Permit n CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC98 -0592
%� DEVELOPMENT SERV SERVICES DATE ISSUED: 09/24/98
PARCEL: 2S1O1DA -00104
SITE ADDRESS...:13333 SW 68TH PKWY #2ND
SUBDIVISION -GTE ZONING:MUE
BLOCK LOT JURISDICTION: TIG
Project Description : Installation of 36 branch circuits. Job No. 78290 -02
- -- RESIDENTIAL UNIT - - -- ----TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp : 0 PUMP /IRRIGATION . 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 — 600 amp • 0 SIGNAL /PANEL - 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION : 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 1 PER HOUR ° 0
401 — 600 amp ° 0 EA ADD'L BRNCH CIRC: 35 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
FARMERS INSURANCE type amount by date recpt
4600 WILSHIRE BOULEVARD PRMT $ 210.00 DEB 09/24/98 98- 309445
LOS ANGELES CA 90010 5PCT $ 10.50 DEB 09/24/98 98- 309445
Phone #:
Contractor:
ELECTRICAL CONTRUCTION CO $ 220.50 TOTAL
PO BOX 10286
REQUIRED INSPECTIONS
PORTLAND OR 97296 Ceiling Cover Elect'l Service
Phone #: 224 -3511 Wall Cover Elect'l Final
Reg #..: 049737
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 t AR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987. 3 �I Permittee Signature: Issued B : . C ( '
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 a
SIGNATURE OF SUPR. ELEC' N : _ t . i J DATE: ? 4
LICENSE NO: 4
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
, "' 07.05; 96 11:53 . $ 503 684 7207 CITY OF TIGARD Zi)02,•u02
Job# 78290 -02 ( Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. .
Tigard, OR 97223 Permit # c ''g -O57 a
h ) �,. � Date Issued -,,t./-?g
� Phone (503039-4171
CITY OF TIGARD FAX (503) 684 -7297 0 9 ,_o360
TDD No. (503) 684 -2772
• Inspection (503) 639 -4175 r
1. Job Address:
4. Complete Fee Schedule Below:
.Name of Development Farmers Insurance - 2nd floor Number of Inspections per permit allowed
Address 13333 SW 68th Parkway Service included: Items Cost(ea) Sum
City/State/Zip Tigard, OR 4a. Resfdsntlal_ - per unit
1000 sq. ft. or less 5110.00 4
Name (or name of business) Farmers Insurance Each eddtllonal 500 sq. n. or
Commercial ® wrwee Energy sidential ❑ portion Meteor 525.00 525.00 1
-
Euh Mamrrd Home or Modular
Maltby Service or Feeder 355.00. 2
-
2a. Contractor installation only:
4b. Services or Feeders
Electrical ContractorELECTRICAL CONSTRUCTION CO. In`rallatlon, alleraven• or relocation 2
Address P.O. BOX 10286
200 amps o 0o amps 3360 � 2
City PORTLAND State OR Zip 97296 401 amps to 600 amps 3120.00 2
Phone No. (503) 224 -3511 801 amps to 1037 amps 3150.00 2
Over 1000 cads or volts 3340.00 2
Job NO. :2•I-02 .eih I Reconnect only $50.00 2
contractor's license NO. 26 -45C 1/ 4c. Temporary Services or Feeders
Contractor's Board Reg. No.4973:' InstafWon.elta,atmn, orreitcatton
Signature of Supr. Elec'n$ 200 amps or Una 2
License No. 2986s one o e 2 351r 201 amps to 400 ethos 560.00 2
1 401 maw to 600 amps 3 75.00 2
-
Over 600 amps to 1000 voIte 3100.0o
2b. For owner installations: Gee 'V above. .
4d. Branch Circuits
Print Owner's Name Now, aneratlon er enenslen per pane
Address 0 The tae for branch circuha wdth
City State Zip purenaes of emcee es feeder fee. 2
Phone No. Each branch circuit 35.00
s) The lee tar branch evasres wfthewt
The installation is being made on property I own which is purchase of service or feeder kw 2
PIM tnch en circuit 355.00 35.00 2
not intended for sale, lease or rent. Each r c i ii : 2 8i eeeua 35.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not Included) 2
2
3. Plan Review section (if required): Each pump or trrtg0Uon circle 340.00 Eaen digs ar miens awning 540.00
Signal euey 1(s) or s limited energy 2
Please cheek appropriate item and enter fee in section 58. Panel. eneratlon w extension 340.00
4 or more residential units in one structure Minor labels (10) 5100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
es described in N.E.C. Chapter 5 Perp0Ce0" x!6.00
Per hour 5 55.00
In Mont 355.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ 210.00 _ '
5% Surcharge (.05 X total feles) $ 10.50
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Su er 25% $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 6b. Enter 25 /a of line A for 220.50
Plan Review if required. (Sec.3) g
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal 5
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. .e.aK.T..-to.e ❑ Trust Account # S
er.. pr
Balance Due $