Permit CITY OF TIGARD
ELECTRICAL FI_RMI1
�i�,� DEVELOPMENT SERVICES PERMIT ISSUED: 1f3�9S •
PARCEL: 25112CB- -05300
SITE ADDRESS...: 15345 SW 82ND PL
SUBDIVISION...,.. :ASHFORD OARS NO. 2 Z ON I NG : R -7 PD
BLOCK........... • LOT .............:067 JURISDICTION: TIG
Project Descri pt ion : Installation of one branch circuit.
• - -- RESIDENTIAL UNIT -- -- -- -TEMP SRVC/FEEDERS.---- •-------- MISCELLANEOUS- - - • - --
1001Z1 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 C I RCU I TS-- --- - -- -- -ADD' L INSPECTIONS - - -- .
0 - 201Z1 amp - 0 W /SERVICE OR FEEDER: 0 PER INSPECTION...„.: 0
201 - 400 amp ° 0 1st W/O SRVC OR FDR.: 1 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: -• - -- - - - - -- -------------------- --
JACK COKE
•
type amount by date recpt
13345 SW 82ND PLACE PRMT $ 35.00 DEB 09/18/98 98- 309274
TIGARD OR 97223 5PCT $ 1.75 DEB 09/18/98 98- 309274
Phone #: 670 -0942.
Contractor: -- --
CHALLENGE ELECTRIC AND CONST. $ 36.75 TOTAL
PO BOX 309
REQUIRED INSPECTIONS -----
IIUBBARD OR 97032 Rough Elect' 1 Final
Phone 4$: 503 -981 -5354 Elect' 1 Service .
Reg #..: 001097
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 follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 thrrh OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to O11NC by calling (503)245 - 1987. _
Permittee Signature: ' :,tee Issued 1_. : ,L . /� ,�_e_ , _
- - - --- -- OWNER I- NSTALLATION ONLY----- - - -- -------
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S .SIGNATURE t DATE:
. ____ �__
------..-_...--__-•------- .-- .- ..._-- .- __.- CONTRAC•rOR INSTALLATION ONLY ----------------
SIGNATURE OF SUPR. EL_EC' N: tell � e-r.-- ' DATE: Q -/frfr
LICENSE NO: ,_ zo-ce,...5 _ _
+ + + ++ + ++ I + + +i- ++ f + + + + + ++ + + ++-{- .... + + +-l-.. + + + + + +- ..... + + + + +-I + ++ + ++ + + + + + + +-F•-1-•+• + +-{-•+•
Call 639-4175 by 7:00 p-m. for an inspection needed the'next business day
+++++++++++++++++++++++++++++++++•+•++++++++++++++++ + ++ + + + + + + + + + + + + + + +•+• + + ++ + + + + ++
•
'CITY OF TIGARD Electrical`Perniit Application Plan C - •J
13125 SW HALL BLVD. Rec'd : ■ 1! &7//
TIGARD OR 97223 Date Rec'd -
G ^ Gt�/ o 1��
Data to P.E.
Phone (503) 639 -4171, x304 \k"EV
Prin or Type Date to DST
Inspection (503) 639 -4175 L, Incomplete or illegible will nit f accepted Permit lu £te 9 &' -0663
Fax (503) 684-7297 Called
1. Job Address: 4. C r Below:
, r , n. 'I.fn' ^ . Ei T
Name of Development // Op Vutri' oo inspect per permit allowed
Name (or name of business) c/fhk. (Dkr Service included: Items Cost Sum
Address .J52V5 Si V g ,X?/ PZ 1 4a. Residential - per unit
Z 1000 sq. ft. or less $110.00 4
City /State/Zip Q2/alp /(?�� ( _ 94,�1��_ Each additional 500 sq. ft. or
rig Limited thereof $25.00 - 1
Commercial 0 Residential
Limited Energy $25.00
Each Manut'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 0 41). Services or Feeders
Electrical Contractor i,r 4r _- Installation, alteration, or relocation
-
- 200 amps or less $6.0,00 2
Address .. _al
201 amps to 400 amps $80,00 2
C ,f _.�_�� � i State /# Zip 9? 401 amps to 600 amps $120.00 2
Phone No. c5O) ��/ !✓ 5 _ 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. V/ 39fie Exp.Date Reconnect only $50.00 2
OR State CCB Rag. No. /0979/9 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
Signature of Supr. Elec n. , �� • �.y 201 amps to 400 amps s75.00 2 -
401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No. /558 5 Exp.Date / 4 2/ 9/9 see "b" above.
Phone No. x'97- 411A07 4d. Branch Circuits
2b. For owner installations: New, alteration or extension per panel
a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder tee.
Address Each branch circui $5.00 2
City State Zip b) without purchase of its
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 circuit $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 (f required):* Signal clrcult(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 58.
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 Par 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 $
5% Surcharge (.05 X total lees) $
KOTICE 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 0 TIME AFTER WORK IS COMMENCED. LJ Trust Account # $ Lj, 75 •
Total balance Due