Permit �- CITY OF TIGARD - ELECTRICAL PERMIT
PERMIT #: ELC2000 -00301
1, DEVELOPMENT SERVICES DATE ISSUED: 06/07/2000
„ �i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 113AB -00600
SITE ADDRESS: 16125 SW 72ND AVE BLD.B
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Install two ( @) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOC PHOENIX ELECTRIC CO
15350 SW SEQUOIA PKWY 7379 SW TECH CENTER DR.
SUITE 300 TIGARD, OR 97223
TIGARD, OR 97224
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 06/07/200C $42.85 0002755 Elect'I Final
5PCT GEO 06/07/200C $3.43 0002755
Total $46.28
ORIG!NAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
SIGNATURE ISSUED BY: /�
PERMITTEE S S / fj'� ,'
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: „J DATE: —7 '
LICENSE NO:
WO
Call 639 -4175 by 7:OOpm for an inspection the next business day
•
MAY -24 -00 WED 08:43 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 ' Date to P.E. Date Recd
Phone (503) 639 -4171, x304 0b Date to DST
Inspection (503) 639 -4175 Print of Type Permit # Fe e Roca -6030/
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development , permit
f Number of Inspections per allowed
Name (or name of business) - P1. �^r) iki,>, Service included: Items Cost Sum Z
Address 1 f01 "a .S .\ u) Ay 4a. Residential - per unit
1 K.� lJ J . 92,l D V 1000 sq. ft. or less $ 117.75 4
• City /State /Zip P"..:414,..4 r / Each additional 500 sq. ft, or
portion thereof $ 2625 1
Commercial ❑ Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 , 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration; or relocation
Electrical Contractor t a iw EiCc.i Z. 200 amps or less $ 64,25 2
201 amps to 400 amps $ 85.50 2
Address )371 1 e [ IN Cf-+r 4 401 amps to 600 amps $ 128.50 2
City ,.4c1 State OR- zip 922) j 601 amps to 1000 amps $ 192.50 2
Phone rdo. • tvF.' `1- .i(ov _ Over 1000 amps or volts $ 363.75 2
Job No. FJOC1 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3f. ?Y) c Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. 4 R S Exp.Date , Installation. alteration, or relocation
COT Business Tax or Metro No. • Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Eleen iii3 _ �. Over 600 amps to 1000 volts,
see "b" above.
License No. W'/ S Exp.Date 4d, Branch Circuits
Phone No. New, alteration or extension per panel
e) The fee for branch circuits
2b. For owner installations: with purchaso of service or
feeder fee.
Print Owners Name Each branch circuit 5 5.35 2
b) The fee for branch circuits
Address _ without purchase of service
City State Zip _ or feeder fee. :a-CO
Phone No. First branch circuit i $ 37.50 -
Each additional branch circuit 1 - $ 5.35 4^, ),.t
The installation is being made on property I own which is not 4 Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuil(s) or a limited energy
panel, alteration or extension $ 60.00
3. Plan Review section (if required):* Minor Labels (10) $ sic
.1004
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over .
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 arnps or more Per hour $ 50.00
- System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as 5, Fees:
described in N.E.C. Chapter 5
5a. l Ater total of above fees $ q)
* Submit 2 sets of plans with application where any of the above apply. 9'b ti Surcharge (416-K total fees) s 3
Not required for temporary construction services. 9'b Subtotal . °S' $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
15 NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR S 1 1 d Ve
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account #
AT ANY TIME AFTER WORK I5 COMMENCED. Total balance Due $ 6 , a s
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