Permit CITY OF T ELECTRICAL PERMIT
PERMIT #: ELC1999 -00732
�DEVELOPMENT SERVICES DATE ISSUED: 12/07/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 BD 00105
SITE ADDRESS: 12805 SW 77TH PL •
SUBDIVISION: ZONING: I -L
• BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: • PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
B R + G CO LLC PHOENIX ELECTRIC CO
PO BOX 23009 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 12/07/199. $42.85 99- 320231 Elect'I Final
5PCT BON 12/07/199, $3.43 99- 320231
Total $46.28 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE (91� 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: ( /� t� DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
DEC -07 -99 TUE 11 41 AM PHOENIX ELECTRIC CO FAX N0, 15036843611 P, 02
CITY OF TIGARD Electrical Permit Application Plan Check # _
11'25 SW HALL BLVD. Reed By
TIGARD OR 97223 • pate Recd
Phone (503) 639 -4171, x304 Date to P.E.
Date to DST •
Inspection (503) 639-4175 Print of Type Permit # l= L.6*(1 7Z-.
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4, Complete Fee Schedule Below:
Name of Development C \ , C ' ■ . �., l. ` \l \ ,-n ( S ( (k t 1, f Number of Inspections por permit allowed
Name (or name of business) _ Service included: Items Cost Sum i
Address S 1 - 1 - 4a. Residential • per unit
1000 sq. ft. or less $ 117.75 4
City /State /zip \ k. C A ' NA, c., t_
Each additional 500 sq. ft, or
t portion thereof $ 28.25 1
Co;nmerci Residential E Limited Energy $ 60.00
�. V-- ', \ .lk.\ - ,'S L� Cr c*-'-> Each Manufd Home or Modular
D welling Service or Feeder
2a. Contractor installation only: . _ $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for CO • • baso). • Installation, alteration, or relocation
Electrical Contractor ,,a.: • - 4 �k • . -'. 200 amps or less _ s 64.25 2
Address (13-16 + 1 201 amps to 400 amps $ 85,50 2
401 amps to 000 amps $ 128.50 2
City lam. �x�i State (_,),c2-..- Zip 601 amps to 1000 amps $ 192.50 2
Phone No :' L0-64 -..(.0 DI-) . _ Over 1000 amps or volts - $ 363.75 2
Job No. ___,(1)\.
_, /1 \. "1 - _)(-) Reconnect o nly $ 53.50 2
Elec. Cont. Lice. No. A 9C- Exp.Date 4c, Temporary Services or Feeders
OR State CCB Reg. No. 5 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. 0(r L .(7 _Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
0.415 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n v e JAIN/P -
Over 600 amps to 1000 volts,
License No. [��� to S Exp.Date sec "b" above.
Phone No. L (( - 7 ( e (\ ) 4d. Branch Circuits
New alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: With purchase of service Or
• feeder fee.
Print Owner's Name Each branch circuit - $ 5.35 2
Address
b) The fee for branch circuits
without purchase of service
•
City State Zip _ or feeder fee. �Z)
$ 37.50 t
Phone No. First branch circuit /
Each additional branch circuit / $ 5.35 5 , 3
The installation is being made on property l own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or fender not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each Sign or outline lighting . 42.75
Signal circuit(s) or a limited energy
* panel, alteration or extension $ 60,00
3. Plan Review section (if required); Minor Labels (10) $ 107.0o
Please check appropriate item and enter fee in section 56. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection 50,00
Per hour 5 50.00
System over 600 volts nominal In Plant $ 5g,00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: r-
Sa. Enter total of above fees $ r j , ,
* Submit 2 seas of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ '
Not required for temporary construction services, Subtotal $
5b, Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $ / _
PERMITS BECOME VOID W WORK OR CONSTRUCTION AUTHORIZED Subtotal $ -- / --
/
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR �_ <_ r l
WORK I5 SIJSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account # - F} . rl c -
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ),
l.\Astslferms \electric doe