Permit .- CITY OFTIGARD
:
DEVELOPMENT SERVICES ELECTRI, C , AL PERMIT � R
PERMIT #: ELC96 -0653
DATE ISSUED.: 10/16/96.
PARCEL :. 1S135DB- O36O1Z1
SITE ADDRESS.....: 11480 SW 92ND AVE
SUBDIVISION.. ° .: .DOGWOOD RIDGE, _ ZONING: R -4. 5
BLOCK. ° LOT...... -9
Project Description: ADDING 2 BRANCH CIRCUITS
- -- RESIDENTIAL UNIT -- - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF' OR LESS— ..: 0 ' 0 .. - 200 amp. o . ° '. ° ° L. 0 PUMP /IRRIGATION....: O
EACH ADD' L 500SF.•..: 0 201 - 400 am:p ° °, ° :,. O. SIGN /OUT LINE LTG.. :. 0
LIMITED ENERGY. °° ° °: 0 401 - 600 amp.......: 0 SIGNAL /PANEL.°°°°.°: 0
MANE.' ..HM /' SVC /FDR..4. 0 601. s- amps - 1000•» volt s' • : 0•' , MINOR LABEL. •(10) ..: 0, ,
•_- ---- SERVICE /FEEDER -- - -- __-- .BRANCH CIRCUITS - - - - -- .__. -ADD' L INSPECTIONS - -
-
O - 200 amp...... 0• W /',SERVICE OR FEEDER :. • 0 • PER INSPECTION— . ° .: O.
201 -- 400 amp......: 0 1st W/O SRVC OR FDR.: 1 PER HOUR° ° ° ° .....: 0
401 - 600 amp— . a : 0 ' EA ADD' L BRNCH_ C I RC: .1 IN PLANT 0
601 - 1000 amp.....: 0 PLAN REVIEW SECTION----- -
1000+ amp /volt. °.: O > =4 RES UNITS.-..... ▪ : > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: -• - - -- •- FEES -----
TERRY SMITH type amount by date recpt
11480 SW 92ND PRMT $,. , 40.00 TAT 10/16/96 96- 285203
SPCT $ 2.00 TAT 10/16/96 96- 285203
TIGARD OR 97223
Phone' #: •
■
Contractor:
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW. TECH CENTER DR.
REQUIRED' INSPECTIONS
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 503- 684 -3600 Wall 'Cover Elect' 1 Service
Reg #..: 2647
This permit i's'issued subject to the regulations .contained, in the T
Tigard Municipal,Coue;• State -, of Ore. Specialty , and: all "other -r Permit t e.e . gnat ure,
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. Issuer, By
OWNER INSTALLATION ONLY-- - - - -_. ---------
The installation i's 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: " ' DATE,: •
LICENSE NO:
Call for inspection,- 639 -4175
. ..
Community Development ELECTRICAL PERMIT APPLICATION
A o 13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued ELO /io "%S
/ , � irl �� I �
A. �i P hone (503) 639 -4171
" FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: �+ 4. Complete Fee Schedule Below:
Name of Development J�C`C\ 1 Number of Inspections per permit allowed
Address 1 1 480 SLAD ck gr.& Service included: Items Cost(ea) Sum
City /State /Zip " ► t Q \ Of V1 4a. Residential - per unit
J 1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ❑ Residential 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
Installation, alteration, or relocation
Electrical Co tractor As • . 200 amps or less $60.00 2
Addres y 7 WI I I I I WI It ITta `y� L `1f • 201 amps to 400 amps $80.00 2
401 amps to 600 amps
$120.00 2
Cit �•- :�± � �J �
' 601 amps to 1000 amps $180.00 2
Phone N' , - • r - �- �L� Over 1000 amps or volts $340.00 2
Job NO. _ I, -� - Reconnect only
$50.00 2
contractor's license NO. irf� 4c. Temporary Services or Feeders
Contractor's Board Reg. No. V�.T.k. Installation, alteration, or relocation
'���� 200 amps or less 2
Signature of Supr. Elec'n �iA`.�
License No. '/ -/CAS one No. tfi�j_ • r 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00
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
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. / �?i 2
First branch circuit 1 $35.00 i tycx 2
not intended for sale, lease or rent. 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) $100.00
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:
5a. Enter total of above fees $ r .
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
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 S $
COMMENCED. word\comdeWeIec- I I Trust Account #
$
prm.app
Balance Due l
CITY OF TIGARD ELF
BUILDING DIVISION PERMIT # .. q6, _ 000.53
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 *441 ic /0--/G0 "g�
Inspection Requests (24 Hrs.): (503) 639 -4175 A r__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: // Li go �� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Z gy,4,,,,,i-X G%'1
OWNER: PHONE #:
CONTRACTOR:44 0 PHONE #:
Inspection Request Scheduled For: Date: e_ 7- 6 7 Pour Time:
Code # Inspection Description Confirm # Contact # . Message
so zf--3 6, zi3
1 ci 9
Corrections /Comments /Instructions:
•
C _______,,
‘,._....._ ( __--
I X PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
l FAIL n CALL FIR INSPECTION n ADDITIONAL FEES ASSESSED
4-
Inspector: / Date: Phone #: (503) 718-
5 /18 /00 Activities for Case #: ELC96 -00653 EXPIRED
4:52:25 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 10/15/96 TAT RECE TAT 10/16/96
ELCA700 Ceiling Cover 10/16/96 TAT 10/16/96
ELCA720 Wall Cover 10/16/96 TAT 10/16/96
ELCA725 Underground Cover 10/16/96 TAT 10/16/96
ELCA730 Elect'I Service 10/16/96 TAT 10/16/96
ELCA799 Elect'I Final 10/16/96 JMT NOTE JT 9/28/98 9/28/98 inspection request
(research) to Chuck D.
ELCA003 Permit created 10/16/96 TAT PASS TAT 10/16/96
ELCA500 (F) Issue permit 10/16/96 TAT APPR TAT 10/16/96
ELCA920 Miscellaneous action 2/18/00 JMT DONE No Hold JMT 2/18/00 SECOND RESEARCH
INSPECTION REQUEST
ELCA580 Expired by limitation 4/6/00 HAP DONE No Hold AKJ 4/6/00
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