Permit • 7. • ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT D: ELC2008-00536
COMMUNITY DEVELOPMENT
DATE ISSUED: 9/17/2008
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 CHURCH
Project Description: (5) branch circuits for bathroom heater and lighting repair.
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: 4 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 #: ELE 34 -18c
[ELPRMT] ELC Permit 9/17/2008 $73.45 LIC 50209
[TAX] 12% State Surchar 9/17/2008 $8.81 SUP 4230S
Total $82.26 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 B 4111.110° Permittee Signature: 5-ee , �% s 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.
Sent By: MIKE'S ELECTRIC; 591 7847; Sep-16-08 15:27; Page 1/2
" 'I : ..TIGARD At: 5035981960
.. t
Electrical Permit A heat' v voa 91 usr. t.),\ LI
-, •' 13 125 SW Flail Blv Tigar Tigard, OR 9722 00
, R T ik. Pormit fro:
:
, (
7,
4..,, Plan Review ' -
' . 12 • ,' Plume. 503.639.4171 Fax: 503.598.1980 VV. C.),V' Dat Other Pennil•
I iti•ARD :
e/13y:
Inspection Line: 503.6194 I 75 NL () S) Date keady/By: Anis: lill See Page 2 for .._
- Internet: wwwtigard-orgov (,\\. 6 - Nuiiti,d,m,thod:
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Supplemental information
TYPE •1)1 * I t i- ' ,. VI( .. .'... 7 -.: ., :.: ..: .... .' . .',...' :..'';:..'..::,..' - .':',, ::.,'.:;::. ':::H :: :: ,:.7 . :•...:,"' ' ...... : :...:. : ,..*4; -- 1, 1 ,1 1 ,*:$1P* . : ....:: :. • ':' " 1: ,..:.'„ .' ,..
p New construction El Addition/alteration/replacement Please check all that Apply (submit / eels of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building ova three stories
El Demolition 0 Other; where the available fault current LI marinas and boatyards,
tXtE difti*AtiiikAir. w::•.••:".'::''''::.•:.••• :: ';,..:'.•'••:'.•.• ,: • , exceeds 10,00lIamps at 150 volt, Or p Floating buildings.
fess to ground, or exceeds 14,000 C] Commercial...so agricultural
0 I - and 2-family dwelling CM ComMercial/inclustrial 0 Accessory building amps for all other installations. buildinga.
D Multi-family 0 Master builder P Other: 0 Fire pm 0 Inzinlintion Of 75 KVA or
larger separately deriver/ system.
.. ' ' ':;r4#:''SYik;;:ti:40010tif.**t.0450010:':q"1:!: PI AE'dn:(7 of s a el i li nClIvr load of
---- " " - ' " " ' • ' - — 0
Job no.: 25621 Job site address: 14145 SW Hall Blvd. loot IP or more. OVeupeney.
ID Six or more residential unite. El Recreational vehicle psi k5,
L il) iSiiIICIZIP: Tigard , OR 97224 0 Heefill-Care ratilitieg. I=1 Supply voltage for Inure than
, -,.., CI Hazardous foinnions, 600 volts nOntinal,
Suite/bldg/opt, no.; Project name: ID Service or feeder 600 amps or more.
:' ,), . .c... ,.. ....... . . . . :.
—
CrONN SVCCCOlircctions to . job .siie;
DeicriptIon ,,—
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1..ot no.: - 1,000 so. ii. cir less 145.15 ,1
'
• - '''" - .. ..... En. add'I 500 sq. ft. or po 4
rtion ' 1
ax mao/parcel no.:
Limited energy, residential
- . - . _733i
. . . . . - : DESP0 1410 t,J: or:*004.:,..E.;:.::: ......::•,:....:,.::,...: (with above sq. fi.) 5 o0 0 2
••'"--
Limited energy, mutti-family
Bathroom heater and lighting repair
residential (will, a bove sq. to ,,. 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
— „
El PROPERTY OWNER - ' . „.- • : r . . -'.. ... .'...:-.!:;:::•:::.::'‘. .''' 201 amps to 400 amps 106.05 2
Name: Hall Blvd Baptist Church 401 amps to 600 amps 160.60 2
— 601 amps to 1,000 amps 240.60 2
Address: 14145 SW Hall Blvd.
Over 1,000 amps or volts 154,65 2
...... ..
C. : it Tigard , OR 97224 Temporary servTees or feeders iistailatIon, alte on, and/or
.. relocation
Phone: (503 ) 624.6321 Fax; ( ) 200 amps or less 66.85 I
......
30
Owner installation: TliTsTnstal installation is being 201 amps to 400 amps 100 2
made on property that I own which is not
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
Ownc.r signature: Date: • ,, .... A. Pee for branch circuits with
...,-.
. :..[Zi APP .',.:::: ;':;•:..;:;i' nki '' above service or feeder fcc,
6,65 2
. ,-----•
each branch circuit .„
Business name;
B. Fee for branch circuits -
without service or feeder fee, I
46,85 46.85
Contact name: 2
first branch circuit
-
26
Address: Each add 'I branch circuit 4 6.65 .60 2
—
• . Miscellaneous (service or fceder not included!
City/State/ZIP:
Mo-II,
Ranh manufactured or ri I alr
90,90
.—,..
dwelling, service and/or feeder 2
Phone: ( ) ,J Fax; : ( , )
Reconnect only - 66.85 2
— — • F ,.., Ptitnp or irrigation circle 53.40 2
.
' ' . '. :. " . '" ' " ''''''• '''' ' '' ' ''.- '''''''''';'` ' ' ' ; • ' -' Sign or outline lighting 53.40 2 ..„
Signal circuit(s) or
Business name: name: JD Miller Construction DBA Mike's Electric
energy panel alteration, or
.,
Address: 11070 SW Allen Blvd. extension. Describe: Page 2 2
City/State/ZIP: Beaverton, OR 97005 Each additional inspection over allowiti;le in any of the aboys
- - - Per inspection 62.50
Phone: (503) 649.6991 Fax: (503) 641.1902
Investigation per hour ( I hr min) 62,50
..„, .._ . ...,,......
_ .
021.3 Lie.: 050209
• ' i Electrical Lic.: 34-18C Suprv. 1.,1e.: 42305 Industrial plant per hour III=
:?:i!? imi''''!'', , i.7 1 .77.7 . !:',7.o.;. , ;', ..- • • : .. ' .::
Suprv. 1.dectrician signature. required:
Subtotal' 73.45
Print nattier Douglas J. Miller Date: 09. 16.08 Plan review (25% of permit fcc):
.. State surcharge (12% of permit fee): 8.81
Authorized signature; , 0 .r. TOTAL PFAMIT FEE. 82.26
i ..
Print oarnc: a Date: This permit application expires if a permit is not obtained within ISO
days after II has been accepted as complete.
• Number of inspection. allowed per permit.
1 .11-111 iltivikOrerin iir,IELC.Permil Aop lee 05123/06 440-46l5T( I ims/conewes
• •
. ,
CITY OF TIGARD
BUILDING DIVISION
AvAm PERMIT #:
ELC2008-00536
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/1/2008 TIME: 7:02AM PAGE: 23
SITE ADDRESS: CLASS OF WORK:
14145 SW HALL BLVD
SUBDIVISION: LOT #: TYPE OF USE:
EDGEWOOD
PROJECT NAME: HALL BLVD BAPTIST CHURCH
DESCRIPTION: (6 branch circuits for bathroom heater and lighting repair.
OWNER: HALL BOULEVARD BAPTIST, PHONE #:
CONTRACTOR: MIKE'S ELECTRIC PHONE #: 6 0 3. 649 . 6991
Inspection Request Scheduled For: Date: 1011/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
----
199 Electrical final / 076150-01 503-649-6991 -- V
Corrections/Comments/Instructions: ( B uDD 1 6
L- b 2- 1 3 'I 1 P■c_c_rs61)
•
. .\.
\ I \
I N
, --,
78' PASS I I PARTIAL APPROVAL n CANCEL fl NO ACCESS
fl FAIL El CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Cr I Lig Date: 10'i 1 Phone #: (503) 718- ii-qq4
_ ,