuits for kitchen remodel.
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: 3 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:
SMITH, ALAN C + DEBORAH B LAUGHLIN ELECTRIC LLC
12398 MILL VIEW CT 3 MONROE PARKWAY STE. P PMB205
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503 - 449 - 7389
FAX 503 - 639 -0077
FEES
Description Date Amount Reg #: ELE C86
[ELPRMT] ELC Permit 5/22/2007 $66.80 LIC 165763
[TAX] 8% State Surcharge 5/22/2007 $5.34 SUP 50975
Total $72.14 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 Permittee Signature: / r
OWNER INSTALLATION ONLY 1
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.
le 23 FROM: TO:5035981960 P.1
rmit Applic t 1 tm t,I I It 1 151 1t\I ,
Ay g -4 . (� `.: , �
of Ti and ,� p � : { o a t :: S Chi'. Perini' No.: EIL _0 are -- 6035 l
` 13125 SW Hall Blvd., Tigard. R ®1: tai L« : • ? ,_a a Plan Review
'� II Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit •
261) -. a152
I It li w Inspection Line: 503.639.4175 Date Ready/By: hale See Page 2 for
Internet: wW.tigard -or,gov MAY 2 2 2001 7 Notified/Method: Supplemental Information
. TYPE WO�tK .. , i , g PLAN REVIEW
ii ❑ New construction ® Additio t eratfon/Wpp1a c e tn erlf t Please check all that apply (submit j sets of plans w /items ducked below).
T's I till: 7'k. , T r', lFV rfl1 ❑ Service or feeder 400 amps or more ❑ Building over three stories.
Et ❑ Demolition ❑ Otte: _ ..:>
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Flung buildings.
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building i mps ground, or exceeds 1 n ❑bo lding Commercial-use agricultural di g amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ".
Job no.: Job site address: 12398 SW Miliview Court 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: Smith Kitchen ❑ Service or feeder 600 amps ormore.
FEE SCHEDULE •
Cross street/directions to job site: • naalpaon I Q4. I roe. I Tom! I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
Kitchen remodel 75.00 2
residential (with above sq. ft.)
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
E PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Smith 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 12398 SW Miliview Court Over 1,000 amps or volts r 454.65 2
City /State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 • l
Owner installation: This installation is being made on property that J 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ` ❑ CONTACT PERSON above service or feeder fee,
1 6.65 2
each branch circuit
Business name: Laughlin Electric, LLC B. Fee for branch circuits
Contact name: Erika M Schervem or Grant R Laughlin without sc
ice
ir cui t u feeder fee, 1 46.85 46.85
first branch without cir 2
Address: 3 Monroe Parkway, Suite P, #205 Each add'l branch circuit 3 6.65 _ 19.95 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Lake Oswego, OR 97035 Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: (503) 449.7389 I Fax: : (503) 639.0077 Reconnect only 66.85 2
E -mail: e.schervem @comcast.net or g.laughlin @comcast.net Pump or irrigation circle 53.40 2
CONTRACTOR ' . Sign or outline lighting 53.40 2
Business name: Laughlin Electric, LLC Signal circuit(s) or limited -
energy panel. alteration, or
Address: 3 Monroe Parkway, Suite P, #205 extension. Describe: Page 2 2
City/State/ZIP: Lake Oswego, OR 97035 Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: (503) 449.7389 I Fax: (503) 639.0077 Investigation per hour (1 hr min) 62.50
CCB Lic.: 165763 I Electrical Lic.: C86 I Suprv. Lie.: 5097S Industrial plant per hour 73.75
ELECTRICAL. PERMIT FEES
Suprv. Electrician signature, required: Plan review (25 %ofpermit fee):
Subtotal: 66.80
Print name: Grant R. Laughlin Date: 5.22.2007 State surcharge (8% of permit fee): 5.34
Authorized signature: i� � TOTAL PERMIT FEE: 72.14
ibis permit application expires if a permit Is not obtained within 180
Print name: Erika M. Schervem- Laughlin I Date: 5.22.2007 dove after It has been accented as immolate.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00351
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/212007
Phone: (503) 639 -4171 A II
Inspection Requests (24 Hrs.): (503) 639 -4175 ., `: -..
INSPECTION WORKSHEET FOR DATE: 6/21/2007 TIME: 7:03AM PAGE: 6
2t / N[
S ITE ADDRESS: 12398 SW MILLVIEW CT CLASS OF WORK:
SUBDIVISION: MILLVIEW LOT #: 035 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: (4) Branch circuits for kitchen remodel.
• OWNER: SMITH, ALAN C + DEBORAH B, PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LLC PHONE #: 503- 449 -7389
Inspection Request Scheduled For: Date: 6/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050685.01 503- 449.7420 N
Corrections /Comments/ Instructions:
iliDASS ❑ "ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ F IL
7rALL FOR INSPECTION • ❑ ADDITIONAL FEES ASSESSED
■
c 1 �/ A�
Inspector: Date: Phone #: (503) 718 ZCy
CITY OF TIGARD iv a* f * /
BUILDING DIVISION '" 1 1 ' s PERMIT #: ELC2007 -00351
13125 SW Hall Blvd., Tigard, OR 97223 �j do -?,v1) DATE ISSUED: 5/22/2007
Phone: (503) 639- 4171apyg'�'�
Inspection Requests (24 Hrs.): (503) 639 -4175 I I
INSPECTION WORKSHEET FOR DATE: 5/23/2007 TIME: 7:00AM PAGE: 38
SITE ADDRESS: 12398 SW MILLVIEW CT CLASS OF WORK:
SUBDIVISION: MILLVIEW LOT #: 035 TYPE OF USE:
PROJECT NAME: SMITH '-
DESCRIPTION: (4) Branch circuits for kitchen remodel.
511-Vd 6%10-
OWNER: SMITH, ALAN C + DEBORAH B, PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LLC PHONE #: 503449 -7389
Inspection Request Scheduled For: Date: 5123/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 048905 -01 503 - 449.7420 Y
Corrections /Comments /Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: klOt
Date: 5/ ( 7 Phone #: (503) 718-