Permit • CITY OF TIGARD ELECTRICAL PERMIT
D EV ELOPMENT SERVICES DATE S: D 04
: 04/ 13/9
8
i��.�a� DATE ISSUED: / 13/9
'� �.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S113AD -01900
SITE ADDRESS...:16640 SW 72ND AVE #B -10
SUBDIVISION -ROSEWOOD ACRE TRACTS ZONING:I —L
BLOCK • LOT •009 JURISDICTION: TIG
Project Description : Electrical TI
- -- 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 • 2 W /SERVICE OR FEEDER: 25 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 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
PACTRUST type amount by date recpt
15350 SW SEQUOIA PKWY PRMT $ 245.00 B 04/13/98 98- 304892
STE 300 5PCT $ 12.25 B 04/13/98 98- 304892
TIGARD OR 97224
Phone #:
Contractor:
STONER ELECTRIC $ 257.25 TOTAL
2701 SE 14TH
REQUIRED INSPECTIONS
PORTLAND OR 97202 Ceiling Cover Elect'1 Service
Phone #: 233 -3631 Wall Cover Elect'1 Final
Reg #..: 000448
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-091-0910 through OAR 952-001 -1987. You say obtain a copy
of these rules or direct questions to OUNC by calling 1 ( , 593) _ 246 -1987. /
Permittee Signature: O1( \ er I \ ✓` Issued By: � ii• A.A. . , 1I ./
I MALtet
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
r --
SIGNATURE OF SUPR. ELEC' N : ( l 19
A PP /\ DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
` i it OF TIGARD NeENK91 Permit Application Plan Check
13125 SW HALL BLVD, Recd By
Date Reed - t -
TIGARD OR 97223 APR 1 3 1998 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST ,,d
Inspection (503) 639-4175 n n, II EL �1t or Type Permit # 51- C4 -oivo
684 -7297 I cO ' i3if or I will not be accepted Called
Fax (503)
1. Job Addre 4. Complete Fee Schedule Below:
Name of Development Number of inspections per permit allowed -
Name (or na e e o� �� business) p��sig J 4, ,e�� Service included: Items Cost Sum
Address - ,ti 'f Sc c w 7 2.,.# 4a. Residential - per unit
1000 sq. lt. or less $110.00 4
City /Statt 1p Pe' erz, , 9722_4 E p n thereof 500 sq. ft. or $25.00 _ 1
Commercial El Residential 0 Li mited Energy $25.00
Each Manned Homo or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor ST €� - t<• Ave_ Installation, alteration, or relocation I zo
200 amps or less 2 $60.00 2
Address 27 ol _ SC 44- 201 amps to 400 amps $80.00 _ 2
City P se7Z hta State c3 Zp 9 7z > - 401 amps to 600 amps $120.00 2
Phone No. 233 6 601 amps to 1000 amps _ $160.00 2
f3 5 Ovar 1000 amps or volts $340.00 2
JOb No. Z Reconnect only $50.00 2
Elec. Cont. Lice. No. 2 -/Z---Z._ -� Exp..Date 9f1
OR State GCB Reg. No. ¢4 Exp.Date 3 /2 4c. Temporary Services or Feeders
COT Business Tax or Metro No.. Exp. ate installation, alteration, or relocation
200 amps or less $50.00 2
✓1�'�/�) 201 amps to 400 amps $75.00 2
Signature of Supr..Elec'n / " t / - 401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No- 3 Exp.Date / see "b" above.
Phone No_ as-3-36_,3,./ 4d. Branch Circuits
•
New, alteration or extension per panel
2b. For owner Installations: at The fee for branch circuits wlth
purchase of service or
Print Owner's Name reeder fee. zS°
Each branch circuit ZS $5.00 - 2
Address b) The foe for branch circuits
City State Zip without purchase of
Phone No. _ service or feeder tee.
First branch circuit $35•00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent_ 4e. Miscellaneous
(Service or testier not included)
Owner's Signature Each pump or irrigation circle 540.00 2
Each sign or outline lighting $40.00 2
� Signal elreuit(s) or a limited energy
3. Plan Review section (if required): panel, alteration or extension $ - 2
Minor Labels (10) 5100.00
Please check appropriate item and enter fee in section 58.
4 or more residential units in one structure 4f. 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 $3500
Classified area or structure Containing special occupancy Per hour x
as described in N.E.C. Chapter 5 In Plant $5J
* submit 2 sets of plans with application where any of the above apply. 5. Fees: 2
Not required for temporary construction services. Sa. Enter total of above fees $
5% Surcharge (.05 X total fees) $ I .7 / 7�
NOTICE - Subtotal $ -
Sb. Enter 25% of line 50 for $
• PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if re4ulred (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS AT ANY 0 Trust Account 4 TIME AFTER WORK IS COMMENCED. 5 Z.5 LS
Total balance Due
HOSTS ELC9B.APP Rev MC