Permit -CITY OF TIGARD ELECTRICAL
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/15/96
•
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S 1 12DC -00701
SITE ADDRESS...: 15957 SW 72ND AVE
SUBDIVISION • FANNO CREEK ACRE TRACTS ZONING:I -P •
BLOCK LOT •38
Project Description: Install 11 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 • 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: 10 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
RUG GALLERY LTS type amount by date recpt
15957 SW 72ND AVE PRMT $ 85.00 CJS 04/15/96 96- 278143
5PCT $ 4.25 CJS 04/15/96 96- 278143
TIGARD OR 97223
Phone #:
Contractor:
BACHOFNER ELECTRIC, INC. $ 89.25 TOTAL
55 SE MAIN
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect' 1 Service
Phone tt: 503 -233 -2006 Wall Cover Elect' 1 Final
Reg 4..: 44569
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm itt ee 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 more L:iln . !p . �7''.v aa/.6
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: On air / rr: fir, 4 DATE: t+/- /5- 96'
LICENSE NO:
Call for inspection - 639 -4175
- Community Development ELECTRICAL PERMIT APPLICATION
.- 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 96- .7,9193
• Permit # f/r96- /)ga�.
Zillir Phone (503) 639 -4171 Date Issued 4/- /s- 9G
__.. FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by c ,-/es S� � ,,,,�/,L
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Rug Gallery Lts. Number of Inspections per permit allowed
Address 1 5 9 5 7 SW 7 2nd Service included: Items Cost(ea) Sum
City /State/Zip Tigard, OR 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) ' rtion tarn 500 "
or
po thereof $25.00 1
Commercial ® Residential ❑ Limited Energy $25.00 - Each Manufd Horne 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 200 amps or less $60.00 2
-
Address 5 5 SE Main 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2 - City Portland State OR Zip 9721 4 601 amps to 1000 amps $180.00 2 -
Phone No. 233 -2006 Over 1000 ampsorvolts $340.00 2
-
Contractor's License No. 2 6 - 4 51 C Reconnect only $50.00 -
Contractor's Board Reg. No. 44569 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n ✓' 200 amps cr less $SO.00 2
License No. 28085 Phone No. 33 -2006 201 amps to 400 amps $75.00 - 401 amps to 600 amps $100.00
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 purchase of service or feeder lee. 2
Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder tee. 2
not intended for sale, lease or rent. First branch circuit 1 $ 3 5.0 0 2
To $ 5.00
Each additional branch circuit - $5.00 50.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
-
4 or more residential units in one structure Minor Labels (10) $100.00
-
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection over
Classified area or structure containing the allowable in any of the above
ining special occupancy
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
-
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:
5a. Enter total of above fees $ 85.00
NOTICE 5% Surcharge (.05 X total fees) $ 4 . 2 5
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 $ 8 9.2 5
wo mdMNMpm.opp
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
Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 1 l ^ I 4° A.M. P.M. Entry:
Address: / ) S S 7 7 Z ,f?.GT
Tenant: Ld(J /< Ste: MST:
BUP:
Con /Own:? 3 2 0 MEC:
PLM:
ELC: THE FOLL WING COR CTIONS ARE REQUIRED: ELR:
c=s
Inspector: Ill/ r c (4 -Q ( /' qeti
Date:
X APPROVED _ DISAPPROVED /CALL FOR REINSP. 4 0 CO