Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2013 00217
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11/2013
Parcel: 2S110AB02200
Jurisdiction: Tigard
Site address: 14315 SW 112TH AVE
Project: Spinelli Subdivision: COLE'S ACRES Lot: 8
Project Description: (1) branch circuit for microwave
Contractor: MIKE'S ELECTRIC Owner: SPINELLI, JEANETTE Y & DAVID J
11070 SW ALLEN BLVD 14315 SW 112TH AVE
BEAVERTON, OR 97005 TIGARD, OR 97224
PHONE: 503 - 649 -6991 PHONE:
FAX: 503 - 641 -1902
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 04 /11/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/11/2013 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 9 2- 001 -0090. You may ' obtain � a - copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. I\
Issued By: � ai. Permittee Signature: �� 4 PPL(CA- 1 9 A
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 503.639.4175 by 7:00 a.m. for the next available Inspection date.
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.
#1848 P . 001/002
04/11/2013 12:43
Electrical Permit Application REcEivE D FOR OFFICE USE ()NI.
na Y
Plaml: \.k.,e..d a.
City of Tigard i Rt.:cis cd e 'dgill 3 * z , .of 3— o 0 ..a
II 13125 Sw Hail Blvct., 'Nora, DR 97123 . , te-Bs.
.-‘ P I R ' 1 1 2013 i , F,':,:. -4 11 ;7.— Othsr Per
' I Phone: 503 718.2439 FR% 503.598 146 ! :na,. -
R
Innpection 1-ine: 503 639.4175 I nle endy: ; I." la S Pste Mr H
TIGARD O
CITY OFTIGARD 1 InG 1 s et "
. I ... j
Internet: www.tigard-ot goy i Notified/me:hoe.
.11inaleinennif r a Cornea Son I
TYPE OF ti4PIN6LDIVISION . PLAN REVIEW -
— —
0 New construction arkdditionial tendon/replacement Please check ail that apply (submit I SCTi of plans %Awls checked below)
0
Ss ii in reOdtr 400 mos or Intirr 0 Su; Id ing over throe Rorie%
0 Demolition 0 Other: ---, iu
; where :he nilable huh Cusieni 0 VinriniS and tann:Sns dn. 1
'' ' •
CATEGORY OF connwcriox : .7..6;0.000 amps a: : in ‘o!t. or 0 Froarinf, builds/rpm
-.
g ei z and 2-family dwelling ID Commerciaitindustrial 0 Accessory building — I, 14 " r° or exc°4$14.000 D rnm''''3621-14e atniculmr21 1
1 amps RN nd orlInt installarica4. buildiNm
I
0 NI 011i-carnily 0 Master builder 1:1 Other: 0 fife pomp. 0 installs:ion or7s KVA 0. I
0 V syswth laigor separaloi, derived sweat j
JOB SITE INFORMATION AND LOCATI()N
0 Addition of new moio• ioao or 0 - N - b - - I ••:!' . - 1.1 - . i
Job no,: 3‘zp- 1 Job site address: / 3t5 Sw_a_ 4>t Inure mclIpS110 .
41
0 Six Or mOrC scstclemiaI wurs, 0 Reaegrunal Yeitick parks
.. . _
City/State/7AP: - 1 -r - i4 (60 , <- 4 4 i cck crixt4_ ..._
1 0 Hcan.c.ic thaiti„. 0 sv,,i voitne foi. more Thu
0 I locaTion,, VW ■VIISII0fturial
_
Suite/bldg/apt. no.: I Project name: 1 0 Siv Of keder oar) btrip a 0, rum.
--,--- IfF.E SCHEDULE
Cross met/directions to job site:
, LVA•npre on , I Or, T F, I T.., I
. _.. .
1 New residential single- or multi-family dwelling unk.
i I Includes attached garage.
—__
Subdivision:
Lot n W0
o.: ! 00 sq ft tie less . --7- 1 ; 77 •1 - . A
— 1 -
— • • — - — _..._... I I . um !red ene fey. residi................_____,...__H.." i,di Ea. eithr! 100 sq. ft in portion . 33.92 1 I 1
Tax map/parcel no.:
—•
OFSCRIPTION (W WORK i wito above sq. fl 1
energy. multi-family I
1 75 00 I
i 2
-- i SirviteS or feeders installation, Alteration, and/or relocation
Clea\ 4 ' RA___CalZisoll ; 200 temps or less ,---,-__
I 100.70 1 i 2_
.
33.3
, 6 h2
El PROPERTY OWNER 0 TENAN-r 1 20; amps in 401.) amps 1
I
—
! 401 amps 106(X) amps I I MO "4
Nam:
......._____ I 601 amps to 1,000 amps I 301 04 1 .. _
Address:
Or t" amps or volts 1 552.26 I 2
— • -. : Tempor services ary sery or feeders installation, sherntion, audior
Cny,'State/Z IP:
' relocation
Fax:( )
1 200 amps or less —I -- n 91f 1--Tri
I 20i amrte io 400 amps 1 .. 12 .. 2 l
Owner installation: This installation is being n;iade on Propert;' that 1 0,k; which is not
I A! artps to 399 imps i I le475
intended for sale. !case. rent, or exchange. accordiq 10 ORS 447. 449. 670. and 701.
h il7ritneh eireuils - new, aneration or eXien4i011 per DMACI I
Owner signature:--- -=---
. . . Date: __• '1 7, - ..ich circuits wid ' i -----•• - -e _1 Fig tii -- -.. — • =_.
I I i 1
,..,
0 APPI,TCAN'r
..._L_ 0 CONTACT PERSON i I nIA,we *.itryled Cm feeder ice.
2 1
....,
! 1 %mei" branch ciahni 1 7-' I 1
BlISitieSa name; I I I i'. Fee for branch circuits wiasiw —
_ Oil si,iec ce.ijer fec, iir41
Contact name:
- - braiII circuit
I , ic .„ ! b
• --1 • : r•i a...ranch me; in 1 ; 36.18 j 5 61 7 I
-
--17-7 1---.
•
Address:
i :, ■liscella ntOus (service or feeder not included)
- _ _
rnannfriano.xi or rno4,477 .
City/State/Z1P:
1 i dwelling. service and'or fcc .. I, i 6784 1 1 2 1
—,—,.---
Phone: ( ) Fax: . ( ) ' Recorbncci oil iv
— 1 — --
1
..1 .-7-1-1
! Po,: , w wripliOrl tank
r I c 1 67 $4 2
_ .
E
es • ' 1 Sign Dr outline lighting , I 67.84 2 I
- .CONTRACTOR
.,
sq,mal eirenios) or limaso-nnerp
I i
,
1 ,.. Business name: Molleuhauer Enierpris. Inc. ORA Mike's Electric 1 rand. alteration. Or Titension. , I 1 Pags2
4
.- ._ ._ --.., t f:arh additions! inspection over allowable III IMV of the- 7
above '
Address: 11070 SW Allen Blvd i I" • • •
, Aodii ions! inspeo.ron ( ! hr min i I 1 66T+7,77 • - .
. . I. . ..
_ ,
i I In‘ cstigation I I hr minl I 66.2:c h I
City/State/ZIP Beaverton, OR 97005
--- -— .---. .._.i 'older-in& plant) 1 hr noro. 78 hr I
--
Phone: (503) 649.6991
Fax: (53) 641.1902 1 . in 4it spcctions fin wnrj h nu tee is 1 I 1
_
; Six.:-.alit listed I nr :Dip, I 40 tit): it: I ! I
CCF3 Lie.: 191094
I Electrical Lic.: C643 Suory. 1.ie.: 4230S ELECFRICAL PERMIT FEES
. _
&pry, Electrician signature. n.Nuired: r,.--- ' 41 - -I Subtotal
__. _____ • i •
. .. _______
Plop tevieu (23% or' permit tie). L 1
,
ih i I IZ
Print name: 130gulas J. Miller
- I
SIAM' Surchetrge ( ! 2% of i)e!rn IL NT) I , e
7, —
:tig f
: ,........____,_.
'-- --, - _
1 ' ____.
i 1 TO*1 AL PERMIT
Authorized siggainm• ..,. -•,./ ,r, •
' 7/ i',Af Or JP•---. : Thh. permit apples:elfin° wins if a permit is not obtained within 40
Print name: Darryl Mnnnh
eauer clan after il inn; been sorrepeed st, rornitiert
... ..■....■. .
---- -r-rr;i11-7. . i s I 1 ..... - - 1 • \ unter or oD.pectioos anowcd per permit.
. I ... :
......... .
I: \nuikieN,AP4.WitaLC•Fetn*App.Sx I.17.0: • i 0
Z4( vl' I : q” COm.WFD .