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Permit
• ELECTRICAL PERMIT j a k - CITY OF TIGARD - PERMIT #: ELC2000- 00102 4.414p DEVELOPMENT SERVICES DATE ISSUED: 03 /10/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ' PARCEL: 2S 112BC= 02000 SITE ADDRESS: 14695 SW 84TH CT SUBDIVISION: HAMBACH PARK_ ' ZONING: R-4.5 BLOCK: LOT : 004 JURISDICTION: TIG Project Description: Installation of a first 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/ SVC/ FDR: 601 +amps' -1 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: • ZULL, THEODORE W + SHARON A - BOB'S ACTION ELECTRIC INC 14695 SW 84TH CT . 2700 NE BURTON ROAD TIGARD, OR 97224 , - STE A. VANCOUVER, WA. 98662 Phone: Phone: 360- 254 -7200 • Reg #: SUP 4322S LIC 00053136 • ELE 37-431C • FEES • Required' Inspection's • • Type By Date • Amount Recei Elect'I Service • PRMT GEO 03/10/200C $37.50 0000607 Elect'l Final ' 5PCT GEO 03/10/200C $3.00 0000607 Total $40.50 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 � ISSUED BY: d 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: ' 0,0 . DATE: 3 "/Q -O d LICENSE NO: 4 /.. 7 0 17 . ---- • Call 639 -4175 by 7:00pm for an inspection the next business day , • e ~ RECEIV D Plan Ch CITY OF TIGARD Electrical Permit Application Check 13125 SW HALL BLVD. By TIGARD OR 97223 MAR 1 2 000 Date Recd �!/ r Date to P.E. Phone (503) 639- 4171,x304COMMUPIITY DEVELOPMENT V l Date to OST Inspection (503) 639 -4175 Print of Type Permit # fee - 04047, Fax (503) 598 -1960 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 of business) Terry Zull Service included: Items Cost Sum Address 14695 SW 84th Ct . 4a. Residential - per unit 1000 sq. fl. or less . $ 117.75 4 City /State /Zip Ti • nrd. OR 97224 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial ❑ Residential © Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). Installation, alteration, or relocation Electrical' Contractor Bob's Action Electric 200 amps or less $ 64.25 2 Address 2700 NE Burton Rd. "A" 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 City Vancouver State WA Zip 98662 601 amps to 1000 amps $ 192.50 2 Phone No. _ 360- 254 -7200 Over 1000 amps or voles $ 363.75 2 Job No. 00 -214 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 37 -431C Exp.Date 10/01 /00 4c. Temporary Services or Feeders OR State CCB Reg. No. 53136 Exp.Date 6/01/03 Installation, alteration, or relocation COT Business Tax or Metro No. 386 Exp.Date 6/01/0 ) 200 amps or less $ 53.50 2 201 amps 10 400 amps $ 80.25 2 401 amps to 600 amps $ 107.00 2 Signature of Supr. Elec'n ,A.,___ "- ��_A__ Over 600 amps to 1000 volts. sae "b" above. License No. 4322S Exp.Date, 10/01/01 4d. Branch Circuits Phone No. 360 54 - 2 nn New, alleration,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 b) The fee for branch circuits Address without purchase of service City State Zip or feeder fee. Phone No. First branch circuit 1 $ 37.50 37.50 Each additional branch circuit 5 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. . (Service or feeder not included) Each pump or Irrigation circle $ 42.75 Each sign or outline lighting $ 42.75 Owner's Signature Signal circuit(s) or a limited energy panel, alteration or extension $ - 60.00 3. Plan Review section (if required):* Minor Labels (10) • $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional Inspection over 4 or more residential units in one structure the allowable In any of rho above Per inspection $ 50.00 Service and feeder 225 amps or more Per hour 5 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ 37.50 * Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ _ 00 Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account IS AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 40.50 i• % rnrmc4 lerlrir (Inc zootj a21vOI,L io M,IO 0961 96S 1:05 xv'l ZE :TT I d 66/60/90