Permit CITY OF T ELECTRICAL PERMIT
� pd . DEVELOPMENT SERVICES PERMIT #: ELC97 -0661
�"NIi�d6�II� DATE ISSUED: 10/08/97
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DC -01500
SITE ADDRESS...:15655 SW 74TH AVE #BLD
SUBDIVISION....:FANNO CREEK ACRE TRACTS ZONING:I —P
BLOCK ° LOT .............:004 JURISDICTION: TIG
Project Description: New building
- -- 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 ° 3 W /SERVICE OR FEEDER: 30 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
JIM CASTILE type amount by date recpt
8100 SW DURHAM ROAD PRMT $ 330.00 JSD 10/08/97 97- 299881
TIGARD OR 97223 5PCT $ 16.50 JSD 10/08/97 97- 299881
Phone #:
Contractor:
D I CKI NSONS ELECTRIC $ ' 346.50 TOTAL
8449 SW BARBUR BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97217 Ceiling Cover Elect'1 Service
Phone #: 246 -3550 Wall Cover Elect' 1 Final
Reg #..: 000006
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 folio a rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 — 7. You may obtain a copy
of these rules or direct questions to. OUNC by calling (503)246 -1987.
Permittee Signature ��� � Issued
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: DATE:
LICENSE NO
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check# -/h
; 1 3125 SW HALL BLVD. 00 Rec'd By "�
TIGARD OR 97223 . �1 O Date Rec'd /O Z 1f
-' /
rI Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit C 7 : 7 - -06-'6
Fax (503) 684 -7297 Called
.-, .,
1. Job Address: ��4 / r'"T �� p / 4 4. Complete Fee Schedule Below
Name of Development / Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
Add ress / J c.:i � T 5
/ Sly • ( ( VA 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip Each additional 500 sq. ft. or
Commercial
/ CJ Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
-
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all urgent icenaes _ 4b. Services or Feeders
Electrical Contractor _ f ' , . e C - /l� Installation, alteration, or relocation / azO�
200 amps or less $60.00 / 2
Addre s �� �. 201 amps to 400 amps $80.00 2
City ' State _Zip ' 401 amps to 600 amps $120.00 2
Phone No. • 9 R ^ S"3'O 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No.2& ^ f t(G L Exp.Date /o-4 - ' �� Reconnect only $so.00 2
OR State CCB Reg. No. b g" Exp.Date / 3 • G � 4c. Temporary Services or Feeders
COT Business Tax or Metro Ne?6, '2_ 'LExp.D. e Installation, alteration, or relocation
200 amps or less $50.00 2
' i 201 amps to 400 amps $75.00 2 •
Signature of .Suer. Elec' _ . _ _ _�'r 401 am to 600 am $100.00 2 -
r �Q-Y1� 5 Exp.Date Over 600 amps to 1000 volts,
License No. p.Date see °b° above.
Phone No. 4 S -'� S" i/5
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee. /6"2" `i ✓
Address Each branch circuity $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 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 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 $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with a where any of the above apply. 5. Fees: 3
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ /J
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A, PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 3 q6 , co
Total balance Due
•
I: \DSTSlELC96.APP Rev 9/96
--a- I
.I
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 7 1 3-0 — gel L A.M. P.M. MST:
Location: /-� 67 55 ,560 7 l 1 BUP
Tenant: Suite: Bldg: MEC:
Contractor: C/ E v Phone: 63 — / 5. 93 PLM:
Owner: /_
Phone: -y— ELC: G � b IG J
FCr / _ - / > EL / R � /� "- / I
PZ07 _ rte_✓ lir
BUILDING BLDG (con't) PLUMBING MECHANICAL / SITE
Site Post/Beam ' Post/Beam Post/Beam over ervice Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump wt Volt
Approved Approved • Approved Approve - Approved
Appr /Sdwlk • Not Approved Not Approved Not Approved Not A roved Not Approved
FINAL FINAL FINAL FINAL FINAL
L V !Z./ G FGi - », 4. E. - & - a
A i Intl a -G -- - di. mq ,
d i t/ )//9 `4 --A (.5 C
1 - - --- M7/3-1--- 7"-- _ 1-1____: A / c 4- 4 - a (s...
_____,
O Call for reinspection O spection fee of $ required before next inspection O Unable to inspect
Inspector: Date: / n
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