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Permit �� --��NN�� ~��~~~ � ELECTRICAL PERMIT PERMIT #: ELC96-0331 � �� OF � - �^�� DATE ISSUED: 05/23/96 COMMUNITY DEVELOPMENl[ DEPARTMENl[ 13125 SW Hall Blvd. Tigard, Oregon 9722 3.8199 (5o3)o39-41r1 PARCEL: 2S1 13AD-01700 SITE ADDRESS...: 16920 SW 72ND AVE SUBDIVISION,...: ROSEWOOD ACRE TRACTS ZONING:C—G BLOCK..........: LOT. ........ ....:30 Project Description: INSTALLING ONE SERVICE OR FEEDER _ _ ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS 1000 SF OR LESS. . . . : 0 0 — 200 amp., . . . . . : 1 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......: 0 W/SERVICE OR FEEDER: 0 PER INSPECTION : 0 201 — 400 amp......: 0 1st W/O 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 ---- TIGARD CENTER type amount by date recpt 16920 SW 72ND AVE PRMT $ 60.00 CJS 05/23/96 96-279808 5PCT $ ' 3.00 CJS 05/23/96 96-279808 TIGARD OR 97223 Phone #: Contractor: ----- — ---- — ---- VIKING ELECTRIC INC $ 63.00 TOTAL 4326 SE WOODSTOCK STE 518 REQUIRED INSPECTIONS PORTLAND OR 97206 Elect' Service _ Phone #: 775-3479 Elect'l Final Reg #..: 056527 This permit is issued subject to the regulations contained in the Tigard Municipal Cade, 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 than N 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: _ --- — CON ATI ONLY-- — ^�� /� //V SIGNATURE OF SUPR. ELEC`N:��'�---��L�� DATE: ~/ v`� 7 LICENSE NO: _ m O �� Call for inspection — 639-4175 • Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # EL(4G-033i i 1pl�plaElh° Date Issued 5-D3- 96 ,�' iI Phone (503) 639 -4171 FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job A 4. Complete Fee Schedule Below: Name of Development 7 ju / / J C e p Number Of Inspections per permit allowed ii V � Address 1 b 1 a 0 5 f� 1 /'� .'0 , v�. Service included: Items Cost(ea) Sum i City/State/Zip Y P `� ' 0 Al d A.-- 4 a. Residential - per unit / 1000 sq. ft. or less $110.00 10.00 4 Name (or name b usiness) Each additional 500 sq. ft. or portion thereof $25.00 Commercial ❑ Residential ❑ Limited Energy $25.00 1 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders , r t ' e Installation, alteration, or relocation Electrical Contractor �G 200 amps or less $60 2 Address q • - 5 y✓ 1 . O r ` !( 201 amps to 400 amps $80.00 2 401 amp to 600 amps $120.00 2 City / ;,. State U l. Zip ''a0 $180.00 2 601 amps to 1000 amps Phone No. 75 77 Over 1000 amps or volts $340.00 2 Job NO. Reconnect only $50.00 2 • contractor's license NO. ad- 6 r 4c. Temporary Services or Feeders Contractor's Board Reg. No Installation, alteration, or relocation Signature of Supr. Elec'n l 200 amps or less 5 ©d 2 License No. 3016.5 Phone No. 773 - 3 4 /7 9 201 amps to 400 amps $50.00 401 amps to 600 amps $75.00 2 Over 600 amps to 1000 volts $100.00 2b. For owner installations: see "b" above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per pane 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. 2 First branch circuit $35.00 not intended for sale, lease or rent. 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: 5a. Enter total of above fees $ 5 00 NOTICE 5% Surcharge (.05 X total fees) $ 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) $ -5/) A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. word\comdeveIec- ❑ Trust Account # $ prm.app Balance Due $ ,j ?.6-'p