Permit •
CCITY F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00224
l� DEVELOPMENT SERVICES DATE ISSUED: 4/15/99
I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 113AA -00900
SITE ADDRESS: 16520 SW 72ND AVE B -07
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT : OOD JURISDICTION: TIG
Project Description: Add two (2) 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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BRIDGE PORT DISTRIBUTION PHOENIX ELECTRIC CO
16520 SW 72ND AVE 7379 SW TECH CENTER DR.
BLDG #7 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 4/15/99 $40.00 99- 314535 Elect'I Final
5PCT GEO 4/15/99 $2.00 99- 314535
Total $42.00
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.
Permit Signature: J 77.--->nreg-a:P 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: , U DATE:
LICENSE NO: //
Call 639 -4175 by 7:OOpm for an inspection the next business day
APR•13 -99 TUE 01:40 PM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit #Fe-e /441- 009
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ \ Number or Inspections per permit allowed
Name (or name of business NA t V x--4, 1, k t Service included: Items Cost Sum
1
Address e. x C - 7e). 11 1►-L' ,,,, 4a, Residential - per unit .
Ci /State2 . r • 1000 sq. fl. or less $110.00
ty p ► - - - - - Each additional 500 sq. ft. or 4
Commercia ! Residential ❑ portion thereof $25,00 1
(�
Limited Energy $25.00
L \ t2 . l C1,� _ l e t i Each Manuf'd Home or Modular
Y y Dwelling Service or Feoder $68.00 2
2a. Contractor installation PR y :
(Attach copy • II current Ileen- =s) 4b. Services or Feeders
Electrical Contracto Ti •-h • %a t,°�. L_c Installation, alteration, or relocation
Address')?f7 . 'fit.1 -ce 1r. c isle r ! zoo amps or less - $60.00 2
201 amps lo 400 amps - $80.00 2
City State ( Zip c . _ • 401 amps to 600 amps $120.00 2
Phone N , - rap 601 amps to 1000 amps - $190.00
2
Job No. ?30.g - 1‹. Over 1000 amps or volts - $340,00 2
Elec. Cont. Lice. No. 3i -,W x'- Exp.Date Reconnect only $50,0 2
OR State CCB Reg. No._ 1 0 Exp.Date_ 4c. Temporary Services or Feeders
•
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or loss $50.00 2 -
Signature of Supr. Elec'n �!� - `� ..' 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100,00 2
Over 600 amps to Woo volts,
License No. f / / Exp. see 'b" above.
Phone No. r
• 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The loo for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circui $5.00 _ 2
b) The fee for branch circuits
city State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit I $35.00 2
The installation is being made on property 1 own which is not Each additional branch circuit 1 $5.00 S
intended for sale, lease or rent.
4e. Miscellaneous
(Service or feeder not Included)
Owner's Signature, Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate Item and enter fee in section 58.
4 or more residential units in one structure 41. Each additional Inspection over
Servico and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Por hour $55.00
as described in N.E.C. Chapter 5 In Plant 555.00
-
r Submit 2 Sets or plans with application Where any of the above apply. 5. Fees: '
` D (,
Not required for temporary construction services. 5a. Enter total of above fens $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ }.,7 (JU
5b. Enter 25% of line Sa for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review jf raaulred (Sec,3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
15 SUSPENDED OR ABANDONED FOR A PERIOD OF 100 DAYS AT ANY
TIME AFTER WORK 15 COMMENCED. Trust Account # r5,9-9W �� i1(
Total balance Due s rl
I:DRTSIELC00.APP Flew !woe