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Permit /, ELECTRICAL PERMIT ," PERMIT #: ELC96-0054 � �� OF � DATE ISSUED: 01/30/96 ��m�� COMMUNITY "� PARCEL: 2S113AD-01800 1otkaaW Hall Blvd. Tigard, Oregon 81119 (k03) 639L4171 SITE ADDRESS...: 16640 SW /eN #B-10 SUBDIVISION....: ROSEWOOD ACRE TRACTS ZONING:I-L BLOCK • LOT...... :11 Project Description: Install one branch circuit. _____________ ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS----- 1000 SF OR LESS....: 0 0 - 200 amp. .. . ... : 0 PUMP/IRRIGATION. ... : 0 EACH ADDvL 5009F..,. : 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: 0 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 -- PRECISTION INTERCONN type amount by date recpt 16640 SW 72ND AVE PRMT $ 35.00 TMP 01/30/96 96-275465 5PCT $ 1.75 TMP 01/30/96 96-275465 TIGARD OR 97223 Phone #: Contractor: --- - -- STONER ELECTRIC $ 36.75 TOTAL 2701 SE 14TH REQUIRED INSPECTIONS ------ PORTLAND OR 97224 Elect'l Service Phone #: Elect'l Final Reg 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 more CA�r/~ than 18N days. Issued By --OWNER INSTALLATION ONLY---- --------- The installation is being made on property I on which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY - ----------- SIGNATURE OF SUPR. ELEC'N: /~d DATE: /- 3.0' 96 LICENSE NO: Call for inspection - 639-4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # � � M � Permit # /kV A r�s5r ,�dji Phone (503) 639 -4171 Date Issued / - 30 .96 �''` FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Issued by c /Pr ,r...„wr Inspection (503) 639 -4175 1. Job Address: c e_� �� c,ss � w -'1� 4. Complete Fee Schedule Below: Name of Developmen (.1le c w z.N.t_c_\-" Number of Inspections per permit allowed Address k•IOYD �W 1 rZ t4.81- P . Service included: Items Cost(ea) Sum City/State/Zip --\■ .:1 rot ©. - `1 a23 4a. Residential - per unit 4 h ` 1000 sq. ft. or less $110.00 - Each add Name (or name of business ate eNgw.4 " � 4erc wT o dw"e 500 sq. ft. or ( portion thereof $25.00 1 - Commercial Residential ❑ Limited Energy $25.00 - Each Maned Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor installation only: ■*eWPC(kS 4b. Services or Feeders rZ ... ` Installation, alteration, or relocation 2 Electrical Contractor -p t�v�r \�∎0 -- -=\ c.- 200 amps or less $60.00 2 Address Q10\ SE. v-4- 201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00 2 City 'R'orNr\aa.,v State O t� Zip o11 2O'L 601 amps to 1000 amps $180.00 2 - Phone No. - _ Over 1000 amps or volts 8340.00 2 - Contractor's License No. _ _ Reconnect only 850.00 - Contractors Board Reg. No. • . 4c. Temporary Services or Feeders . Installation, alteration, or relocation 2 Signature of Supr. Elec'n /� �� 200 amps or less $50.00 2 - L No. L4 ID as S • Ph • e No. , 201 amps to 400 amps 875.00 - 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 fee. 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 fee. i � o0 2 not intended for sale, lease or rent. First branch circuit bit $35.00 Each additional branch circuit 85.00 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) 8100.00 - 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 inspection $35.00 - Per hour $55.00 - In Plant 855.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: ea NOTICE 5a. Enter total of above fees $ -2 )5.1 5% Surcharge (.05 X total fees) $S PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 3 5b. Enter 25% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec.3) $ --' CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ `A( A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ Balance Due $ -3(07 S meoy AWwlw¢m.,pp ter. .