Permit CI -TY OF TIGARD . ELECTRICAL PERMIT
PERMIT #: ELC2003 -00473
�l�l DEVELOPMENT SERVICES DATE ISSUED: 8/1/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
10253 90th 14-vg" PARCEL: 1S135AB-00100
SITE ADDRESS: 1 62.55 -SW 90TI I AVw
SUBDIVISION: TOWN OF METZGER ZONING: R
BLOCK: LOT : 005 JURISDICTION: TIG
Project Description: Relocate (3) services for portable classrooms that have been relocated.
Job No: 420603 -88136
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS • ADD'L INSPECTIONS
0 - 200 amp: 3 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON CLACKAMAS CO BROADWAY ELECTRIC - COCHRAN INC
SCHOOL DIST 23J 626 SE MAIN
6960 SW SANDBURG STREET PORTLAND, OR 97214
TIGARD, OR 97223 •
Phone: Phone: FAX 238 - 2098
Reg #: 214 -6564 00072942
SUP 3447S
FEES ELE 37 -546C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/1/03 $240.90
[TAX] 8% State Tax 8/1/03 $19.27 Elect'l Service
Elect'l Final
Total $260.17
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR •. -0: -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
1- 800 -33. 344.
Issue • By: • t o , 44/ // . i L Permit Signature: / // �� 4 vor-iej--L.,
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: -P-� ��'; DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
Auc 01 03 11:26a COCHRRN BROADWAY (503)238 -2098 p.1
t38■
It
]Electrical Perm t
,, A : - U U . Datereceived: Permit no.: Eu 1 -c '73
' •,I 1? City of Tigard 1\1‘cl (1 T Project/appl. no Expire date: .
City of Tigard Address: 13125 SW Hall Blvd, Tigard; O R9722230) Date issued: By: 1 Receipt no.:
Phone: (503) 639 -4171 -. y 0 1v k S kON
C`
Fax: (503) 598 -1960 �� ® ,� G 0 Case file no.:.. Payment type: .
•
Land use approval:
-- Al. 7 04;'03 - 049 390 :
TYPE OF PERMIT - —
CI 1 & 2 family dwelling or accessory preommercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction Cl Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFORMATION .
Job address: -s / 'AO 1 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: 'Subdivision: Wit/ ,{,�..E-er ,--
Project name: Description and location of work on premises Q I ,4 77 m 4,2 R %dssi
Estimated date of completion/inspection: .1E6-- "7-�O
CON% R ACTOR APPLICATION FEE S('IIEDULE `'
Job no: 2,46 663e i /g4, . tee MX(
Business name: 13 j�ir = ( G t t� +� �G7hG
Description Qty. (ea) i Total no. Islip . New residential - single or multi - family per
Address:
� l/ - - dwelling unit Includesattached garage.
City: /d r / I StateeA. ZIP: 9 7 2_ 19 Serviceincluded:
Phone:�34 _ �� I Fax;2,3 249TE -mail: 1000 sq. ft. or less 4
CCB no.: ? Z 9 iCy I Elec. bus. lic. no: S17-54(6, Each additional 500 sq. ft or portion thereof
Limited energy, residential 2
City /melt c. o.: _ Limited energy, non- residential 2
.0--/-;e5,4 Each manufactured home or modular dwelling
Signature of supervisttlg electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): .�v■t ..• License no: 3 --1.5 Sern lion or eeders- installation, -
PROPERTY OWNER aiteradoaorrelowtion 2
200 amps or less
Name (print): T It -d - 77 t a_14 e 2 201 amps to 400 amps 2
!f 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnectonly I
Owner installation: The installation is being made on property I own Temporary services or feeders - , .
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP B. Fee for branch circuits without purchase
Phone Fax: E-mail: service or feeder fee, first branch circuit: 2
Each additional branch circuit
PLAN REYH :% %'(Please check all that apply) Misc. (Service or feeder not included):
0 Service over 225 amps - commercial Cl Health -care facility Each pump or irrigation circle 2
0 Service over 320 amps - rating of 1812 0 Hazardous Location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration. or extension' 2
0 Building over three stories 0 Feeders. 400 amps or more 'Description: _ -
0 Occupant load over 99 persons 0 Manufactured structures or RV paric Et ch additional Inspection over the allowable In any of the above:
0 Egress/lighting plan 0 Other. Per inspection I
Submit sets of plans with any of the above. " Investigation fee 1
The above are not applicable to temporary construction service. Other
N W,alt iunsdic ions accept credit cards. please call jurisdiction for more information. Notice: This permit application Permit fee $
visa 0 M °• .� _ I ',:. - �-� --- expires if a permit is not obtained Plan review (at %) $
Credit emd . - -- _ ` -- r �-• - within 180 days after it has been State surcharge (8%) .... $
e �s l /A dbq .' • - q/ €4,2S -: 17 accepted as complete. TOTAL $ - `
m
of ol as slider on credit card
Cardholder signature Amount / 440-4615 6900/C0M)
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