Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00323
I6 DEVE r S o ERV ICES 639 -4171 DATE ISSUED: 5/27/99
�� PARCEL: 2S112BC -08900
SITE ADDRESS: 14733 SW 80TH AVE
SUBDIVISION: RAZE MEADOWS 4 ZONING: R -4.5
BLOCK: LOT : 012 J `):!.,DICTION: TIG
Project Description: Installation of one branch circuit.
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/ SVCI 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: IN PLANT: •
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: . > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JUDY CARTER 3 D ELECTRICAL SERVICES INC
14733 SW 80TH AVE PO BOX 1255
TIGARD, OR 97015 CLACKAMAS, OR 97015
Phone: Phone: 650 -2308
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DRA 5/27/99 $35.00 99- 315722 Elect'I Final
5PCT DRA 5/27/99 $1.75 99- 315722
Total $36.75
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 workis.not.started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to plow Ilow rules adopted - by-the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You m y obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Permit Signature: y 1A)oft / Issued By: l.2 Mli L �
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: j‹' C4 ) h Le �t DATE: 5 --F
LICENSE NO: 3 / ' 3 S
Call 639 -4175 by 7:OOpm for an inspection the next business day
e" r Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # icq X 32
�a�rm i f � , Date Issued .T 2 t
,.f II Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175 � / 3 7�
1. Job Address: . Complete Fee Schedule Below:
Name of Development ^ Number of Inspections per permit allowed
Address 14133 S ' ' 4 , ,C Service included: Items Cost(ea) Sum
City /State /Zip ( Icy #2D y �fZ 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or $26.00
portion thereof
Commercial ❑ ResidentialiIV 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
Electrical Contractor 3� j,CK7 #'ICS ICGS -r` ( Installation, alteration, or relocation 5 $60.00 2
- r 200 amps or less
Address p- '. Q_ l 3 s7 c 201 amps to 400 amps $80.00 2
ry
Cit lb+� S 401 amps t o 600 amps $120.00 2
y �MtQ State � � Zip 9'jQI 601 amps to 1000 amps $180.00 2
Phone No. .3 2-9 ` nl / i Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $50.00 2
Contractor's license NO. 1 -"Apo C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 135 Installation, alteration, or relocation
Signature of Supr. Elec'n ,t 200 amps or less 2
r n 201 amps to 400 amps $50.00 2
License No. $7`135 Phone No. (rSO r 401 amps to 600 amps $75.00 2
IQ-/ mod' 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 2
purchase of service or feeder fee.
City State Zip 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. 1D0 2
not intended for sale, lease or rent. First branch circuit ( $35.00
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) $too.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: o o
5a. Enter total of above fees 3-
NOTICE 5% Surcharge (.05 X total fees) $ 1 .
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 3 (t.-7'5 r
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. word\comdev\eiec- ❑ Trust Account # $
m.aPP $ s
pr
Balance Due 3 `Q