Permit .CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT ISSUED: 9/9/2008
TIGARD E9/2008 -00521
DATE I 9/2008
T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S135DD -05106
SITE ADDRESS: 11995 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: BRUNO DENTAL
Project Description: (1) branch circuit for A/C.
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+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WEIREX CO INC + MIKE'S ELECTRIC
CCC PROPERTY MANAGEMENT LLC 11070 SW ALLEN BLVD
14001 WILLAMINA CREEK RD BEAVERTON, OR 97005
WILLAMINA, OR 97369
Phone: Contact #: PRI 503 - 649 - 6991
FAX 503 -641 -1902
FEES
Description Date Amount Reg #: ELE 34 - I 8C
[ELPRMT] ELC Permit 9/9/2008 $46.85 LIC 50209
[TAX] 12% State Surchar 9/9/2008 $5.62 SUP 4230S
Total $52.47 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 Permittee Signature: _ _cC° t' c--g*?5r/�
j/-
WNER 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.
liBy ELECTRIC; 5035981 960 591 7847; Sep-8-08 13:43; Page 1/2
Spt : MIKE'S
At :
To : TIGARD
P &
•
Electrical Permit Application RECEIVED F. (11:1:1(:. E USE ONI.
•
City of Tigard Received
umera : , 1117. MlorAg Fennit No.: g , j o 4.--....
II .- • 4 13125 SW klall Rlvd., Tigard, OR 97223 SEP - 8 2008 ----
Plan Review ' . 1
W ' Phone; 503.639,4 I 71 Fan: 503.598.1960
Datally: Other Permit:
...
insPeClion I .ine: 503.639,4175
Dalt Ready/Sy : 1IMIL. &I See Pugs 3 for
Internet: www.tigard-or.guy CITY OF TIGARD Nutitied/Merhod:
--1:74 I s.upplemearst ram-matron
-...1
• . irytE. OF MitUDINGIMVISION • '''-' • - •• -
---
0 New conStruction 0 Addition/alteration/replacemenl Please check air thin apply (submit 2 sets of plans wiireins chocked below)
0 Service or feeder 400 amps or more 0 Building over three stories.
E.1 Demolition 0 Other:
where the available &lilt current 0 Maus imd boatyards.
• ' .7:77-71',A.: "i)ftW'f.'114 sritkir*.•;%...--;,-,:.:-.:', 471 ''.'!:•-;c:-.':.7 exceeds 10000 amps at 150 volts or ['Floating buildi, gs.
lens to ground, or exceeds 14,000 0 Commercial-use agricult I- and 2-lamily dwelling jitr 0 Accessory building
amps for all other installatios, buildings.
0 Multi-family 0 Master builder []Other: CiFire pump.
0 Installation uf 75 K VA or
larger sepisrately derived system.
• .• ' ' .. ... ......'i ......,r..... • .. • Cl 0 Addition of new motor lone of 0 "A". "E", - 1 - 2",
Job no.: 25597 mb site address: 11995 SW Pacific Hwy - 10014P or more.
Cl six or more i esidential units. occupancy.
LI Recreatinal vehicle parks, •
-
Ci 1)/Slalt:i7.1 9: Tigard, OR
0 Health-core facilities. 0 Supply voltage for nmre than
Cl Hazardous locations. 600 voila nominal.
SU i Lc/bldg./apt. no.: Project name / rWlici ...611 I : D Service or feeder 600 amps or more.
-
-* „ .. 1 ,L‘ I iITT. T 3' =fv.:1 a.:4, : : ; ; . 2.: -:- :,•: . • ..•-•.: - .
Cm ro sirecticlirections In job site: ( =
inrri°11" 4. , Pea Total •
ew residential single- or multi-family dwelling unit.
Includes attached garage.
-.-.
,
Subdivision: Lot n .: 1 • 1,000 sq. ft. or less 145.15 4 -----/-
______ 50"---6.---/ion 33.40 '- 1
Tax map/parcel no.:
• - 7 Limiest energy, residential
- • ' • - - ..DEKATIMOftl:of::2,0*•,-,...7,-..... .:•:::.-...::- ..:.....:....., i..,... , (with abuft se. ft) 7500 2
Branch circuit for A/C
.
,
Limited energy, multi
75.00 2
- - -
residential (with above 5. ft.)
_
Services or feeders installationolteratton, and/or relocation
200 amps or less 80.30 2
____
PROPER IT OWNER . • ' • . •. ••.: ... -:-.. ENA141.•;• - .... - - - ,:. 201 amps to 400 amps 106.85 2
. . .. • ..,. ..,- ,•. ••, •.
Name: %, . :_ q .s... .....t ..:4_,.., • irle.,/ t cc
401 amps to 600 amps
--- 160.60 2
Address! 1.t “514.i! A S 0 601 amps to 1.000 amps
Over 1,000 amps or volts 240,60 2
454.65 2
- .
City/State/71P.
• . q •- -.1. Temporary cervices or feeders installation. alteration. ad/or
. relocation
Fax ( ) 200 amps or less 66.85 1
-
-
100.30 2
Owner installation: Ibis installation is being made on property that town which is not 2°1 ill t a mPs
- -
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
BnInch circuits - new, alteration or extension, r panel
Owner signature: Date:
'--..,,.' A. Fee for branch circuits with
• • 0..0 ....Ot ..;;,. .:, ,I..L.;:::::;.:i,FRINIMI:;.ifJ:Mlili d " 4 , .,;',;.:(!;i above service or feeder fce.
6.651 2
each branch circuit
Business name: Apollo Air,
B. Fee for branch circuits •
_ without service or feeder fcc, 1 46.85 46.85 2
Contact name: Mike
first branch circuit
Address: Each adci'l branch circuit 6.65 i 2
Miseellaneousiservice or feeder not Included) ______
Ci Ey/State/71P:
Each manufimtured or modular
90,90 2
-
dwelling. service and/or feeder
Phone: ( 503)348.8554 Fax: : ( )
______
Reconnect only __
66.85 2
I
• --
_,...
F-mail:
Pump or irrigation circle 5144 2
-
• - '' ...:%•'. ..e .. .-:,,s,,,,.,3,4,-.:;,--,,,,,,,.777if ited
Sign or outline lighting 53.40 2
....,..--..........,:..,t,„,a.„,,,ii:zAttf,:i4:-,;,P21_,V,q1.•*-k.,":"V,■.4,-'",.,,:',.:.4.i■i ,..
Signal cirmit(s) or lim-
•
Business name: JD Miller Construction DBA Mike's Electric
energy panel. alteration. or
e
Address: 11070 SW Allen Blvd. extension. Describe: Page 2 2
City/State/ZIP: Beaverton, OR 97005 _ Each additional Inspection over allowable in any of the above
_,...._____
-- Per inspection 62.50
Phone: (503) 649.6991 Fax: (503) 641.1902
- Investigatiou per hour ti Iv AIM)
- -
CCB Lie.: 050209 FTcvical Li734-1EZW Lin.: 42.30S Indusuiat plant per hour 73.75
-,
^- '4,S4:§i,t4--'---r'----r'-"---i8i.0:7gggg,'il):WW_
Suprv. Electrician signature. required:
Subtotal: 46.85
Print name; Douglas J. Miller Dale 09.08.08 - Plan review (25% of permit fee):
_
...
Stale surcharge (1 of permit fee): 5 62
_
A uthorized signature: I ..... "
TOTAL PERMIT FEE!
_
sa.... -- /.... . t'af' _
• 52.47
Print name: ill Date: This hermit exiMita it A permit is not obtained within ISO
days after It has been accepted as complete.
----
--- • Number or inspecrions allowed per permit.
I 03 uildins■Poimitrun,c-PermitApp Six 05/2.4/00
410-46 I 5111110KOWWEB
CITY OF TIGARD .1 ic
BUILDING DIVISION PERMIT #: ELC2008- 00521
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 9/9/2008
Phone: (503) 639 -4171 �a „
Inspection Requests (24 Hrs.): (503) 639 -4175 ``'m.
INSPECTION WORKSHEET FOR DATE: 9/2612008 TIME: 7:00AM PAGE: 8
SITE ADDRESS: 11995 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: BRUNO DENTAL
DESCRIPTION: (1) branch circuit for A/C.
OWNER: WEIREX CO INC +, PHONE #:
CONTRACTOR: MIKE'S ELECTRIC PHONE #: 503-649-6991
Inspection Request Scheduled For: Date. ' 912617008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075985 -01 603 348.8554 \ Y
Corrections /Comments /Instructions: - I `
Fa(k F■ c,Q.t ss . )°:6 0 LO
- N.
\. ,\.
N \ J
r■
VVV I /
jl1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY N (A ..E Date: _i Phone #: (503) 718- IAA_