Permit CITY OF T ELECTRICAL
PERMIT #: ELC97IO421
DEVELOPMENT SERVICES DATE ISSUED: 07 /01/97
OR
,4411- 13125 SW Hall Blvd., Tigard, PARCEL: 2S112AA -00900
SITE ADDRESS...:1414O SW 72ND AVE #100
SUBDIVISION -NELSON BUSINESS CENTER ZONING:I —H
BLOCK • LOT • JURISDICTION: TIG
Pro.j ect Description : Installation of 10 branch circuits.
- -- 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/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 9 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
OREGREEN ELECTRICAL type amount by date recpt
10260 SW NIBUS AVE STE M -12 PRMT $ 80.00 DRA 07/01/97 97- 296579
PORTLAND OR 97223 5PCT $ 4.00 DRA 07/01/97 97- 296579
Phone #:
Contractor:
OREGREEN ELECTRICAL CONST. CO. $ 84.00 TOTAL
10260 SW NIMBUS M -12
REQUIRED INSPECTIONS
TIGARD OR 97223 Wall Cover Elect'l Final
Phone #: 620 -7952 Elect'l Service
Reg #..: 000423
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 through OAR 952-881 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: Issued = : 4 0
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'N: ,A00 DATE: 7447
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. .46 97 � � `
) ,
Tigard, OR 97223 Permit #
, 4pl�T l ,. Date Issued 6, -.-2D -9 7
,,,I 1 I Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: / (' 4. Complete Fee Schedule Below:
Name of Development -h ( f a . OI Number of Inspections per permit allowed
/ 9 r
Address / y/4 7a� O S ed 537.2 .9.'ter - Apo Service included: Items Cost(ea) Sum
City/State /Zip %(( d 04 - y 4a. Residential - per unit
cl / 1000 sq. ft. or less $110.00 4
Name (or name of business)' �/ L / (1 go u 4, O P Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial IZ Residential Limited Energy $25.00
Each Maned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installs ► n only: r
M / //e A////G! ea .. ,‹ v e c S�ht� 4b. Services or Feeders
Electrical Contractor eg£C; R A
F " el e , . '- , In stallation, alteration, or relocation $60 00 2
200 amps or less
Address /4/4 N / 14.S cN .S'.- 201 amps to 400 amps $80.0o 2
City �o RTC .o✓ State O A Zip 9,7.2/? 401 amps to soo amps $ .� 2
601 amps to 1000 amps 2
Phone No. a�$ - �8�/� Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$50.00 2
contractor's license NO. 3 4S4 r 4c. Temporary Services or Feeders
Contractor's Board Reg. No. .. 3 - 35 • Installation, alteration, or relocation
Signature of Supr. Elec'n _, AgirWAIIIF 200 amps or less 2
�� 201 amps to 400 amps $50.00 2
License No. A 4.2 3 5 Phone No. - - 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
p urchase of service or feeder fee. 2
The installation is being made on property I own which is / $35.00 2
First branch circuit
not intended for sale, lease or rent. Each additional branch circuit $5.00 ,
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle \ 540.00 2
Each sign or outline lighting 540.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension 540.00
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
as described in N.E.C. Chapter 5 Per inspection 535.00
-
Per hour 555.00
-
In Plant 555.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5, Fees: Q G
5a. Enter total of above fees $ 2
NOTICE 5% Surcharge (.05 X total fees)
Subtotal $ c
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec.3)
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wmQtcomdeNekF ❑ Trust Account #
$
prm.epp Balance Due