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Permit / CITY OF TIGARD ELECTRICAL PERMIT �' I . COMMUNITY DEVELOPMENT PERMIT D: E /2008 00014 DATE ISSUED: 1/8/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 111 AA -00401 SITE ADDRESS: 14145 SW HALL BLVD ZONING: R -7 SUBDIVISION: EDGEWOOD LOT : JURISDICTION: TIG PROJECT: HALL BLVD. BAPTIST roject Description: (3) branch circuits. (various areas of church) 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: 2 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: HALL BOULEVARD BAPTIST MIKE'S ELECTRIC CHURCH 11070 SW ALLEN BLVD PO BOX 230130 BEAVERTON, OR 97005 TIGARD, OR 97223 Phone: Contact #: PRI 503 - 649 -6991 FAX 503 - 641 -1902 FEES Description Date Amount Reg #: ELF 34 -18c [ELPRMT] ELC Permit 1/8/2008 $60.15 LIC 50209 [TAX] 12% State Surchar 1/8/2008 $7.21 SUP 4230S Total $67.36 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: ta >_ Permittee Signature: t s)- yt / r ,yi p` 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 � .,, =Tent By: MIKE'S ELECTRIC; �°� 7; Jan -7 -08 16:06; Page 1/2 i To: TIGARD At: d . eOEI t . Electrical Permit Application JAN 0 , 2008 Received • City f Tigard Por;tNo w ty g TY OF W ARD Pian g y: v' l 13 g �g �m� 13125 SW Hail Blvd., Tigard, OR 9 pl Revi _ Phone. 503.639,4171 Fax: 503 $ d I4l�w DIVISION ��+ nalelBy Permit; g Page 2 for F. .I} Inspection Line: 503.639.4175 � f� �i�UU1V1Sro� Date Read /By Internet: www.tigard.or.gov Notified/Method: Supplemental information TYPE OF WORK • below)' El New construction El Addition /alteration/replacement please cl,rck all that apply (enbmit 2 pea of plans wtitema chucked ❑ Service or feeder 400 amps or more 0 Building ever three stories ❑ Demolition ❑ Other; where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSCRUC#'ION exceeds 1 O,OOD amps at 150 volts or ©fleeting buildings. less to ground, or exceeds 14,000 0 Commercinlwrse agricultural ❑ 1- and 2- family dwelling 133 Commercial /industrial ❑ Accessory building amps far all other installations, buildings. ❑ Multi-family 0 Master builder ❑ Other: 0 Fire pump. a Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency of new m. larger separately derived system. ❑ Addition of new motor load of ❑ "A" "E" "1 -2" '9 -3" Job no.: 247$4 Job site address: 14145 SW Hall Blvd. 100HP or more. occupancy. w wry Du or more residential units ❑ Recreational vehicle parks. City/State /ZIP: Tigard, OR 97224 s ❑Heaah•corefacilities. ❑ Supply whelp fin moos than _ �i ❑ Hazardous locations, 600 volts nominal, Suitc/bldg. /apt. no,: Project name: 7 l� O Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: ne.e l tom. rate. T Tate' I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 - Es. add'l 500 sq. ft. or portion 33.40 1 ..._ "Tax map/parcel no.: Limited energy, residential 75.00 2 . DESCRIPTION OF WORK � (with above sq. It) Various projects around the church Limited energy, (with multi-family 75.00 2 P � residential (wish abme sq, fl.) Services or feeders installation rt _ lteration and/or relocation 200 amps or less 110.30 2 0 PROPERTY OWNER . • ' I ❑ TENANT , . , 201 amps to 400 amps 106.85 2 Name: Hall Blvd, Baptist Church 401 amps to 600tlmps 160.60 _ 2- 601 amps to 1,000 amps 240,60 2 Address: 14145 SW Hall Blvd. . Over 1,000 amps or volts 454.65 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: Tigard, OR 97224 —, _ .,,,,, ___.. relocation Phone: (503 ) 320.1622 Fax: ( ) 200 rumps or less 66.85 I Owner installation: This installation is being made on property [fiat 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 599 amps 133.75 2 Branch circuits ttew or extension, per panel Owner signature= _ Date: A. Fee for [[ranch circuits with ❑ APPLICANT • : , . I . ❑ CONTACT PERSON . • .. ' above service or feeder fcc, 6.ti5 2 each branch circuit - _ __ Business name: B. Fee for branch circuits "" without service or fader foe, 1 46.85 46 2 Contact name: first branch circuit Address: rvT Each add'l branch circuit _ - 2 6.65 13.3u 2 W-- - - Mlacellaneona (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) hex: ( ) Reconnect only 66,85 2 E Pump or irrigation circle ___ - 53,40 2 • CONTRACTOR Sign or outline lighting 53.40 2 • Business name: JO Miller Construction DBA Mike's Electric Signal circuit(s) or lim _ _ energy panel, alteration, or Address: 11070 SW Allen Blvd. extension. Describe: Page 2 2 City/Statc/ZTP: Beaver ton, OR 97005 Each additional inspection over allo h i wable say of the above — Per inspection 62.50 Phone: ( 503 ) 649.6991 Fax: (503 ) 641.1902 .. 50 _ lavest tion per hour (i iv mm) 62. Ccl3 Lie.: 050209 Electrical Lie,: 34 -18C Suprv. Lie.: 4 2305 rnduatrial plant per hour 73.75 / _ • ' ELEC'T'RICAL PERMIT FEES... Suprv. Electrician signature, required ) if .� subtotal: 60.15 Print name: Douglas J. Miller Gate; 01 .07.08 . Flan review (2536 of permit fee): 111 State surchargetilb of permit flee): 7 Authorized signature: • TOTAL PERMIT FEE: 67.36 • D ate: __ Tb. p ermit applies liar explree if a penult is not obtained within 180 Print name: I � . days after it has been accepted as complete, Number of inspections allowed per permit. t. tiauilelinprerrnlie2Ft .C- eermtApp.doc 05(27/06 440- 461ST'( I/05 /COM/WOB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2008-00014 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /130008 Phone: (503) 639-4171 40140 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2/1/2008 PAGE: 63 TIME: '7:02AM SITE ADDRESS: 1414 SW HALL BLVD CLASS OF WORK: SUBDIVISION: EDGEWOOD LOT #: TYPE OF USE: PROJECT NAME: HALL BLVD. BAPTIST DESCRIPTION: (3) branch circuits. (various areas of church) OWNER: HALL BOULEVARD BAPTIST, PHONE #: CONTRACTOR: MIKE'S ELECTRIC Nt\opp., PHONE #: 503-649-6991 Inspection Request Scheduled For: Date: 2/1/2008 Pour Time: Code # Inspection Description Confirm Contact # Message 199 Electrical final 064339-01 603-649-6991 NI Y Corrections/Comments/Instructions: 9 -A- N 7 PARTIAL APPROVAL 111 CANCEL 7 NO ACCESS 7 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: 6 t Date: 61 Phone #: (503) 718- 2-`144S"