Permit •
f ,• CITY OF TIGARD 'ELECTRICAL PERMIT
PERMIT #: ELC2005 -00925
DEVELOPMENT SERVICES DATE ISSUED: 12/2/2005
I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S102A6 -00501
SITE ADDRESS: 12115 SW LINCOLN AVE ZONING: R-4.5
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT : 063 JURISDICTION: TIG
Project Description: Circuit for kiln
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: 1st 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+ ampNolt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CAROL SCOGIN MIKES ELECTRIC
' 12115 SW LINCOLN AVE 11070 SWALLEN BLVD
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503 -887 -5703 Phone: 503 -649 -6991
FEES Reg #: LIC 50209
SUP 4230S
Description Date Amount ELE 34 -18c
[ELPRMT] ELC Permit 12/2/2005 $46.85
[TAX] 8% State Surcharge 12/2/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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: AR /4N DzieitocK. Permittee Signature: DN AWPL / e...4 /\-)
• 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; Dec -1 -05 12:59; Page 1/2
To: TIGARD At: 5035981960
3
Electrical Permit A lie lo 5Q L OR 01 FRT. USE uN Ll'
City of Ti and Received
131 Sw Hall Blvd., Tigard, OR Darafn - A- .1 "QS 15.5 % Permit Tao.: EL C 20GS - .
lo „ Plan Review Other Permit n
Phone: 503.639.4171 Fax: 503.598.1960 A - I I Dats/B :
1J
Inspection Line: 503.639.4175 j)F / a 1.�. ,I 11 Date Ready/Fly: See Page 2 for
Internet: aww.ci.tigatd.or.us O T \GI\ O-- Notifed/Method: L j
® 0 / S,# 157M Supplemental Information
4 ,, 1 '' .. . .. .. • 4 r
.. fi -. , Jrt:fl' l t F .Y. ; r�. ' .
❑ New construction ❑ . tion/alteration/replacentent Please check all that apply:
❑Demolition ❑Other Service over 225 amps, comm Hazardous location
o , i ` 1, . i ❑ ervice over 320 amps - rating ❑ Buildng over 10.000 sq. ft..
� : l i s L ! : q; -� of I- and 2demily dwellings 4 or more new residential
a 1- and 2- family dwelling [ J CotnmercialTiindugtrial El Accessory building ❑System over 600 volts notional units in one structure
❑ Multi- family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders. 400 amps or more
['o load over 99 paeans OManufactured structures or
.. _ . , ._ _... _ _ _ _ ,.: , • ? :.'. : ❑EB�BhtinB Plan RV park
lob no.: 22286 Job site address: 12115 SW Lincoln Ave . ❑Heaith-eare facility ❑vr:
above.
Submit." seta of plans with any of the above.
City/State/ZIP: Tigard , OR. 97223 The above nc not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name:
Dbo4,d a Qtr. o... Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage _
1,000 aq. ft or less 145.15 4
Subdivision: Lot no.: Ea- add'l 500 sq. tt or portion 33.40 • l
Tax map/parcel no.: Limited residential 75.00 2
r t' ennon-reeidential
75.00 • 2
,, ', ' t ' ... Each manufactured or modular
New circuit in electrical kiln dwell' ; eerv'ee and/or feeder 90.90 2
Services or feeders instillation, alteration, and/or relocation
200 amps or less 80.30 2
106.85 2
401 atrps tq 600 amps 160.60 2
Name: Carol Scogin 601 amps to 1,000 amps 240.60 z
Address; 12115 SW Lincoln Ave . Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 j 2
City /StaIn/ZIP: Tigard, OR. 97223 Temporary services or feeders Installation, alteration, and/or
( 5 a 3 887.5703 Fax: ( ) relocation
Phone: 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 snips 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 133.73 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
a;, `,�:. . -�:.: - A.Fcaforblmtchcucuitswirll
. f h
st:rvice or feeder ee, sac 6.65 2
Business name: branch circuit _
B. Fee for branch circuits
Contact name: without service or feeder fee. 1 46.83 46.85 2
each branch circuit
Address:
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included) ,
` Pump or irrigation circle 53.40 ' 2
Phone: ( ) ._.. `. Fax:: ( ) Sign nr outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
ti: an rgy panel, alteration, or
extension. Describe: Page 2 2
Businesantulle:Mlke's Electric - JO Miller Const. Co -
Address: Each additional inspection over allowable hi any of the above
1 10 7 0 S W ill Llvk pa inspection 62.50
City /State/2IP: B - . v - . , a ; • a a Invesdgatian per hour (1 hr nla) 62.50
Phone: (,03) 649.6991 Fax:
5 0 3) 641 .19 0 2 Industrial plant per hoot 73.75
CCB Lic.: 0 0 a • Electrical lie.: _ : 4+6 85
r213311Mill Subtotal 4
Suprv. Electrician signature, require' ` / , Plan review (25% of permit fee)
di State surcharge (5% of permit fee) 3.7r
Print name. D o u : 1 t; s J Miller Date. 12.01.05 TOTAL PERMIT FEE 5040
Authorized signature: This permit application expires if o permit is not obtained within 180
Print name: days after It bee been accepted as complete
Date: • Pee methodology set by T i -Comfy Building Industry Service Board
•• Number of inspections per permit allowed.
t%BU IiP n.eonHLC-P•no@App,doa 12103 wo..emiT(manitahswas
CITY OF TIGARD 1111/ C-
BUILDING DIVISION PERMIT #: S OS — oD b../ 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
ti
Phone: (503) 639 -4171 A W�td r�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / �– I I /
14// eC.19 -- " CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: •
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: • : te: 3 — 0- 3 — D C Pour Time:
Code # Inspect escrjption Confi # Contact # Message
9 cl G am ' 6 LF9 — (2 ci q 1
Corrections /Comments /Instructions:
0
. •
e AI
Z1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v I'+� YJ Date: 3(2 3 0b Phone #: (503) 718- 041