Permit CITY OF T PERMIT I #: ELC98 -0540
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- DEVELOPMENT SERVICES DATE ISSUED: 09/11/98
'� ii• 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PARCEL: 2S 101 D A - 00104
SITE ADDRESS...: 13333 SW 68TH PKWY #1ST
SUBDIVISION. -GTE ZONING:MUE
BLOCK • LOT JURISDICTION: TIG
Project Description: Installation of 1 signal circuit or limited energy panel.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD'L 500SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 - 600 amp.......: 0 SIGNAL /PANEL.......: 1
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/0 SRVC OR FDR.: 0 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
F I G HOLDING COMPANY type amount by date recpt
ATTN RUBY COURTLAND PRMT $ 40.00 DEB 09/11/98 98- 309060
4680 WILSHIRE BLVD SPCT $ 2.00 DEB 09/11/98 98- 309060
LOS ANGELES CA 90010
Phone #:
Contractor:
ELECTRICAL CONTRUCTION CO $ 42.00 TOTAL
PO BOX 10286
REQUIRED INSPECTIONS
PORTLAND OR 97296 Elect' 1 Service
Phone #: 224 -3511 Elect'1 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: Or: ;. - ires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 i.e41 -0910 through F' 952- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
/ 060.4.14i.
r Permittee Signature: ..XU.J�.Q.(~ Issu-• By: _
-
OWNER INSTALLATION ONLY •-
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
• - -- CONTRACTOR INSTALLATION ONLY -•
1.'i
SIGNATURE OF SUPR. p ELEC' N: �.! � .:,x_11 ,., DATE: q / /ig
LICENSE NO: aT t iO s
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + ++ + + + + + + + + + + + + + + + + + + + + + + ++
07/05/ 96 11:53 '$503 680. 7297 CITY OF TIGARD 0002,'002
Job# 78365 (7W) 9 -1 -98 - J
Community Development �p ELECTRICAL PERMIT APPLICATION G
13125 SW Hall Blvd. �, / ,� ?? CD-Cc Tigard, OR 97 Permit # (�
A ,I - P Q Date Issued (l -9./ "l . � �i Phone (503) 639 -4171 �l�
FAX (503) 684 -7297 Install telecommunication outlets for Credit Union
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Farmers Insurance -CU Number of Inspections per permit allowed
Address 13333 SW 68th Parkway Service included: Items Cest(ea) Sum
City /State /Zip Tigard, OR 97223 -8304 • 4a. Residential • per unit
1000 sq. ft. er less 3110.00 4
Name (or name of business) Farmers Insurance Each additional 500 sq. n. or
portion thereof 325.00
Commercial Residential 0 Limited Energy 525.00 1
Each Manurd Home or Modular
OWPW hg Servke or Feeder 568.00. 2
-
2a. Contractor installation only:
4b. Services or Feeders
Electrical ContractorELECTRICAL CONSTRUCTION CO. Installation, a6eraUen, or retaeatlen 2
200 amps Of less 580.00
Address P.O. BOX 10286 _ 201 amps to 400 amps 580.00 2
City PORTLAND State OR Zip 97296 401 amps to 600 amps 5120.00 2
Phone No. (5032224- 3511 601 amps to 1000 amps
3160.00 2
over 1000 amiss or volts 5340,00 2
Job NO._ 78165 A,. Roconnecs only 350.00 2 •
contractor's license NO. 26 -45C �
4c. Temporary Services or Feeders
Contractor's Board Reg. No. 49737 L Installation. alteration, or reloeatton
Signature of Supr. Elec'n �)(' W 41111,- MO amps er tame 2
License No. 79R, s /` P •ne No(503)2.24 -3511 201 amps p40oam X0 2
401 amps to 600 amps 375.00
Over 600 amps 10 1000 vans 5100.00
2b. For owner installations: see •b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The tea for branch circuits with 2
pu►enase of servfee or feaster fee.
City State Zip Each branch trait 36.00
. Phone No. b) The tee ter branch etreuna without
The installation is being made on property I own which is purchase of service or feeder foe. 2
2
First branch circuit 535.00
snot intended for sale, lease or rent. Each addnlenat branch elre.un 55.00
Owners Signature 4e. Mlseellaneous
((Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrtgatlon circle 340.00
2
Eau+ alp er attains lighting 340.00
Signal cweu t(s) or a limited energy 2
Please check appropriate item and enter fee in section 58. panel, alteration or extension 1 340.00 40.00
4 or more residential units in one structure Minor Labels (10) 5100.00
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal
Classified area or structure containing special occupancy this allowable in any of the above
es described in N.E.C. Chapter 5 PerMspection 436,00
Per hour 35
In Plant 155.00
-
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE Sa. Enter total of above fees 40.00
5% Surcharge (.05 X total fgea) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 6b. Enter 25% of line A for
-
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ..., ❑ Trust Account # S
pf.?
Balance Due 42.00
S
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