Permit 7:\ -- ' -- ��' __ -- �~�~~~~.~�~��
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r'_,_ ���� � � ��� � � � �m�m�-��� � ��p . / ELECTRICAL PERMIT
DEVELOPMENT SERVICES ~~~~~ ~~^�`~^ ^~^~~^~ ^ ~~~~^^~ ^~~~~~~ PERMIT #: ELC97-0060
~� 13125 SW Hall Bhvd.. Tigard, ORQ7223 (503)6394171 DATE ISSUED: 02/03/97
PARCEL: 2S113AB-00800 .
SITE. ADDRESS...: 15995 SW 74TH AVE •
SUBDIVISION.....: ' , - ` ' % `Z8NING: I-P
BLOCK..........: LOT.............:
Project Description: Installing two feeders and 45 circuits.
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---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/FDRL� :' 0'�^~ ' 601+a�ps�1 p, H., MINOR LABEL (10) . . . : 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS INSPECTIONS---
0 - 200 amp. . . . . .: ,0_.2 W/SERVICE OR FEEDER: 45: PER INSPECTION. . . . . : 0 •.„
201 - 4060 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 -
JOHN DUNCAN type amount by date recpt
16055 SW 74TH AVENUE.- . , PRMT $. -225.00 *** 97-289782
5PCT $ 11.25 *** 01/31/97 97-289782
TIGARD OR 97223
Phone #:
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Contractor: : ---------
ELECTRO-WIRE INC • $ 236.25 TOTAL
18857 SE SUNNYSIDE RD
------- REQUIRED INSPECTIONS -------
BORING OR 97009-9222 Ceiling Cover Elect'l Service
Phone #: 658-8136 : ~ . . Wall Cover Elect'l Final
Reg #..: 006787
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This permit is issued. suhect to the • regYlation�cnnt�nnd�inthe����~ ':• -- ' ~ (\-----
_____(:;,,,),_______
T�� timnicipal .Code,_Stater ot. Ore. .Specialty Codes, and •alkother , • ' ee Signature
applicable laws. All work will be done in accordance with ` w�w~-
approved plans. This permit •wiDexpire if,wock• Is not startgd:
within 180 daysof is�oance, nr if work' is suspended. for more' �
than 180 days. • • ssued By
---- --OWNER INSTALLATION ONLY ---------
The installation'is being made on property J own which is not intended for
. sale, lease, or rent,
OWNER'S SIGNATURE: DATE:
----------- -CONTRACTOR INSTALLATION ONLY-- -
IGNATURE OF SUPR. ELEC'N: _ DATE: __ .
LICENSE NO: _ __
.. ,, Cal). for ir!spectio)a 7,63974175 .
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A- 60 Nil soy
!ITYOFTIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd /13)/ 7
Date to P.E. r
Phone (503) 639 -4171, x304 Date to DSj
Print or Type
Inspection (503) 639 -4175 Permit# t% (5 17 - 0 (1 1.e0
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ��--�� Number of Inspections per permit allowed
Name (or name bu ' ess) � ��� PU Man Service included: Items Cost Sum
Address
j� - 4a. Residential - per unit
y e 1 1000 sq. ft. or less $110.00 4
City /State /Zip / / c3 ;^r>.I Each additional 500 sq. ft. or
.----y .----y n portion thereof $25.00 1
Commercial '7°J Residential ID 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 current licenses) t 4b. Services or Feeders ;,
t r D G{.) i . Installation, alteration, or relocation •
Electrical Contractor / e ►^ 200 amps or less t $60.00 0 - ----".
Addreks ;l Crr 5 7 S L :1.- iii./ ^ ; �F /rq 201 amps to 400 amps (9 $80.00 I4.:,,-,:-..... 2
City 15 �}ir; 140 State 1R7vt Zip 4 7 -" , aft 7 401 amps to 600 amps I ' $120.00 / 2
Phone No. � l f �; j 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. ..1.6, -4 -, C.7 Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No. 6 7S"79 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 Signature of Supr. Elec'n,� ! �i� 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 2:1 i.7 3 Exp.Date AO •- /975' see "b" above.
Phone No. Gags z - `ie /. -3 6-, 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.
Address Each branch circuit 4 7 1 :::% $5.00 7+x.5 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 application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 23
5% Surcharge (.05 X total fees) S $ L 3 -
NOTICE Subtotal $ C
5b. Enter 25% of line 5a for 11. 2.5 ~
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 ❑Trust Account #
TIME AFTER WORK IS COMMENCED. $ ;
Total balance Due a5 ctilt •
fel, 917 2gg7d
I: \DSTS \ELC96.APP Rev 9/96 o - 0 (Eq
CITY OF TIGARD
EXPENDITURE REQUEST
This form is a multi -use form. Appropriate receipts and documentation must be attached to this form. Approved
request due Wednesday 10:00 AM to A/P for checks by Friday.
VENDOR NO.: DATE: February 3, 1997
PAYABLE TO: John Duncan REQUESTED BY: Debbie Adamski
7060 SW Palmer Way
Beaverton, OR 97007
MISCELLANEOUS EXPENDITURES:
Date Description, Invoice No., etc. Account No. Amount
2 -3 -97 Reimbursement for overpayment on receipt 97- 289782 23- 0000 - 431510 $140.00
10 -0000- 230010 $ 7.00
(Re: ELC97 -0060, electrical application included
some items already taken out on a previous app so
they were taken off the permit & $ to be refunded)
Total $147.00
Mileage $0.31
APPROPRIATION BALANCE: AS OF: SIGNATURE:
(Up TO $25.00) Section Manage/ 1 . gent
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($25.01- 2,500.00) Division Manager
($2,500.01- 7,500.00) Dept. Head
($7,500.01- 15,000.00) City Administrator
($15,000.01 - ?) Local Contract Review Board
I: \adm \jo \expendrq
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.
Daher: .L /
Date: 1 f f 1
A.M. P.M. Entry:
Address: l.5 / 9'. 7
Tenant: Ste: MST:
/� BUP:
Con /Own: In g x( ' - 00 cg 44....) MEC:
PLM:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: '
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Inspector: /h r h .rte -{' Date: 2-9 ---7 '
_APPROVED ■ DISAPPROVED /C' OR REINS?). CF CO
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: ��II
Dat : 7 7 A.M. P.M. Entry:
Address: ! � ��l] y
Tenant: c - Ce) Ste: MST:
BUP:
Con /Own: MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
.rs >
Inspector: // -- _ Date:
`may 1■PPROVED DISAPPROVED/CALL FOR REINSP. AO CO
•
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: i �
Date:. ? / ( /1 • A.M. • P.M. Entry:
Address 1 5' C "I q • ..., : 7 9 . /
Tenant: - - Ste: . • MST:
BUP:
Con /Own: (, El — oa Lf ( /(c - 1a
// MEC:
PLM:
i/ & 1 riCc. -,LC: 7 (- -) c
THE 'FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector_ I r i-/� •4P / /fi Date: "D -a l 7
APPROVED D ISAPPROVED /CALL -FOR REINS CF CO .