Permit CITY OF TIGARD
1 9( MAI
DEVELOPMENT SERVICES ELECTRICAL PERMIT
h M't I
: I L 13125 SW H a l l Blvd., T i g a r d , OR 9 7 2 2 3 ( 5 0 3 ) 639.4171 PERMIT # : ELC97 -0261
DATE ISSUED: 05 / 02 / 97
PARCEL: 2S111AA- 07200
SITE ADDRESS...:14377 SW 88TH AVE
SUBDIVISION :GREENSWARD PARK NO. 2 ZONING:R -4.5
BLOCK • LOT •058 JURISDICTION:
Project Description : insti 2 branch circuits // job * 2859 -148
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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 +amp; -1000 volts.: 0 MINOR LABEL (1O)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 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: 1 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
JOSH /TARA BAUMANN type amount by date recpt
14377 SW 88TH AVE PRMT $ 40.00 TAT 05/02/97 97- 294048
TIGARD OR 97224 5PCT $ 2.00 TAT 05/02/97 97- 294048
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS
TIGARD OR 97223 . ' ` I RED Ceiling Cover Underground Cove
Phone #: 684 -3600 Wall Cover Elect'1 Service
Reg #..: 000522
This permit is issued subject to the regulations contained in the ,�
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm ' t t e S gnat ure r 7
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started , within 188 days of issuance, or if work is suspended for more
than 18@ days. 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 : 02Z. Q4/Zid DATE: 5 l 2- 7
LICENSE NO: y/ c 7 / 03
Call for inspection — 639 -4175
MAY -02 -97 FRI 08:08 AM PHOENIX ELECTRIC FAX NO, 503 684 3611 P,02/02
CITY OF TIGARD Electrical Permit Application Plan Check a
Reed By
13125 SW HALL BLVD. Date Rec'd
TIGARD OR 97223 Date to R.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST -�
Inspection (503) 639 -4175 Permit # �� �'tE'f
Fax (503) 684-7297 Incomplete or illegible will not be accepted CaEled-
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development - Number of Inspections per permit allowed -
Name (or name of businesZCSk y f U 10 t‘11 Service included: Items Cost Sum
)
Address 4 CQa 4a. Residential - per unit
J� 1000 sq. ft. or less $110.00 4
City /State/p 1LL t "M C I7 L; Each additional 500 sq. tt or
�� portion thereof x. 1
/Commercial ❑ ResidentiaipL Limited Energy $25.00
A Each Manure Home or Modular
C[�4�S`t 2 j��ihL Dwelling Service or Feeder $68.00 .. 2
`2a. C installation only: 4b. Services or Feeders
(Attach copy \ I current licenses) Installation, alteration, or relocation
Electrical Contractor -r &.w∎ a, ue� � et 200 amps or less $60 -00 2
Addr - Ss Ts - -..-- T5wL w � 1 1111■1=1 201 amps to 400 amps , , $80.00 2
City - .. A..+. State ' ZI Z. iiS -At 401 amps to 600 amps $120.00 2
-
Phone N r _ -..t- ►, _- L1 601 amps to 1000 amps 5180.00 2
Job No. __e ti 9 �`L r-!a Over 1000 amps or vottb _ $340 -00 a
Reconnect only 550.00 2
Elec. Cont. Lice. No. --Al Exp.Date 10N.
OR State GCB Reg. No., cc a.1 -Sekil Exp.Date 1 ••-• 41 do Temporary Services or Feeders.
COT Business Tax or Metro N No. Exp.Date .i 1 - Installation, alteration. orreiocation
200 amps or less $ 50 . 00 2
-
201 amps to 400 amps 575.00 2
Signature of Supr. Elec'n, 4 / 401 amps to 500 amps 5100.00 2
�/ Over 600 amps to 1000 volts,
V License No. e.25 Exp.Date • see "b" atom
• Phone No. LO Q 4d. Branch Circuits ,
• New, alteration or extension per et rf . -; : .
2b. For owner installations: a) The fee for branch atoarts � at " ,�
purchase of service or
Print Owner's Name feeder fee-
Each branch circuit $ z -
Address - b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. I d 2
First branch circuit $35.00
The installation is being made on property I own which is not
Each additional branch circuit - S "WI 4. 2
intended for sale, lease or rent. be. 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 $000
Minor labels (10)
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 teeder 225 amps or more the allowable in any of the above
System over 600 volts nominal - $55.00
Per inspection
Classified area or structure containing special occupancy Per hour $.55,00
as described in N.E.C. Chapter 5 In Plant
* Submit 2 sets of plans with application where any of the above apply 5. Fees: JI •
Not required for temporary construction services. 5a. Enter total of above tees $
5% Surcharge (.05 X total fees) $ , T�
NOTICE Subtotal $
sb. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it_requtra¢ (Sec,3) $
NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR WORK S Drotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY rust Account # - �1 ) • TIME AFTER WORK IS COMMENCED. �� / S
Total balance Due