Permit w '
ELECTRICAL PERMIT
CITY
OF TIGARD
DATE ISSUED: N8/13/96
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K��0U�y�K��0UTY DEVELOPMENT DEPARTMENT
~~'� ^~~~�~^ ~~' ^~' '~
1u^25mw*all Blvd. Tigard, Oregon 97223°8199 (503) 639-4171
PARCEL: 25111BA-04700
SITE ADDRESS...: 14025 SW 97TH AVE
SUBDIVISION....: OMEGA ZONING:R-4.5
BLOCK ^ LOT..... ........ :3
Project Description: Installing one branchcircuit for a Carrier air conditioner
to 3Hp.
_
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 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 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: 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: ---- — ------ FEES
MCPHILLIP type amount by date recpt
14025 SW 97TH AVE PRMT $ 35.00 CJS 08/13/96 96-282852
5PCT $ 1.75 CJS 08/13/96 96-282852
TIGARD OR 97223
Phone #:
Contractor: ---- — —
SUNSET FUEL CO ' $ 36.75 TOTAL
PO BOX 42287
2944 SE POWELL BLVD (97202) — REQUIRED INSPECTIONS -------
PORTLAND OR 97242-0287 Wall Cover Elect'l Final
Phone #: 503-234-0611 Elect'l Service _
Reg #..: 2374
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 18N 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 •
' '
t
r Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # Lr 9T- J 3 a_
mr �)f�l; Date Issued P - 13 - q-
�i�
Phone (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 Number of Inspections per permit allowed
Address I L 3L Q.--‘ 1 Service included: Items Cost(ea) Sum
City /State /Zip -\---\ C J�CJ' . CZ a ll a, 4a. Residential - per unit
U 1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residential Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
I nstallation, alteration, or relocation
Electrical Contractor �� LAO Installation, 2
200 amps or less
Addr9.‘sc 4 k -. Pc 201 amps to 400 amps $80.00 2
City ( ` ) ■- 0 -/N'\C State QC--- ZipG1 O - 401 amps to 600 amps No.,-P('51-4-00(t Over 10 to 1000 amps $180.00 2
601 Phone No.
Over 1000 0 amps or volts $340.00 2
` $50.00 2
Job NO. _ . 4� Reconnect only
contractor's license NO. ...- ‘%11.0_ u ) r 4c. Temporary Services or Feeders
Contractor's Board Reg. No. //� r l I alteration, or relocation
• Signature of S pr. El c'n �. .,,. 200 amps or less 2
License No. ?.".c ( 'Phone No. 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 without
The installation is being made on property I own which is purchase of service or feeder fee. a zz 2
, First branch circuit
not intended for sale lease or rent. $35.00 c.�'
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 $55.00
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 $ _00
NOTICE 5% Surcharge (.05 X total fees) $ 1 - - AS
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ (
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. word \comdev\eieo ❑ Trust Account #
$
prm.app
Balance Due $ c___,"0.--1
\SL4
CITY OF TIGARD BUILDING INSPECTION NOTICE t
Inspection Line: 639 -4175 Business Phone: 639-4171"
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing - Y ecli
PIbg.Und /Flr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in • Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other t / L 111./s4
� 7
Date: r. ' t A.M. P.M. A Entry
Address: 1 `f O Z S 7
Tenant: Ste: MST:
BU P:
Con /Own: MEC:
• PLM:
ELC: °f(, ",s ? r
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Ins ector: ` Date: __ ____ f _
APPROVED DISAPPROVED /CALL FOR REINSP. CF CO