Permit _ CITY O F TIGARD
ELECTRICAL PERMIT
41.00 PERMIT #: ELC1999 -00225
i DEVELOPMENT SERVICES DATE ISSUED: 4/15/99
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^:- 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 a first branch circuit.
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
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 $35.00 99- 314536 Elect'I Final
5PCT GEO 4/15/99 $1.75 99- 314536
Total $36.75
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: Issued By: - / /j� /
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 Q
4/C SIGNATURE OF SUPR. ELEC'N: Jf DATE: 47 T
LICENSE NO: Q/ ' - S [/
Call 639 -4175 by 7:OOpm for an inspection the next business day
APR -13 -99 TUE 02:37 PM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02
�r r E lectrical Permit Application
CITY OF TIGARD Ptah Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 APR 1 3 1999 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 utvtturlrltaT Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit f(� C/tf-oa �,
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business 1 r Pt> r b *4 L Service included: items Cost Sum
t'l Address a � � '1 r�} '�`' � k
` C 4a. Residential - per unit
�
/ G1 -1-1- 1000 Sq. ft. or lest 31 10.0
City/State/Zip )4.1 v l �ek. , C -. I )T 4
Ea ch additional sq ft. or
$25,00
Commercial portion thereof -
Residential ❑ Umited Energy X25,00 1
n l - , � Each Maned Home or Modular
(+` `) t. `1 L ` Dwelling Sorvice or Feeder $68,00
2a. Conirac or l tallat 2
(Attach copy - of- . current licenses) 4b. Services or Feeders
Electrical Contractor ' J .• , , Installation, alteration, or relocation
Address7.� . id 1 c e (,. it f ft 200 amps or less 560.00 2
201 amps to 400 amps 380.00 2
City State ('1C Zip /-) sk'S 401 amps to 600 amps $120.00
-
2
Phone No . ( • •' e nn 601 amps to 1000 amps $180.00 2
Job No., . in'V1 / - Over 1000 amps or volts $340.00
• - Reconnect onty $50.00 2
Elec, Cont. Lice. No. _ x = Exp.Date 2
OR State COB Reg. No. . 1Mi„' Exp.Date 4c. Temporary Services or Feeders
•
COT Business Tax or Metro No.at p4t" Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec 201 amps to 400 amps 375.00 2
401 amps to 600 amps 5100.00 2
Over 600 amps to 1000 volts,
License No. < el Exp.Date see "b" above.
Phone No. ri (' - 4 T,
4d. Branch Circuits
Now, alteration or extension per panel
2b. For owner installations: a) The lee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Each branch circuit $5.00 2 -
Address b) The fee for branch circuits
City " State, Zip without purchase of
•
Phone No. service or feeder fee. ei q-
First branch circuit J___, $35.00 2
The installation is being made on property I own which is not Each additional branch circuit 55.00 2
intended for sale, lease or rent. 4e, Miscellaneous •
(Service or Leader not Included)
Owner's Signature _ Each pump or irrigation circle $40.00 2
Each sign or outline lighting 340.00 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 5B.
4 or more residential units in one structure 4 Each additional Inspection over •
Service 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 Per hour $55.00
as described in N.E.C. Chapter 5 In Plant 555.00
* Submit 2 sots of plans with application Where any of the above apply. 5. Fees: A Not required for temporary construction services, Se. Enter total of above fees $ 5% Surcharge (.05 X total fees) $
1407164 Subtotal $
512. Enter 25% of line 5a for
PERMITS BECOME VOID IP WORK OR CONSTRUCTION AUTHORIZED IS Plan Reviewlt renuired (Sec,3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK S ubtotal _ $
IS SUSPENDED OR TIME AFTER WORK IS COMMENCED. R A PERIOD OF 180 DAYS AT ANY T rust Account # J e .g $
C�(O �S
Total balance Due
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