Permit - 5
i // a CITY OF TIGARD ELECTRICAL PERMIT .1
PERMIT #: ELC2008 -00022
COMMUNITY DEVELOPMENT DATE ISSUED: 1/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 1028 D -01701
SITE ADDRESS: 12830 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 00A JURISDICTION: TIG
PROJECT: DAVIDSON'S CASUAL DINING
Project Description: 1 branch circuit for fire suppression at grill.
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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: SIGNAUPANEL:
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: lst W/O SRVC OR FDR: 1 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:
DAVIDSON, WILLIAM G + DIXIE L MIKE'S ELECTRIC
8915 SW COMMERCIAL 11070 SW ALLEN BLVD
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503 - 639 - 5111 Contact #: PRI 503 - 649 -6991
FAX 503 - 641 -1902
FEES
Description Date Amount Reg #: ELE 34 -18c
[ELPRMT] ELC Permit 1/10/2008 $46.85 LIC 50209
[TAX] 12% State Surchar 1/10/2008 $5.62 SUP 4230S
Total $52.47 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: Permittee Signature: O4 /
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; .J an -9 -08 10:46; Page 1/2
To; ° TIGARD At :. 5035981960 .L _ 4 I/ -7, 2
. �J K.� 0 J
Electrical Permit A I Ili Via_)1 :: 'L; E'i ED 1E :)lt' )Fl l( I: t 51: ()NI:,
City of Tigard Received ! Permit No. _ 00 ,
• i i
13125 SW Hall Blvd„ Tigard, OR 1104 0 9 '1008 Ply ' .
' ('hone: 503.639.4171 Fax: 503. 98.1960 relay: • Other Permit:
t . , k 1 , Inspection Line: 503.639.4175 Cti7Y 0w awkiip Pate Ready/By: Fui+ 10 See Page 2 for
Internet; www.tigard- or.gov BUllDl�rnnnMON Notified/Method: J SapplementalInformation
. • 'TYPE OF WORK
. . . „ PLAN REVIEW .
❑ New construction ❑ Addition /alteration/replacement Please check all that apply (submit $ seta of plans w /items checked below):
O Service or feeder 400 amps or more ❑ Building over thine stories.
1=I Demolition ID Other:
where the available hull enurent ❑ Marinas and boatyards.
' • ' •• ' • :: : 'CATEGORY OF CONSTRUCTION • 2 `. - , ' ' crsoeerb 10,000 emirs al 150 volts Or O Rodin buildings.
less to around. or etweede 14,000 O Commercial -we agricultural
❑ 1 • and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installation,. build
❑ Multi - family ❑ Master builder ❑ Other: . Ohre pump. ❑ Inrlallmica of 75 KVA or
• JOB SITE INFORMATION 'AND. LOCATION O Emergency system. larger separately derived system.
[3 Addition of new motor land of ❑ "A ", "F", "1 -2 ", "I -3 ",
Job no.: 24771. Job site address: 12830 SW Pacific Hwy 100tiP or more• buy.
o Six or more residential unite. Cl Recreational vehicle parka.
City /State/ZlP: Tigard , OR 97223 ❑ Heahttrare facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no.: { Project name: O Serviso or feeder 600 amps or more.
FEE SCHEDULE •
Cross street/directions to job site: orwlpaee t et, i 'u. I Tula I •
New residential single- or multi- family dwelling unit.
ludt* a ttached Qara
w
Subdivision: Lot no.: . 1,000 sq. ft. or less 145.15 ( 4
Tax map /parcel no.:
Ca add'I 500 sq. ft or portion 33.40 1
Limited energy, residential
• DESCRIP iTON OF WORK (with shoe eq. R.) 75.00 2
Limited energy, multi- family
Fire suppresion for grill residential (with above sq. R) f 75.00 2
Serviced or feedm imtallatkru and/or ration
200 amps or leas 80.30 2
- ❑ .PROPERTY OWNER . • I . . . ID TENANT. .. 201 amps to 400 amps ` 106.85 2
Name: Davidson's Restaurant 401 amps to 600 amps 160.60 2
Address: 12830 SW Pacific Hwy.
601 amps to E000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City /State/ZIP: Tigard, OR 97223 Temporary servieesorfeedersinitalla Ter rer oneT" ,andTei
relocation
Phone: C503 ) 516.5 719 Fax ( ) 200 amps or less 66,8$ 1
Owner installation: This installation is being made on property that 1 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
' la APPLICANT .:. . . I .. ❑ CONTACT PERSON` ;. ;'..: above service or feeder fee, 6.65 2
each branch circuit
Business name: ' R. Fee for branch circuits
Contact t name: without service or fader fee 1 46.85 46.85 2
first branch circus
Address: Each add'I branch circuit 6.65 2
Mlecdlaneoua_(aerviee or feeder not Included)
City /State/ZIP: Bach manufactured or modular 2
- -' - -" dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
—
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting -- 53.40 2
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Business name: JD Miller Construction DBA Mike's Electric energ y panel, a) or lim n, alteratioo n, , o or r
Address: 11070 SW Allen Blvd. extension. Describe: Page 2 2
City/State/ZIP: Beaverton , OR 97005 Each additional inspection over allowable in a of the above
Per inspection Phone: ( 503) • 649.6991 Fax: (503 ) 641.1902 62.50
lnvesUgation per hour (t >r ' min) 62.50
CCB Lie.: 050209 EIectrical Lie.: 34 -18C I Suprv. Lic.: 4234 S Industrial plant per how 73.75
I , . • ELECTRICAL PERMIT FEES.
Suprv. Electrician signature, required: / �e Al � i ` -
Subtotal:
Print name: Douglas J. Miller 47.te: 01.08.08 . _ Plan raview(25 %ofpennit
-- ( I ' W State surcharge (Prof permit fee): 5.62
Authorized signature: TOTAL PERMIT FCC: 52.47
Print name: I Date: TVs permi appilcadva expires lie peanuts net obtained within 190
days after it boa been 'tempted et complete.
' • Number of inspections allowed per permit.
I. 1a ui1dina1Permier5F .LC.PermBApp.doc 05/21!06 4•0- 4e151`(1 I/Uliend WF]! '
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1 CITY OF TIGARD , 17'Wv- &//7
BUILDING DIVISION PERMIT #: EL.C2008.00022
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2008
Phone: (503) 639 -4171 'Wpy 1 A a
Inspection Requests (24 Hrs.): (503) 639 -4175 ^ 'I �I
INSPECTION WORKSHEET FOR DATE: 6/18/2008 TIME: 7:02AM PAGE: 68
SITE ADDRESS: 12830 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 00A TYPE OF USE:
PROJECT NAME: DAVIDSON'S CASUAL DINING
DESCRIPTION: [1 branch circuit for fire suppression at grill. .
OWNER: DAVIDSON, WILLIAM G + DIXIE L, PHONE #: 503-639-5111
CONTRACTOR: MIKE'S ELECTRIC PHONE #: 503-649-699 I
Inspection Request Scheduled For: Date: 6/18/2008 Pour Time:
Code # Ins ion Description Confirm Contact # Message
199 Electrical final
7 O171 503-649-6991 N
Corrections /Comments /Instructions:
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PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /I 4.lk.- Date DV Phone #: (503) 718-
//