Permit ELECTRICAL PERMIT
- I 1 T OF TIGARD DATE PERMIT ISSUED: C O2/2
N 1 /96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 2S 1 1 EDC - 00701
SITE ADDRESS...: 15957 SW 72ND AVE
SUBDIVISION....: FANNO CREEK ACRE TRACTS 2ONIiNG:I -P
BLOCK..........: LOT • 3S
Project Description: Install one service or feeder to 200 amps or less and five
branch circuits.
---- 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 • 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......: 1 W /SERVICE OR FEEDER: 5 PER INSPECTION.....: 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR 0
401 - 600 amp...... : 0 EA ADD' L BRNCH C I RC : 0 IN PLANT.. ....... 0
601 - 1000 amp 0 PLAN REVIEW SECTION --
10000+ amp /volt ° 0 >=4 RES UNITS..... ° ° . > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: - -- FEES -----
NW RUG GALLERIES type amount by date recpt
15957 SW 72ND PRMT $ 85.00 CJS 02/21/96 96-276107
SPCT 't 4.25 CJS 02/21/96 96- 276107
TIGARD OR 97223
Phone *:
Contractor: - - -- --------- -.
BACHOFNER ELECTRIC, INC. $ 89.25 TOTAL
55 SE MAIN
- - - - - -- REQUIRED INSPECTIONS -- - - - - -•
PORTLAND OR 97214 Wail Cover Elect' I Final
Phone #: Elect'1 Service
Re c; fir
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 lore _CAar.-e..r Sc hmidr4
than 180 days. Issued By
- - -- - - - 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: i�icci lec( DATE: a- a./ - 96
LICENSE NO
Call for inspection - 639 -4175
36°L-1
..,. ; Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 9,4
ar���`l1 ~�' Ii i Permit # e c96-o/ /0
Ph one (503) 639 -4171
,.�- ''� � Date Issued a. - a/ - 96
CITY OF TIGARD FAX (503) 684-7297 Issued by Liar /Pf Sc fi e
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address 15957 S.W 72nd Service included: Items Cost(ea) Sum
City /State/Zipmigard, Oregon 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) N. W Rua Galleries Each re) 500 sq. h. or 1
portion on t thehereof $25.00
Commercial Residential ❑ Limited Energy 525.00 - Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor Bachofner Electric, Inc. 200 amps or less 1 560.0o 60.00 2
Address 55 S .E Main St. 201 amps to 400 amps 580.00 2
Portland, State Or Zip 97214 401 amps to 600 amps 5120.00 2
City P Got amps to 1000 amps 5180.00 2
Phone No. 233 -2006 - Over 1000 amps or volts $340.00 2 -
Contractor's License No. 26 -451C Reconnect only 550.00
- Contractor's Board Reg. No. 44569 4c. Temporary Services or Feeders
��'.� Installation, alteration, or relocation 2
Signature of Supr. Elec'n
/; � / " / � , /..�� 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
- License No.�8685 Phone No. 233-206F 401 amps to 600 amps 5100.00
Over 600 amps to 1000 volts
2b. For owner installations: see - b - above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip Each purchase
circuit or feeder fee. 2
5 5500 25.00
Phone No. b) The fee for branch circuits without
The installation is being made on property 1 own which is purchase of service or feeder lee. 2
not intended for sale lease or rent.
First additional circuit br $55.00 2
r Each additional branch circuit 55.00
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 inspectio $35.00
Per hour 555.00
-
In Plant $55.00
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 $ 85.00
5% Surcharge (.05 X total fees) $ 4.25
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. 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 # $
Balance Due $ 89.25
ronnoomd•Naleo-prm.;p
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation 411algo
Post/Beam Struct. Mech. Rough -in Gyp. Bd. • -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: - .2- A.M. P.M. Entry:
Address: /45 ,e-, , 7 7 _ _ ✓'`',
Tenant: N LA) Ste: MST:
BUP:
Con /Own: Mg
_&tE71.,„erill____,_
� .3.3 Zo o f o ELC:
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
t o:i 1 C,--) -/ Zr e35
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/
Spector: / •.o- -� 'e 4' Date:
PPROVED PPROVED _ DISAPPROVED /CALL FOR REINSP. CO
CO I