Permit CITY OF TIGARD
:, DEVELOPMENT SERVICES ELECTRICAL PERMIT
T� PERMIT #: ELC96 -0619
"� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 11/04/96
PARCEL: 26113AD -01800
SITE ADDRESS...: 16640 SW 72ND AVE #B -10
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING:I -L
BLOCK LOT °11
Project Description: Installing services or feeders: 2 200 amps, 3 400 amps, 1
1,000 amps, 1 over 1,000 amps.
- -- 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: 0 PER INSPECTION ° 0
201 - 400 amp • 3 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 • 1 PLAN REVIEW SECTION
1000+ amp /volt • 1 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: _ FEES
•
STONER\ELEC RIC type amount by date recpt
2701 SE 1 H PRMT $ 0.00 B 10/01/96 96- 284540
PLCK $ 0.00 B 10/01/96 96- 284540
PORTL D R 97224 5PCT $ 0.00 B 10/01/96 96- 284540
Phon #:.2 3 -3631 PRMT $ 880.00
Additional fees not shown here
Contractor:
STONER ELECTRIC $ 1144.00 TOTAL
2701 SE 14TH
REQUIRED INSPECTIONS
PORTLAND OR 97224 Ceiling Cover Underground Cove
Phone #: 503 -233 -3631 Wall Cover Elect'1 Service
Reg #..: 000448
A
This permit is issued subject to the regulations contained in the n. /1� 011 etpp'(6101111671
Tigard Municipal Code, State of Ore. Specialty Codes and. all other . Perm it ee Si gnat ure l
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 v•-
than 180 days. 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 : !9'Vv ll C DATE :
IV
LICENSE NO
Call for inspection - 639 -4175
- TO eg
I lie Development ELECTRICAL PERMIT APPLICATION
..4 Tigard, SW Hall Blvd.
.. Tigard, OR 97223 Planck/Rec. # I� (a
l Permit #
"t�' r�11 Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: /f71r,,fle4I 4. Complete Fee Schedule Below:
Name of Development / -L I n� Number of Inspections per permit allowed
Address /6 CyO -.A.3, 7 2 ' ( 4l)• 6'40 Service included: Items Cost(ea) Sum
City /State/Zip Port q72-2-4.1 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
(or name of business)
Each additional r f sq. ft. or
Name
( ) portion thereof $25.00 1 -
Commercial Residential ❑ Limited Energy $25.00
,�j.
�( v Each Manurd Home or Modular 2
•it` �7 �� Q Dwelling Service or Feeder $68.00 -
2a. Contractor installation only: 4b. services or Feeders
/� I alteration, or relocation 2
Electrical Contractor ,7012 fa e ?1 I G 200 amps or leas 2. $so.00 / Z. ° 2
Address 2701 $f. ) ti 71+ 201 amps to 400 amps -3 $80.00 2 K 2
City Poe f1 ir,.1A State OR Zip `in 2,-i 401 amps to 600 amps $120.00
sot amps to l000 amps -r 2 $180.00 1 80 2
Phone No. Sa 3 - q31-.34,31 Over 1000 amps or volts I $340.00 _'Z I.{ t) 2
Contractor's License No.24 - / 2 2. Reconnect only $50.00 -
Contractor's Board Reg. No. . Z 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n _°.FAW 200 amps or less $50.00 2 - L No. 'lt).Z6 S Ph- e No. - _ 201 amps to 400 amps $75.00 - 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 Zi purchase o/ service of feeder lee. 2
tY p Each brarfch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service Or feeder fee. 2
not intended for sale, lease or rent. First branch circuit blt $$5.00 2
r Each additional branch circuit $5.00
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) $100.00
-( 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 $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ gE 0
5% Surcharge (.05 X total fees) $ L/ 6 4
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ 2A4t)
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $ 101'1
Balance Due $ l l _--
radbandnM•opm.;p .
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: /` 7 ^77 A.M. P.M. Entry:
Address: 4 y� 5 etc—) 7 2,. Tenant: Ste: MST:
BUP:
Con /Own: 5 4:=.0-e 4:=.0-e r �J
_
PLM: /
J ®e ELC: CA E•
THE FOLLOWING CORRECTIONS ARE REQUIRED:+
"Z/'r'i‘ i 5-::11Cr9 (
Inspector: li ... — • - Date: .--s
APPROVED _ DISAPPROVED /CALL FOR REINSP. CO