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Permit r- . J- ,, CITY OF TIGARD ELECTRICAL PERMIT III et -• COMMUNITY DEVELOPMENT Permit #: ELC2009 -00260 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/03/2009 Parcel: 1 S 134 BD07004 Jurisdiction: Tigard Site address: 11344 SW COTTONWOOD LN Subdivision: Lot: 0 Project: Gray Project Description: Upgrade electrical panel Owner: FEES STEVE GRAY Quantity Description Date Amount 11344 SW COTTONWOOD LN TIGARD, OR 97223 1 ea Services or Feeders - 200 06/03/2009 $80.30 amps or less PHONE: 503 - 320 -4311 1 ea 12% State Surcharge - 06/03/2009 $9.64 Electrical Contractor: JD MILLER CONSTRUCTION CO 11070 SW ALLEN BLVD BEAVERTON, OR 97005 PHONE: 503 - 649 -6991 FAX: 503 -641 -1902 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503 246.6699 or 1.800.332.2344. / Issued By: Y� C +'_ _ _ Permittee Signature: 7 � / / /'2.7 e��© ./ 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' 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. /A Sent By: MIKE'S ELECTRIC; 591 7847; May-29-09 14:59; Page 1/2 To: =IGARD At: 5035981960 Ate �/ ECEIvE, Electrical Permit Application MAY 2 Fop, f�l r It 1: (4i :,t;�.�i City of Ti by ;- ° � � e �• � t • i 3125 SW H all B lvd., Tigard, OR 97223 CITY f n•, + O � Dete/8 : . /CJ V -r' Pcrmil No ei4 n ,_a 1 f� ' " an Revie ' s �� (��. 0 Phone: 503.639.4171 Fax: 503,598.196 lJ�t :J i(. \k! -) Inspection Line: 503.639.4175 N,ni �/ 4.F zeo' ' !an B : Other Permit. Internet: Line: gafd -0rg4 � I- " ° DI • 5I iVi y,,— Jura: .. � See P gge 2 for �_, TYPE E .(7!t WI1PC — SuPPlemerttal Jntormerien� et W d ❑ New construction .:'''., ; ,:. ':' ..,,. .,. OY D W ,,..;r,:,.:,'.. I 0 Addi tion /alteration /replacement Please check all ,„, , apply ( t © D rioIi[ion sr�bmu S sets of fans w /items checked Wool' — —, El S ervice m fe eder 400 amps or mire In mild . . .' ,. , 4. 1t . . ,.; '.. .., . r,,, m ., w the available ['cult current es. Other: ing over three shales. • _ C A I 1'.;' 7F:`t 1 91 • t" , C O Marin and boatyards ! :4 to ; ,.. c .;... ,. ; ;i,:' exceeds 10,000 amps at 150 volts or I - and 2- family dwelling Q Commercial /industrial Ices to ground, e r exceeds 14,000 CI fl oating ca e agricultural gs, ❑ Accessory k w - � CnmmerciaF. us 0 Multi - family Master a • Y aster bulldcr Other: E Fig pump. hultdinge. • Jt I1:S1I SITE' f , : Q 1.111,11 0n of 75 t;vn Of .. : stir Y t v'7rj , Z� 1ci r I:Emergenc system. larger separately derived ,ysin n. •: . C I addition o Jo new 31 ' i new motor load of • J o h site ad dress: 11344 SW Cottonwo0c Ln_ 100111" or pore. occupancy. C: i l y /SLaLC; LfF ° Six or inure residential units. © Recreational vehicle perks. Tigard, OR 9722 ❑Hcalth•carefaciliriea. 0 Su 1 Voltage mum theft ----- ----- pA Y c fhr m n Suite /bid /a I, no.: i -- 0 Hazardous locations nun g- p Project name: rolls nominal ' d Service at feeder 600 Cl-o>. Slrect'dircction.S 1001) Siic: r- Is or mote a l slnylaj multi -family t 1 y e. or multi f dwelling t Total " I Yee. New residential y tt u • �� Subdivision: Includes attached garage. �_ ` �J Lot r o,; 1,000 sq. It. 01 less 145.15 4 Tax map /parcel nu.: .i1M,S� II1'P7ION residential f)� W{Ir1G Limited energy, �Y I 4U sq. , or portion 33. ) &I11C11 75.00 (with above aq. a) 2 Upgrade pAll@1 I invi energy, multi family . _I- residential with above : ,. R. 75.00 2 Services or feeders ho on ] PROPERTY OWNER amps to 400 a , ---•- 200 amps or less 080 an elucati t ee g 20 test A attOn, alteration r 201 m g0.3 2 Name: l0li.8S 2 Steve Gray 401 ttmps(0600amps 160.60 2 Address .r- 601 amps to 1,00011,1111A 240.60 2 .. Ova I,O00 amps or volts 454, 2 City /State /711': Temporary aervlre or feeders .. { edcra Instetltatlon, alteration, and /or p1101e ( 503 ) 320.4311 f relocation Ft ( ) i Z00 amps or less Owner installation: This installation is being made on property that i own v 201 amps to 400 am ich is not _ P amps 66.315 .1 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, s d 701. i 33 . 75 2 " .75 2 Owner signature: Branch amps to 599 amps 1 33 raneh circuits - new alteration or extension, , er 1 Ane1 ..�T.,.. - _ _ APRLI ? y to"~ .. r- L'Ife A. Pee for hfanch . - 1. 6 , , . m x 7 , ,yy above service or feeder fee, Business name: 1 each branch circuit 6.65 2 1 B. F ee For kraal h cirxuits Contact name: without service Or feeder fee, --- — 4 first branch circuit 46.85 2 Address: 1 Each add'I bumf/ circuit 6.65 .2 • (sly /State /ZIP: `�" Miscellaneous (service or feeder net included Each manufactured or modular Phone; 90 90 ( ) fax : ( ) r dw elling, service and /or feeder 2 E -mail: 1 _ Reconnect only 66 85 2 I Pump or irrigation circle 53.40 2 �-- c ....,., __. { , . r Sign or outline lighting 53,40' 2 Signal circuit(s) or limited - • Business name JD Miller Construction BHA Mike's Electric Address: 1 1070 SW Allen Blvd. 6 energy panel, alteration, or 1 extension, Describe; Page 2 2 Ccry/ State /Zip: Reaverton, OR 97005 Each additional ina , e rtiun over allowable in an of th above Phone: (503) 6.49.6991 Fax (503) 641,1902 Per inspection 62,50 -, • -, vestr alien p hot C't'I3 l.ic.: 050209 1?Icctrical Lie,: 34 -I i[,. Suprv, i n ' t' " n 1 `., 1 , in 6Z 50 Lie.: 42, S Industrial plant per 11uur 73,75 ., Suprv. Electrician signature, required: -� 1`' ,:h.''.'L. S Print name: Douglas J. Miller pate 05 .29 � 09 Plan review (25% of permit fee): Authorized signature: Suite surc permit fee); TOTAL PERMIT FE a 64 „ t/ '' " -1-1 FEE 89.94 Print name: 0 Th is pp p llaLC: permit application ec fires if a permit is not obtained wi thin i gp days after It bets been accepted as complete, i ta u J d i np\Pnmas/LLC•Fe..ailApp . d.,,: 05r23roo • Number ufinspcaions allowed per permit. 440 f ((I 05 /cOM/WLa 1 I d