Permit CITY OF TIGARD .
. "
& DEVELOPMENT SERVICES ELECTRICAL PERMIT
I �jl�� PERMIT #:. ELC98 -0752
---. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/31/98
PARCEL: 2S104AB -04700
SITE ADDRESS „..:12256 SW 135TH AVE
SUBDIVISION....: ZONING: R -4. 5
BLOCK ....... ...° LOT .............. JURISDICTION: TIG
Project Description : OUR REDEEMER LUTHERAN CHURCH monument sign
- -- 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..: 1
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. : 0 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 > = 2.25 AMPS..: CLASS AREA /SPEC OCC. :
Owner : ---- -• - - -- FEES
OUR REDEEMER LUTHERAN CHURCH type amount by date recpt
12256 SW 135TH AVE PRMT $ 40.00 DRA 12/29/98 98 -- 311784
TIGARD OR 97223 SPCT $ 2. 00 DRA 12/29/98 98- 311784
Phone #:
Contract or:
RAMSAY SIGNS $ 42.00 TOTAL.
9160 SE 74TH AVE
REQUIRED INSPECTIONS - r -.___-
PORTLAND OR 97206 Elect'1 Service
Phone #: 777 -4555 Elect'l Final
Reg #..: 000634
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 app owed plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more th 180 d s. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules .e set orth il l'R 952 -081 -0010 through OAR 952 -001- 987. You may obt G --/
of these rules or direct questions to OUNC b; callin (503) 46 -19
- / 'fir
Permittee Signatur- ° - ii 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 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++- h++++++++++++++++++++++++++++++++++++++++ ++ +++ + + + ++ ±++ +++ + ++++ + + + ++ + ++ ++
Community Dev ELECTRICAL PERMIT APPLICATION - 7.-- L.
r 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
/ i l Permit # e�--c -0
, �i Phone (503) 639 -4171 Date Issued / 3 / .
4 1 1 . - ? -.. FAX (503) 684 -7297 I
CITY OF TIGARD TDD No. (503) 684 - 2772 Issued by - i /'_� 70 %7 -
Inspection (503) 639 -4175 r
■
1. Job Address: 4. Complete Fee Schedule Below:
Name of Developmentl)u.e 47rzeFI / 6e. 447AI. Number of Inspections per permit allowed
Address /,220 A.2 /J5 ' Service included: Items Cost(ea) Sum
City /State/Zip_1 E )A f 7„r,..?if 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Each portion r sq ft. or
portion thereof f $25.00 1
Commercial ❑ Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor /,Ir7.5,0,/ c 5 /✓ S 200 amps or less $60.00 2
Address ,/de) 7 77‘ � (/ 201 amps to 400 amps $80.00 2
City /2 TXA./ a State/) Zip 97o2d6 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. 7 7 7 - ySS.S- Over 1000 amps or volts $340.00 2
Contractor's License No. ..?l, : L',CS Reconnect only $50.00
Contractor's Board Reg. No. 4.?'y�Z 4c. Temporary Services or Feeders
g p ( ��/ J
Installation, alteration, or relocation 2
Signature of Su r. Elec GC/� 200 amps or less $50.00 2
License No,�97 , Phon o. S 7 7 7 -51 -13-0- 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b` above.
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The lee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
. Phone No. b) The tee 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 $35.00 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 $46.00
C 2
O
Each sign or outline lighting T $40.00 44 , -
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 ins $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:
00
NOTICE 5a . Enter total of above fees $ 2' - /
5% Surcharge (.05 X total fees) $ .? -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 442 e!2
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 $ ..0 ° d
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