Permit CITY TIGARD ELECTRICAL PERMIT
g & DEVELOPMENT SERVICES PERMIT #: ELC97 -0382
H r� DATE ISSUED: 06/17/97 7
'=-.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 291O3BD —HGOO5
SITE ADDRESS...:1254a SW 116TH AVE
SUBDIVISION - HUNTER'S GLEN ZONING:R -4.5 PD
BLOCK - LOT •005 JURISDICTION: TIG
Project Description: insti 1 branch circuit / /job # ?
- -- 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
BRETT SCHNEIGER type amount by date recpt
12537 SW 116TH AVE PRMT $ 35.00 TAT 06/17/97 97- 296083
TIGARD OR 97223 5PCT $ 1.75 TAT 06/17/97 97- 296083
Phone #:
Contractor:
JPC ELECTRICAL SERVICES INC $ 36.75 TOTAL
4120 SE INTERNATIONAL. WY
STE A -107 -- - - -• -- REQUIRED INSPECTIONS
MILWAUKIE OR 97222 Ceiling Cover Underground Cove
Phone #: 654 -3325 Wall Cover Elect' 1 Service
Reg #..: 093774
This permit 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 permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -10 through OAR 952- 001-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5 246 -1987.
Permittee Signature: Issued By: I / /T
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 : I ti /J� DATE: /-%
LICENSE NO: Iv .`
++++++++++++++++++++++++ + + + + + + + + + + + + + + + + +++ ++ + ++ ++ ++ +-I + + +++ + + + + +- + + ++ + + + + ++ + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
ra
Y Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
-, r° Tigard, OR. 97223 Planck/Rec. #
Permit # t-= �7
/ 1!" ' l � Phone (503) 639 -4171
FAX (503) 684-7297
Date Issued
6111/W i
O TI by TDD No. (503) 684 -2772 Issued b 1
Iv_], Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address la 3" a.,..) (1 to -Prot, Service included: Items Cost(ea) Sum
City/State/Zip C / C:1 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) t 3 J y wej -eis" Each additional 500 sq. ft. o r
t✓'
portion thereof $25.00 1
Commercial ❑ Residential ®-*--- Limited Energy $25.00
Each Maned Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
s Installation, alteration, or relocation 2
ElectricalContractori I
. 200 amps or less $60.00 2
y
Address �'12D 5E: 1 n l-eyyl o 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City �1 k I,c.� �ICa,e. St Cie Zi -I?2. 2
City 601 amps to 1000 amps $180.00
Phone No. (n ,3-3 Over 1000 amps or volts $340.00
Contractor's License No. 14. - 3'"j('', Reconnect only $50.00
- Contractor's Board Reg. No. 0 9 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
i✓�
Signature of Supr. Elec'n � 2
200 amps or less $50.00 2
201 amps to 400 amps $75.00
License No. 1 / No. 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b' above.
• 4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
ry p 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. 2
not intended for sale, lease or rent. First branch circuit 1 , $35.00 . 3.S7,- 05 ° . 3.S7,- 05 ° 2
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
the allowable in any of the above
Classified area or structure containing special occupancy
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:
NOTICE 5a. Enter total of above fees $ -
5% Surcharge (.05 X total fees) $ t 7S
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 Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ 3;7 S
wad`candaN.laopm.app
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 5-W
7 -.. cc', 6 1 7 /� A.M. P.M. MST:
Location: / a 5 4E' / / b-t CtOE J BUP:
Tenant: ` 1 Suite: Bldg: MEC: '
V
Contractor: Phone: 6 S 7` ` 3a5 PLM:
Owner: 6C1+01 S Phone: i■301J E C-rt UJ 97-6,58c. ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL C ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam - Cover/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 .,. — :._:.:. ed Not Approved
FINAL FINAL FINAL FINAL / FINAL
q a p. C 13 5-7- P /9- v r L —
•
C 1
•
O Call for reinspecti Reinspection fee of $ - required before next inspection O Unable to inspect
Inspector: Date: 7-,z1zG Page of