Permit s R .
CITY OF TIQARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00653
. COMMUNITY DEVELOPMENT DATE ISSUED: 9/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136CB-04000
SITE ADDRESS: 08370 SW STEVE ST ZONING: R -4.5
SUBDIVISION: STEVE + HUGHIE'S PLACE LOT : 012 JURISDICTION: TIG
PROJECT: MONTPLAISIR
• Project Description: Service and 4 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: SIGNAUPANEL:
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: 4 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:
MIKKELSON, ALICE V MIKE'S ELECTRIC
8370 SW STEVE ST 11070 SW ALLEN BLVD
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: . Contact #: PRI 503- 649 -6991
FAX 503 - 641 -1902
FEES
Description Date Amount Reg #: ELE 34 -18c
IELPRMT] ELC Permit 9/19/2007 $106.90 LIC 50209
[TAX] 8% State Surcharge 9/19/2007 $8.55 SUP 4230S
Total $115.45 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 expiie 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: &At & Permittee Signature �I
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.
.i ELECTRIC; 591 7847; Sep -19 -07 7:59; Page 1/2
At: 5035981960
Eleci.Aical Permit, Application FOR OFFICE USE ONLY
��ECE ED Reed. °. ,
Permit , ,.7-00153
City of Tigard nawB .
13125 SW Hall Blvd„ Tigard, OR 1 PlaO ive w Other Permit:
Inspection Line: 503.639.4175 S E P
F. -
Photte: 503.639.4111 Fax; 501.598.1960 L 'jiff' O °mil" ---� r� �� g„ pageafmr
1 9 ./111./ •.- A-7" pate Beady/By / Supplemental P2 f rorma .
httemet: www.d.tigard.or cis Notified/Method! _______
::::.1,.',C4'..-,,,,I,',.",:',:;;', T . rr� i ry _ ➢rIr� �,i`�''#�w;�'':.;. � ^ ;-
�'.'.:tt. _.... .. -.I .. . 1l 1 ",( ;� !iJ ( 17 f .�.. .. �.. :'. a , .`�.. � r Li' I �. ' i ,:.. i
^1E t .:1,� •� all that appty
: �::t:,..X ; :TA -. r + , � ••- .:
: _ ,- ; '._ , : ; "' -_ -"'""I'' .. - Please check :
❑ New construction ❑ tt • • alterano . rep
❑Service over 225 amps, eomm'1 []Hazardous location
❑ Demolition ❑ O ❑s fa
,. ...,, •_ • .: • .. •:.,: „•, ;, ?y-T �:4 ^,' .;,rl:, - ' 7 l . i� d�"� of and Z f •
...... .:: . ... ••,, ., ......:,; .: l ., t' %7 i,�i' =;i;�pik: ' '
„ y gra dwellings 320
•.:, . ;'.. ., " .. .. • ,L�. residential „ ...,:. • .. over v its in one e
� Lure
❑System ver 600 voila nominal units
El 1 - and 2 -family dwelling ❑ Commercial/industrial ❑ Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- fatnil ❑ Master builder ❑ Other ❑Occupant load over 99 persons DMenufactured structures or
:';,errs 'ri % iti;s li eas/li tie Ian RV. park
'��' ��it�i�ti �i ❑ sr Bh Sp
❑I[ealth-care facility Other.
Job no.: 24417 lob site address: 8370 SW Steve St . Submit 3, acts of plans with any of the above.
OR 97223 ard, not applicable to construction service.
CitylStalelZlP: 1 8 The above are n t applit abl temporary con c -
Suite/bldg. /apt- T1o.: Project name: Dmerlptlal Pee. T.e.1
I ..
Cross street/directions to job site: New residential slhgle- or multi- family dwelling unit.
includes attached garage. _ •
_ 1,000 sq. R, or less 145,15 4 ,
Subdivision: Lot no.: Ea_ add'l 500 sq. ft. or portion 33.40 • l
Limited energy, residential 75.00 2
Tax map /parcel no - : • Limited energy, a 75.00 2
'' 7: � i `�' 'ar `' o, ' j' !' ;• u � ' s � Each manu modular
t d/ f d 90 90 2
• S upg dwelling,stavlccan o ec cr
S ervices or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
- • ,,. -
,'� • � - ;:I :�j 201 amps to 400 amps 106.85 • ., , ...,,.. ,' • ,,,< .. • - .. , . ..- ,a_ :.,... . ... ....: _ .. - 401 amps to 600 ire
Name: Brad Montplaisir _601 amps to 1,000 amps 240.60 'L
-
8370 SW Steve St. over 1.000 amps or volts 454.65 2
�� Reconnect only 66.85 l 2
City/ State/ZIP: Tigard, OR 97223 Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( 503 ) 968.9833 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
=Y: A.Fee for branch circuity with
I ': tl• ' 4 26. ti0
�;;=''.._ r -. : :..:. .... ........... ._. .... ..�... .... .. ......._..,. service fee, ch 6.65 2
or feeder ee to
Business name: branch circuit
Ii, Fee for branch circuits
Contact name: without service or feeder fee, 46.65 2
each branch circuit
Address: ' Each add'i branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder tent included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) sign or outline lighting 53.40 _ 2
E-mail:
Signal circuit(s) or limited-
, :, �;;? , i ": " �'; * enerBYp�el,alteretion or
Page 2
.:'�',,..... ........ ....... ......__..,,...........,._, ,....,....._....... a %tenSlOn- fkaCT
Businees mime: Mike' s Electric: — JD Miller Const Co
Each additional Inspection over a llowable In any o the a
Address: 1 10 7 0 W A .. - t. B1 ° . Pet inapeCtion 62.50
City /State/ZIP: - - • r 8 i p 1 investigation per hour (1 hr men) 62.50
btdnao•ial plant . er•hour 73.75
Phone: (503) 649 . 6991 Fax ( 503) 641 1 02 ''' . ' :- :!:Fi � ' r" 1' ,i .._.. : -i - _0.. :
:, B': YriAl
CCB Lic.: 050 1 • Electrical Lie.: • _ ; Suprv. Lie.: 8 h subtotal 1 • • ' e
Plan review (25% of permit fee)
Suprv. Electrician signature, required' 6 _ O '
State surcharge (8% of permit fee) 8.55
Print name-. Do Date: 09.19.07 IT FEE — 115.45 -�
u _ias J Miller rOTnLPERM
Authorized signature: Tht4 permit eppeeaion expires it • permit it not obtained within ISD
_ days after It has been accepted as complete
Date: • Fee methodology set by tri -County Building Industry Service Board
Print name: •• Number of tospeetlone per permit allowed.
E\Bun&igWormtuZLC.PWTtMppdee 12/07 4.0-461 St(10/02/CObrtWH9 .
CITY OF TIGARD
-
BUILDING DIVISION �* PERMIT #: ELC2007 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/28/2007 TIME: 7 :00AM PAGE: 75
SITE ADDRESS: 08370 SW STEVE ST CLASS OF WORK:
SUBDIVISION: STEVE + HUGHIES PLACE LOT #: 0.12 TYPE OF USE:
PROJECT NAME: MONTPLAISIR
DESCRIPTION: Service and 4 branch circuits.
OWNER: MIKKEL SON , ALICE V, PHONE #:
CONTRACTOR: MIKES ELECTRIC PHONE #: 503649 -6991
Inspection Request Scheduled For: Date: 9/78/2007 Pour Time:
Code # Inspection Description _ Confirm ># Contact # Message
199 Electrical final 056513.01 503 64E1 Y
Corrections /Comments/ Instructions:
J
11 t.1 oo(-- Mp. I .
Gov - sv)t -s 2..a.
`A y
N
1 , 1
\,\ l rn` /
/J V
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - \ vv� �-�. Date: Z- Q Phone #: (503) 718-
. F'