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~�u���~"_~�" "m"�~"�" ~�~~""�n~�=~=* PERMIT #: ELC97-0344
-_-.. 13125 SW Hall Blvd., Tigard, OR87223 (503)639-4171 DATE ISSUED: 06/06/97
PARCEL: 2S114D0-00101
SITE ADDRESS...:17005 SW 92ND AVE
SUBDIVISION ^ ZONING:R-4.5
BLOCK ^ LOT ^ JURISDICTION: TIG
Project Descript ion : Installing temporary service Tigard Festival of Balloons
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS
1000 SF OR LESS ^ 0 0 - 200 amp • 1 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.: 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 >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner: FEES
type amount by date recpt
PRMT $ 50.00 DRA 06/06/97 97-295580
5PCT $ 2.50 DRA 06/06/97 97-295580
Phone #: '
Contractor:
EVENT LIGHTING SERVICES $ 52.50 TOTAL
DARREN M ERICKSON •
1115 SW 78TH ST REQUIRED INSPECTIONS
__
TIGARD OR 97223 Elect'l Service
Phone #: Elect'l Final
Reg #..: 011511
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 .C1400.444
than 18N days. fi 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: .ON �� Y ���^ ' DATE:
LICENSE NO:
Call for inspection 639-4175
^ ' '
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Permit #
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development / � (��� Number of Inspections per permit allowed
Name (or name of business)116Ko I !-`x V -0 '!r'r Service included: Items Cost Sum
Address COOK il`` f It 4 / 7aa5 � tO 94 A e . 4a. Residential - per unit
City /State /Zip '7 l'b A C 2.6 GO N Each additional it or less $11 0.00 4
Each additional 500 sq. ft. or
Commercial El Residential El Limited 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 all current licenses) L 4b. Services or Feeders
Electrical Contractor LQ r r e et - - t c k S 0 v1 Installation, alteration, or relocation
Address // / S Slit/ 7�'i-lt. / it -. 20 amps to or less $60.00 2
201 amps to 400 amps $80.00 2
City g 4 rot State 0 itZ, Zip Z Z 3 401 amps to 600 amps $120.00 2
Phone No. 3 9.3 9 X 1 601 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. 66 S r Exp.Date / / 9
OR State CCB Reg. No. 0/ / S7 / L/ Exp.Date '7/ /D/ 9 7 4c. Temporary Services or Feeders
COT Business Tax or Metro No. l Exp. ate Installation, alteration, or relocation ey
200 amps or less X $50.00 2
Signature of Supr. Elec'n, 7,ei.� 01 201 amps to 400 amps $75.00
2
401 amps to 600 amps $100.0100.0 0 2
- Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No.
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 $35.00 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 58.
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. S. Fees: 50 r D v
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ -A, SO
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 # 509N. ()
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: i' C ( - A.M. V P.M. MST:
Location: rook_ fWt.Ji,l� -- i / )O � 5 2,44 il BUP:
Tenant: Suite: q Bldg: MEC:
Contractor: f t- t(,CQ_ � & Phone: 7 p I 5500 PLM:
Owner: Phone: CO ��7 -O3 T
T
*-' `,p3-1_01-L eezie-00-7.1 e� ELR:
Ca- f ctJe /ST PO LE _ SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL SITE
Site Post/Beam Post/Beam Post/Beam • a f ■ 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 - ■ emp Service MISC.
Masonry Ceiling Rain Drain A/C • •
Shear /Sheath Fire Spkli /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Ap •v - Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ► . • ,. s oved Not Approved
FINAL FINAL FINAL F I • FINAL
___/e[ : Ste( l/ le - ' G tr �J
0
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Ins ctor: �� C / 9 !
Pe ���/ ( � �� _, ( /�'ZGL�,� Date: (� `- 7- ( 7 Page 1 of r
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10/7/99 Activities for Case #: ELC97 -00344
2:28:33 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received • 6/6/97 DRA PASS DST 6/6/97
ELCC003 Permit created 6/6/97 DRA PASS DST 6/6/97
ELCC799 Elect'I Final 6/6/97 6/9/97 MJR PASS J *H 6/17/97
ELCC500 (F)lssue permit 6/6/97 DRA PASS DST 6/6/97
ELCC800 Case Finaled 6/9/97 JMH PASS J *H 6/17/97
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