Permit CITY OF TIGARD ELECTRICAL PERMIT
,, , „,\ DEVELOPMENT SERVICES PERMIT #: ELCS7 -0443
�� � I DATE ISSUED: 07/09/97
� .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1O3CD -00400
SITE ADDRESS...:13615 SW 115TH AVE '
SUBDIVISION ZONING:R -4.5
BLOCK ° LOT . JURISDICTION: TIG
Project Description: Install one branch circuit.
- -- 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 +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/0 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
ANDREW BITHER type amount by date recpt
13615 SW 115TH PRMT $ 35.00 DRA 07/09/97 97- 296944
TIGARD OR 97223 5PCT $ 1.75 DRA 07/09/97 97- 296944
Phone #: 624 -8578
Contractor: .
SHARPE ELECTRIC INC $ 36.75 TOTAL
22605 SW RIGGS
REQUIRED INSPECTIONS
BEAVERTON OR 97007 Elect' 1 Service
Phone #: 642 -7937 Elect' 1 Final
Reg #..: 000815
This peroit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This per ®it will expire if work is not started within 180
days of issuance, or if work is suspe•,•' for sore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. 'ose ules are set forth in OAR 952 - 001-8010 thr h OAR 952 -001 -1987. You say obtain a copy
of these rules or direct questio - to O 'calling (503)2),-1987.
Permittee Signature: ” �� �/ / sued By k , . . t'ik.t.-1/2_;
-• 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 SUP R. ELEC' N : Q .�:.161J�LY
LICENSE NO: !! J!J ( cl $- (u--y DATE:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++ E++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++
, ---
CITY OF TIGARD Electrical Permit Application Plan Chec /},
Recd B 0 b
, 13125 SW HALL BLVD. Date Rec'd ?-4 -97
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Permit # /_C9 7 -0V/4"3
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called ----
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 /� Number of Inspections per permit allowed
Name (or name of�bussiness)s) 1i1 j
°j � ccl / Til t' I �' Service included: Items Cost Sum
Address / c 40 _J ` t.) / (5 4a. Residential - per unit
�-�� 1000 sq. ft. or less $110.00 4
City /State /Zip / i C a Each additional 500 sq. ft. or
Commercial ❑ � ' d Residential Li portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of II urrent lice s ) / � 4b. Services or Feeders
Electrical Contracto 2 rfls.4rIG /N G Installation, alteration, or relocation
Addr4s )5 S A. 09 iet 200 amps or less $60.00 2
ty � 201 amps to 400 amps $80.00 2
Ci State 17 W Zip q - 717 0 7 401 amps to 600 amps $120.00 2
Phone No. 4 Y. - 7 - 3 '7 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No -.3-n Exp.Date • - -
OR State CCB Reg. No. S'I s l ' Exp.Date -6-q; 4c. Temporary Services or Feeders
COT Business Tax or Metro c Z 3/ Exp.Date - - ^9 a In stallation, alteration, or relocation
I�r 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec' ALMA.i.t,' 401 amps to 600 amps $100.00 2
License No. 3 3 Y I P �- �y Over 600 amps to 1000 volts, `� Exp.Date /0 - 93 see "b" above.
Phone No. (p y -7 73 7
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit l $35.00 ' SJL 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. 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 2
Minor Labels (10) $100.00
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 feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 5e 0L.
Not required for temporary construction services. 5a. Enter total of above fees $ T (/�
5% Surcharge (.05 X total fees) $ IM
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 75
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
! CITY OF TIGARD BUILDING INSPECTION DIVISION
/ 24 -Hour Inspection Line: 639 -41.75 Business Phone: 639 -4171
Date Requested: 7 , " / 7 A.M. P.M. MST:
Location: /36/5 . �) ///'' ,t" BUP:
Tenant: ,I , Suite: Bldg: MEC:
r ✓
Contracto . 't /1 _ r . / Phone: PLM:
Owner: 1 0 4 .112' " I Phone: 4 4f'_z -- 1 3 7 ELC: 97 i - 1 •
I '
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL — "Nk SITE
Site Post/Beam Post/Beam Post/Beam 'over/Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump . Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ...rm. e k. • ved Not Approved
FINAL FINAL FINAL . F I FINAL
`t-7) R tVftkl4y CP IN PR.7 vat —
G 11/ lZ - 3J AECo t-t t-t n/,O6.D -- ioAD AC •(..is s 4- A
A/ f S' ca /1/'/tr",. C j —
_....„..)
C
____
0 Call for reinspection 4 A O inspection fee of $ required before next inspection O Unable to inspect
Inspector: + Date: 7 _l (3 'L-1-1 l xt Page of
5/30/00 Activities for Case #: ELC97 -00443
2:47:57 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 7/9/97 DRA PASS DST 7/9/97
ELCA003 Permit created 7/9/97 DRA PASS DST 7/9/97
ELCA730 Elect'I Service 7/9/97 7/16/97 BRP PASS J *H 7/20/97 40 AMP MURRAY CB IN
PANEL - FLNR -35
RECOMMENDED - PROPER
FUSES ARE IN DISCONNECT.
ELCA799 Elect'I Final 7/9/97 7/16/97 BRP PASS J *H 7/20/97
ELCA500 (F) Issue permit 7/9/97 DRA PASS DST 7/9/97
ELCA800 Case finaled 7/16/97 BRP PASS J *H 7/20/97
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