Permit CITY O TIGARD ELECTRICAL PERMIT
PERMIT #: ELC98 -0116
�� � ` ; I ;1 DEVELOPMENT SERVICES
ACES
:„. DATE ISSUED: 03/11/98
� PARCEL: 15135BC -00211
SITE ADDRESS...:1O765 SW GREENBURG RD
SUBDIVISION ZONING:C —G
BLOCK...........: LOT - JURISDICTION: TICS
Project Description : 7 -11 Install one branch circuit.
- -- 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/O 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
7 — ELEVEN (SOUTHLAND) type amount by date recpt
1,0765 SW GREENBURG RD PRMT $ 35.00 JSD 03/11/98 98- 304010
TIGARD OR 97223 5PCT $ 1.75 JSD 03/11/98 98- 304010
Phone #:
Contractor:
BECK ELECTRIC INC $ 36.75 TOTAL
9318 SE CHURCH ST
REQUIRED INSPECTIONS
CLACKAMAS OR 97015 Ceiling Cover Underground Cove
Phone #: 656 -7396 Wall Cover Elect'l Final
Reg #..: 000026
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 w approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more th 1 days. ATTENTION: Oregon law requires you to foll'' e rules adopted by
the Oregon Utility Notification Center. Those rul ' e se forth in OAR 952 - 001 -0010 through OAR 952 1 �!��•1'1•:. You may obtain a copy
of these rules or direct questions to OUNC y cairn (503)24 1987.
Permittee Signaturd Issued By:
. . Or .
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:
++++++++++++++++++++- I-+++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
(Are s .,
,. Tigard, OR 97223 Planck/Rec. #
x �•:-,, Permit # C k C t? �, 0//(0
-- ,1- -,.�14 Phone (503) 639 -4171 Date Issued 03// /rod/
FAX (503) 684 -7297 Issued by
CITY OF TIGARD
TDD No. (503) 684 -2772 �
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address
ss D ) (05 ,u) ( Service included: Items Cost(ea) Sum
City /State/Zi 3 O � 4a. Residential - per unit 4
\ l000 sq. ft. or less $110.00
Name (or name •f business) 9- Each additional 500 sq. e. or
portion thereof $25.00 1
Commercial r4 Residential ❑ Limited Energy $25.00
. Each Manuf'd Home or Modular 2
Dwelling Senrira or Feeder $58.00 •
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation • . 2
Electrical ontracto ., . J�, 200 amps or less $60.00 2
Address • Y -L. Jii■, 201 amps to 400 amps $80.00 . 2
Ci State • ! Zip ' • 401 amps to 600 amps $120.00 2
V P 601 amps to 1000 amps $180.00 2
Phone No. Q.5(0 - 1 • 0 Over 1000 amps or volts $340.00 2
Contractor's License No. C Reconnect only $50.00
Contractor's Board Reg. No. .. `! o •
9 - 4c. Temporary Services or Feeders
' W dM� Installation, amps or less $50.00 2
alteration, or relocation 2
Signature of Su r. El 1 i, 200 mps
License No. 1.....6.(..0- _ Ph, a No e , • - . • _ 201 s"'� t° 400 �"� $75.00 2
401 amps�o,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
Each branch circuit $5.00
Phone No. b) The tee for braneh.circuits without
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 c35 - 2
Each additional branch circuit • $5.00
Owners 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 on st ructure Mi nor 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 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 $ 3b. CO
•
5% Surcharge (.05 X total fees) $ 1
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ( p
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 S (D, 7 c)
esencomeesemoossess
o
/3260
072,
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 •
Date Requested: //� / .5-.2-7-7g A.M. P.M. MST:
(0
Location: 7(0 5 l &L1)1.:eC..ki buAqr BUP:
Tenant: '7 - I I / Suite: / Bldg: MEC:
Contractor: i�C � .•— (� Ct Phone: 6.6 ° 73 96 PLM: p
Owner: Phone: ELC: / ( ?'o 1
I bA(241--j`- Cr� ��/( ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ,ELECTRICA j SITE
Site Post/Beam Post/Beam PostBeam Cov z� 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 roved Not Approved
FINAL FINAL FINAL FINAL FINAL
/ - 6,.4 i a' — ::-j e r .0C12.71 t -1;7G',--e--e-- / H..J -r°
A-CS"
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•
• •
•
Call for reinspection Cl Reinspection fee of $ required before next inspection, Cl Unable to inspect
Inspector: Date: ) Z 7/9, Page of
.