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Permit
/QE/°R,Arna. 4b'L. wo /tAC // / CITY OF TIGARD ELECTRICAL PERMIT 11111 I - • COMMUNITY DEVELOPMENT Permit #: ELC2009 -00406 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2009 Parcel: 2S104BAl2800 Jurisdiction: Tigard Site address: 13710 SW MARCIA DR Subdivision: Lot: 0 Project: Morejon Project Description: (1) branch circuit for A/C. 8/19/09: ADD (2) branch circuits. Owner: FEES GREG MOREJON Quantity Description Date Amount 13710 SW MARCIA DR. 1 crt Branch Circuits 08/06/2009 $46.85 TIGARD, OR 97223 wo /Purchase Service or PHONE: 503 - 869 -0257 Feeder 1 ea 12% State Surcharge - 08/06/2009 $5.62 Electrical Contractor: 2 crt Branch Circuits w /Purchase 08/19/2009 $13.30 JD MILLER CONSTRUCTION CO Service or Feeder 11070 SW ALLEN BLVD 0 ea 12% State Surcharge - 08/19/2009 $1.60 BEAVERTON, OR 97005 Electrical PHONE: 503 - 649 -6991 FAX: 503 -641 -1902 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $67.37 - 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 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: Permittee Signature: LW /G/ Ce5 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 603.639.4175 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. r, A CITY OF TIGARD ELECTRICAL PERMIT n •1 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00406 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2009 Parcel: 2S104BAl2800 Jurisdiction: Tigard Site address: 13710 SW MARCIA DR Subdivision: Lot: 0 Project: Morejon Project Description: (1) branch circuit for A/C. Owner. FEES GREG MOREJON Quantity Description Date Amount 13710 SW MARCIA DR. TIGARD, OR 97223 1 crt Branch Circuits 08/06/2009 $46.85 wo /Purchase Service or PHONE: 503 - 869 - 0257 Feeder • 1 ea 12% State Surcharge - 08/06/2009 $5.62 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 • $52.47 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 OA 952 -001 -010 . 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: Permittee Signature: 0 Z✓ 7 -70 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 603.639.4176 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. • &' ent By: MIKE'S ELECTRIC; 591 7847; Aug -18 -09 8:55; Page 1/2 Td: TIGARD At: 5035981960 RECE . • Electrical Permit Application 1 Fllr. f)r1 ICI': Ilse tiNl.v City of Tigard g A 11 G 18 20 a find (� G � Permit "n •�. Q ° 13125 S W Hall Blvd., Ti std. OR 97223 y` ...... -`ICD E 1 • Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGA t an Revie o : Oilier remit: Tre;nao Inspection Line: 503.639.4175 BUILDING DIVISE el'' Ready/By: �' '�>• � ® See Page 2 fel Internet: www.tigerd- or.gov 'oh ed/Method' I SupplemenraI Information TYPE OF WORK • .. • . PLO.:5.MYT.i?W ❑ Nr.w construction ❑ Addition !alteration /replaccmcnt Please check all that apply (submit 2 sets °ratans wlitems checked help l • ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: • where die available Stubs current 0 Marinas and boatyards CATEt;Oft i OF COT4St t)( " - ; exceeds 10,000 amps at 150 volts or 0 Fleeting buildings ' -- lt less to pound. or eseeells 4. 0 (Um mercml. use agnc a II u al a I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory Building amps for all other installations, buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Insinuation of 73 KVA or Emergency system larger ae par arg se ale y dori.m.1 , r Sic JOB SITE a7oe6I120 _ 10 A1YEJ;iL'#'1 $`FiC !T ;: : 0 Adrfirinn nf new motor load of WIMP in more, Occupancy. Job nit.: I Job s ite address, 13710 SW Marci Dr. parks 2 6518 -I ❑ Six or more residential units U Rec reational vehicle L il k 5lulu Ll lt: Ti end 0R 97223 ❑ Health-care facilities. D Supply vuliagc t'w more diem Q ,�, " - - 1] Hacetduus IUWtivus. 600 coils nominal. Suite /bldg.Iapl. nu.: Project name: ❑ Service or feeder 600 maps or mare. ............. . Cross stfcit'direelions to job site: n.0 :tlnn Qty. 1 Fee. I T"..t t ' - New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot:no.: 1,000 sq. ft. or less 145.15 a . --• Ea. edd'I 500 sq. ft. or portion 33.40 _ 1 I'ax map/parcel no.: Limited energy, residential 75.01) 2 DESCRIPTION Off'••WORK .''• ... • • .. t will) above sq. ft.) _ . - __ Limited energy, multi- family 75.00 2 Central air conditioner residential (with above se. R) �d 2) nw CH *ilteU I Z Servlcee or feeders installation, alteration, and /or reloratin _ _ N 200 ampriOr less 80.30 2 • r ❑ PROPERTY OWN .. "D1ENANT� 201 amps to 400 amps 106.85 - 7 Name: Creg Morejon _ 401 amps to 600 amps - ^- 160.60 ' 2 ___.._. -_... _ 601 turps to 1,000 amps 240,60 Address: 13710 SW Marcia Dr. Over 1,000 amps or volts 454.65 2 City /StmcJZ,IP: Temporary services or feeders installation, alteration, and /t)r T�,gard ,- __ _2223. _, reloeatlon Phone: i 503 869.0257 Fax: ( ) 200 amps or less 66.85 I _ Owner installation: This installation is being made on property that I owr which is not 201 amps to 400 amps 10030 2 intended for sale. lease, rent, or exchange. according to ORS 447, 449, 67(0, and 701. 401 amps to 599 amps 133.75 2 Branch circuits- new, alteraHarbor extension, per panel _ Owner signature: Date: A, Fee for branch circuits with ~ ❑ APPLICANT „ ; ' .. ,.C, 7;b,; . <•.' , . , ...1;.,,....i...!•:.. above service or feeder fee, 6.65 2 ! each branch circuit - Business name: ki. Fee fir branch circuits " without service or feeder fee, 1 46.85 • 2 Contact name: first branch circuit Address: Each ndd'I branch circuit 2. 6.65 " 1 3.30 2 „- Miscellaneous (service or feeder not included) • City/State/ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fttx:: ( ) Reconnect only 66.85 2 F.- (nail: Pump or irrigetinn circle 53.40 2 40 Sign or outline lighting • .. Signal circuit(a) nr limited. Business (tame: JO Miller Construction DRA Mike's Electric • energy petrel, alteration, or Address: 11070 SW Allen Blvd. _ extension. Describe: Page 2 2 • • City /Stale / LII'; Beaverton. OR 97005 • Each additional los�iun user alto +cable in any of the ahorc , .., _.i._ . Per Inspection 62.50 1 r bons : ( 6 N Fax (503) 641.190 Investigation per hour (l hr tnin) 62 CC'13 I,ic.: 0502099 Electrical Lie.: 34 -I RC Suprv. Lic,: 4230S Industrial plant per hour 73.75 ''i ^; : ::ET lyt't ii '1`EiiMIT . F.E0 8 Suprv. Electrician signature, required: Subtotal: •= Plan review (25%ot' permit fee): i Print name: Douglas J. Miller Date: 06.05.09 - - _ State surcharge (12% of permit fee): - 1.115 t' Authorized signuture: G TOTAL PERMIT FEE: . x i � ` This permit app expires if a permit is not obtained within ISO Print name: Date: Jays after It has been accepted as complete .... L. 6 7. 37 • Number of inspections allowed per penult. Taped: „y'.Pnmitait1C•Pr. "d, App doc 05(2)fM 440.46 15111 1 /O5/COM/WES 3D fl i t 4:....-........ ya o S A B MIKE'S ELECTRIC; 591 7847; Aug-5-09 10:38; Page 3/4 • Electrical Permit ApplicaRECEIVED ; FOR OFFICE It:t; u',l ( >..'1,1' N City of Tigard Received a 1 SW Hall Blvd,. Tigard, OR 974 G 0 5 2009 Date/By: Di 0 6 / a i r ` ., P erm i t Nn a �/ (fi a Phone: 503.639.4171 Fax; 503.598,1960 flan Review ' ' /(J f7 Inspection Lin: 5 CITY OF TIGARD D ale R ' Other Perntu. nilnlcD P 03.639.4;75 D oeteReadyre Internet: www.tigard•or.gov y ` Iu "s' 11tt S ee Pa .... 11 -- Ndtifted/Method: Page 2 (or • ► • . S upplemental Information TYPE f1F • WORK : ( LAN` REV FEW... ❑ New construction 0 Addition/alteration/replacement Please check all that apply (submit j sits ofplans w/items checked belowl: ❑ Service or feedtx400 amps or more 0 Building over three stollen ❑ Demolition ❑ Other; where the available fault omen' ❑ Mnnnas and boatyards. C'ATECORY 0F. tDNS'fietti 1(, -- " - t exceeds 10,000 amps at 150 volts nr I � .. - .... .---i ..... ❑ Fleming buildin�+9. 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory buildin less to ground, Or exceeds 14.000 ❑ Comnrercial a uiiirrnl I ❑ M ttlti- family 0 Master builder ❑ Other: S ❑ Fire pump amps for el , other installations. moldings. a anon o f ..... . • 75 f, VA IA JOB SITE ;II'lFditiwlifitiOl At�l;'tI p! . .... r 9(: E mo mergency system. . m I larger Separately derived sys _ ._.... •,._;; ❑ dtltonofnew r n ur ❑- A....t... ,luh net,: 26518 Job site address: 13710 SW Marc Dr 7� .i I00100111 100111 or more. oeeupency _ _ � - ❑ SIX or more residential units, ❑ Recreational ',owe parks Ill) tilldr:,[. : Tigard L OR 97223 ❑Heath -:are reentries. 0 suppl voltage for more than ❑ Ha>ardous locations. 600 volts nominal. Suitt /bldg. /apt, no.: Project name: ❑ Servtcaor feeder 600 amps of more. CI a +, sirt:ct/dirct ions Ip lob srtC: New m uLifi: Doc ion .:. 10 Fee. Tom 1 single - or 11 family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less •145.15 _ j TUN map/parcel no Fa. add'1 500 sq. ft. or portion 33.40 � mited energy, residential -- Li Y, DESCRIP'TION -OF_ WOIt1C .. • , ': . (with above sq. ft,) 75.00 2 } Limited energy, multi-family Central air conditioner residential (with shove an. R.) 75.00 2 • Services or feeders installation, alteration, a nd/or relocation 200 am s or less 80.30 2 ?FS . ANTF . P ❑ PROPERTY OWNER ©.�� � N .. 201 amps to 400 amps 106.85 2 II Name: Greg Morejon 401 amps to 600 amps 160.60 -. 2 601 amps to 1,000 amps _ 240.60 2 Address; 13710 SW Marcia Dr. - Over 1,000 amps or volts _ 454.65 2 Temporary services or feedere Installation, alteration, audio City/State/ZIP: Tigard. d . 722 relocation Plume: 1 503 869 Fax: ( ) ,. 200 amps or less _...1 ' 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 7.. intended for sale. lease, rent, or exchange. according to ORS 447, 449, 670, rind 701. 401 amps to 599 amps 133.75 p 2 Branch circuits - new, alteration. or extension, per panel Owner signature: Date: A. Fee for branch circuits with C 0. APPLICANT _ . ,,„: , , (. f 't!! }V -,` above service or feeder fee, Business name: each breach circuit 6'65 _ 2 _ ! B. Fee for branch circuits without service or feeder fee, Contact name: _ �I first branch circuit a. 46.85 46.85 2 Address: . Each add'l branch circuit 6.65 2 • L Miscellaneous service or feeder not included) w City/Slate/ZAP: i Each'manufacmrcd or modular t 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) I Reconnect only 66.85 2 E -mail: ___ W Pump er irrigation circle 53:40 2 °t,: 'a -7 ° � >:' ' :. c n ' ::' ;:,, i ... Sign or outline lighting 53. .. 2 • '" ' Signal circuits) or limited. Business name: JD Miller Construction DOA Mike's Electric energy panel, alteration, or Address: 11070 SW Allen Blvd. extension. Describe: Page 2 2 • City/State/ZIP; Beaverton, OR 97005 Each additloaat inspection over allowable In any of the above _. 1 Per inspection 62.50 Phone: 1503) 649.6991 I Fox: (503)641.1902 1 • hlvestlgetlotl per, hour (t In mix) 62.50 CCB Lie.: 050209 E lectrical • Lle_ . 34 - 18C . Suprv. Lie.: 4 x305 ✓ industrial plsutperhour 73.75 .:„ ..._h , :•. :...:i, '7 a " Suprv. Electrician signature, required: t Subtotal; 46.85 I (25% of Plan review Print name: Douglas J. Miller Date: 08.15.09 _ ( permit fee): _ State surcharge (12% of permit fee); 5.62 Authorized signature: `tea TOTAL PERMI•r FEE; 52.47 V NI'i111 name: . D a t e: This permit application expires if a permit Is am obtained within ISO } days after 11 has been accepted an complete. t • Number or inspections anowee per permit. I UruildinsWe,n itlELC- PermimAppdoe 05/23/00 . . ,440- 40141111O5/COMA46B r } 1 .