Permit CITY O
DEVELOPMENT ELECTRICAL PERMIT
SERVICES PERMIT #: ELC96-0681
�L. 13125 SW Hall Blvd., Tigard, �~�— ' DATE ISSUED: 10/23/96
PARCEL: 2S114AB-13700
SITE ADDRESS...: 16247 SW 93RD AVE
SUBDIVISION. KNEELAND ESTATES NO.2 ' ZONING:R-4.5
BLOCK..........: LOT. ........ ....:110
Project` Description: ADDING-BRANCH-CIRCUITS ,
______ _
'
• -=--RESIDENTIAL UNIT---- .r """ SRVC/FEEDERS---- MISCELLANEOUS----- •
1000 SF OR LESS....: 0 0 — 200 amp.......: 0 PUMP/IRRIGATION....: 0
EACH ADD'L 500SF...: 0' 201 —'400 . SIGN/OUT LINE LTG..: 0
LIMITED ENERGY ^ 0 401 — 600 amp.......: 0 SIGNAL/PANEL.......: 0
MANF. HM/' SVC/FDR.: 0 • 6014amps-1000'volts.:. 0 MINOR LABEL (10)...: 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� ADDOL BRNC• CIRC: 1 . IN. PLANT ^ 0
601 — 1000 amp ^ 0 PLAN REVIEW SECTION -----
.1000+—amp/volt ^ G/` >=4 RES > 600.VOLT NOMINAL..:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner:. ----- ------- - ,FEES --- .
HOELLA type amount by date recpt
16247 SW 93RD AVE • — • ' PRMT $ 40.00.TAT 10/23/96 96-285617
5PCT $ 5.00 TAT 10/23/96 96-285617
TIGARD OR 97223
Phone #:
Contractor: — —
ALL CITY ELECTRIC $ 45.00 TOTAL
7017 NE HIGHWAY 99
, SUITE 116 • ------- REQUIRED INSPECTIONS
VANCOUVER WA 98665 Ceiling Cover Underground Cove
Phone 360-223-0592 • • ' ' Wall Cover Elect'l Service • •
Reg #..: 087014
�
/
� the This permit is issued subject to � regulations contained the contai in the - '
Tigard Municipal Code, State of Ore. Specialty Codos,and all other Permittee - Ignature
applicable laws. All work will be done in accordance with
approved plans: This permit will expire 'if work is not startpd:
within 180days of issuamce, or if work is suspended formoro' • _ ^ ^
than 180.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: DATE:
_
LICENSE NO:
' 'Call for inspection — 639-4175
l -23 -96 WED 01:46 PM P.02
� - ° Community Development ELECTRICAL PERMIT APPLICATION
yP ` 13123 SW Hall Blvd.
J;
Tigard, OR 97223 Permit #
�<
.,., , : # .: Date Issued 9ry - b i
_, , JI Phone (503) 639.4171
CITY OF �10AQD FAX ( 684 -7297
TDD No. (503) 684-2772
inspection (503) 639 -4175
1. Job Address:
4. Complete Fee Schedule Below:
Name of Development
Number of inspections per permit allowed _..]
Address
Sert'1Qe Included: trams Ccattea) Sum
City/State/Zip 19.-<—
ad. Residential - per unit
Name (or name of business) �� 1000 sq. °'teS :113.30
Each aeeMbnal 503 so. R a
portion thereof Commercial ❑ Residential x.00
3 s.00
,� 1
Each Manure! Ham. or Mrodumr
2a. Contractor installation only: �"'°" F 2
-
4b. Services or Feeders,
Electrical Contractor e , . ' / rise, ,00.,. owe*, at „
Address I i - •• • i1/ft, 201 to Sao iQstoo a
City ' :i Star I�` ""P` sa° -°0 2 003 amps Phone No. --- ,. 1, Z{p 401 arms to 000 $180.o�o 2
Job NO. 6 over woo amps or vats sa4o.00 2
contractor's license NO. Rammed U0.00 2
' 4c. Ta
Reg. No. Z� ; Temporary Services or Feeders
Contractor's Board
. , Signature of up S ,'n , Installation. or le lbn. or re,aoatloe
License NO �Q :� . . ' ' "'��r�� 203 amps or less 2 • t). 207 amps to 400 a,r,p. sso.00 -- 2
� y rt 401 amps m 800 amps .
. 2b. For owner installations: ,R6/36 J `/+� sos' to 1000 Volta --- s7i.0o 2
><m '°' agave. 6103.00 -- -_
Print Owner's Name 4d. Branch Circuits
Address .
Ne, mention or extension ension per Pe
City a) The fee far brans, circuits WI*
State Zip prom. ofso iceor 2
Phone No. Each branch oral
The installation is being made on property I own which is °) The tee purchase
ftt of orW f (*coin wr>r ss.co feeder not intended for sale, lease or rent. F °f '�
Each addition __71: 15 s5
al branch cicek .00 ` 2
Owner's Signature .00
ee. Miscellaneous
3. Plan Review section (if required): Each (Servi or feeder not Included) 2
PAP or irripssion Ord. $13.33 2
Each sign or owing Opting
Please check appropriate item and eater fee In section GB.
vales. 810 00
Signal wro�(a) s rere** energy
4 or more residential unite in one structure etc iol
(10) or eaenskm 2
Service amps or more
and feeder 225 s4o.ao
$103,03
System over 800 volts nominal 4f. Each additional inspection over
Classified area or structure containing sperm occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Pfff hIMSC:5011
Per haw ---__ 18S.0
Submit t sets of plans with application where any of the above
In Pao 555.03
apply. Not required for rem ra SW.00 -- P° ry construction services.
5. Fees:
NOT1GE Se. Enter total of above fees
-3
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal
5% Surcharge (.05 X total fees) S
AUTHORIZED iS NOT COMMENCED WITHIN 180 DAYS, OR IF Enter 2 S
CONSTRUCTION OR IA ORK iS SUSPENDED OR ABANDONED FOR 3 vi five A for $
bb' Enter
A PERIOD OF 180 DAYS AT ANY 'TIME AFTE WORK IS R ;rat
R if required (5e�3) s
COMMENCED. U /��' _
S
'+",` "°`m'"`"om° Trust Account # Q �J
Balance Due
$ '4r-: