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Permit r . ./ ELECTRICAL PERMIT ^ ^�� I TY � � � ��v� � � ������=�����m�n DATE ISSUED: 698/30/96 : °• ' COMMUNUTY DEVELOPMENT DEPARTMENT � 1o1csnvv*^xo*u Tigard, Oregon 97223.8199 (503) \ Blvd. ' PARCEL: 1S135AB-00100 / SITE ADDRESS...: 10255 SW 90TH AVE SUBDIVISION....: TOWN OF METZGER ZONING:R-4.5 � BLOCK..........: LOT .5 Project Description: MAINTENANCE OF FLOURESCENT LIGHTING FIXTURES, CHANGE—OUT LAMPS AND BALLASTS AS NEEDED, ESTIMATE OK PER MIKE RUDD. _ _ _ _ _______ _ ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS 16900 SF OR LESS. ... : 0 0 — 200 amp.. ..... : 0 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.: 1 PER HOUR...........: 0 401 — 600 amp......: 0 EA ADD'L BRNCH CIRC: 43 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 ----- TIGARD—TUALATIN SCHOOL DIST type amount by date recpt 23J PRMT $ 250.00 JMH 08/30/96 96-283458 13137 SW PACIFIC HWY 5PCT $ 12.50 JMH 08/30/96 96-283458 TIGARD OR 97223 Phone #: 620-1620 Contractor: — — — ------------ ENERGY SERVICES LLC $ 262.50 TOTAL P 0 BOX 1062 — REQUIRED INSPECTIONS ------- HAILEY ID 83333 Ceiling Cover Elect'l Final Phone #: 208-788-1137 Elect'l Service ____ Reg #..: 114958 • . 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 plaos. This permit will expire if work is not started , / . ` � within 180 days of issuance, or if work is suspended for more 41 ^~ ~ 4 j ~�' than 180 days. sued By ---- --OWNER INSTALLAT�� ONLY---- -- --------- The installation is being made on property�� own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ ___ __ ------CONTRACTOR INSTALLATION ONLY ----- --- SIGNATURE OF SUPR. ELEC'N: _ __ DATE: LICENSE NO: ___ ___ ____ ____- Cal for inspection — 639-4175 ^ .. Community Development . ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # 1.0 6 Q5 b7 , ��, Date Issued OR 00/ 96 � . I Phone (503) 639 -4171 CITY OF TIGAItD FAX (503) 684 -7297 • _ TDD No. (503) 684-2772 -__ _ __ ___ Inspection (503) 639 -4175 - - -- - - . - 1. Job Address: 4. Complete Fee Schedule Below: Name of Development L1 `) L" E I e- "-"- ~ -•'-7 Number of Inspections per permit allowed Address (to 2 SS . 1......3 ' ©. /4. ,...-o_ Service included: Items Cost(ea) Sum City/State/Zip - T . ; c £# i 0 /2 4a. Residential - per unit 1000 sq. ft. or less $110.00 . 4 Name (or name of business) Each additional 500 sq. ft. or portion thereof $25.00 Commercial Rz Residential ❑ Limited Energy $25.00 1 Each Manurd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Electrical Contractor EKt-')7 S.." ,c - L tC 2 Inataf�tbn,alteration,�nslocation � ' 200 amps or less S60.00 ' Address ` 6;a Po 13 6,r. (v „G__. 201 amps to 400 amps $80.00 2 City 44 + L.. State TD_ Zip 4 3 'i ; 401 amps to 600 amps $120.00. 2 601 amps to 1000 amps $180.00 2 Phone No. ' Z c -- 7 .t" j- t i 17 Over 1000 amps or volts $340.00 2 Job NO. Reconnect only - S50.00 2 - contractors license NO. 74' L S 4c. Temporary Services or Feeders Contractor's Board Reg. iVO. // S'd` Installation, alteration, or relocation Signature of Supr. Eiea: n 4 _, 200 amps or less 2 License No. Phone No. 2 0,f-7,14.--//32 201 amps to 400 amps $50.00 2 401 amps to 600 amps $75.00 Over 600 amps to 1000 volts $100.00 . 2b. For owner installations: see le above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per pane Address a) The fee for branch circuits with City State Zip pruchase of service or feeder fee. 2 Each branch circuit $5.00 Phone No. b) The fee for branch circuits wi hout The installation is being made on property I own which is purchase of service or feeder fee. f 2 First. branch circuit =to ' 3 f 2 not intended for sale, lease or rent. Each additional branch circuit " t r _ $5.00 s-- - Owner's Signature 4e. Miscellaneous t �U_ (Service or feeder not included) 2 Each pump or irrigation circle $40.00 2 - 3. Plan Review section (if required): Each sign or outline righting $40.00 Signal circuit(s) or a Whited 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) 5100.00 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 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 $ 2 00 5% Surcharge (.05 X total fees) $ /.. . 50 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ,--2-6, a. SO 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. -°a o- ❑ Trust Account # P..17 $ v. Balance Due $ 5/12/99 Activities for Case #: ELC96 -00567 9:45:26 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC500 (F)Issue permit 8/30/96 JMH PAID J *H 8/30/96 RECD /CREATED TODAY, ISSUED TODAY. ELCC800 Case Finaled 9/5/96 MJR PASS MJR 1/8/97 • Page 1 of 1