Permit CITY OF TIGARD
Ac• DEVELOPMENT ������Uo�����
�~�����"�" .°.�.� u ~��."�.~����
A' �� 13125 SW Hall 8lvd' Tigard, CR97223 (503) 639-4171
ELECTRICAL PERMIT
PERMIT #: ELC97-0148
DATE ISSUED: 04/15/97
PARCEL: 2S111CC-09601
SITE ADDRESS...:15740 SW GREENS WAY
SUBDIVISION ^SUMMERFIELD NO.2 ZONING:R-12
BLOCK ^ LOT .............:123 JURISDICTION: TIG
Project Description: lNSTL 1 88ANCH [%RCUIT •
_
---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..: 0
LIMITED ENERGY - 0 401 - 600 amp.......: 0 GIGNAL/PANEL.... • 0
MANF. HM/ SVC/FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10). . . : 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
@ - 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
YVONNE MARCELLIUS .type amount by date recpt
15740 SW GREENSWAY PRMT $ 35.00 TAT 03/12/97 97-291580
TIGARD OR 97223 • 5PCT $ 1.75 TAT 03/12/97 97-291580
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 36.75 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS ----�
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 503-684-3600 Wall Cover Elect'l Service
Reg #..: 052288
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 184) days of issuance, or if work is suspended for more
than days. 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 for inspection 7 63974175 ~^
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
Ato 'I � 13125 SW Hall Blvd., Tigard, OR 97223 503) 639 -4171 D PERMIT S > DLCO3 / 12 / 8
� DATE ISSUED. 03/12/97
PARCEL.: 2S111CC -09601
RITE ?DURESS.. 1 e 157k'2 SW GREENS WAY
SU6DIVISIC'�:= a n o s
SUMMERFIELD N22 ZONINGsR -12
B OC.oan.o.a..o LOT ..............123
Project Descriptions INSTL 1 BRANCH CIRCUIT
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS.. -as 0 0 - 200 amp.......: 0 PUMP /IRRIGATION.,...: 0
EACH ADD'L 500SFoo.s 0 201 - 400 amp.......: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY... -=s 0 401 - 600 amp... -...: 0 SIGNAL /PANEL.......: 0
MANF. HM/ SVC /FDR.. s, 0,, 601+amps -1000 volts.: 0 MINOR LABEL (10) ... s 0
----SERVICE/FEEDER---- - - -- BRANCH CIRCUITS----- -- -ADD'L INSPECTIONS-- -
0 - 200 ampsoae..: 0 W /SERVICE OR FEEDER: 0 PER INSPECTION - - --; 0
201 - 400 amp. -.. - -s 0 1st W/O SRVC OR FDR.s 1 PER HOUR........._.: 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT- noo- n.n.aws 0
601 - 1000 amp--; 0 -- -- PLAN REVIEW SECT I ON - ---.-
1000+ amp /volt.....: 0 > =4 RES UNITS........: > 600 VOLT NOMINAL..:
Reconnect on 1 v- e ... s 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC. s
Owners - FEES
YVONNE MARCELLIUS type amount by date recpt
15740 SW GREENSWAY PRMT 35.00 TAT 03/12/97 97- 291580
SPCT $ 1.75 TAT 03/12/97 97- 291580
TIGARD OR 97223
Phone #:
•
Contractor:
PHOENIX ELECTRIC CO $ 36.75 TOTAL
7379 SW TECH CENTER DR.
REG!U I RED INSPECTIONS ---
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 503- 684 -3600 Wall Cover Elect'1 Service
Reg #.. s 000026
/
This parait is issued subject to the regulations contained in the � �../,
Tigard Code, State of Pre. Specialty Codes and all ,o &r - Permit i .Signature
applicable laws. All work will he done in accordance with r�
approved plans. This permit will expire if work is not started ��'��
within 1@ days of issuance, or if work is suspended for core /.
than tE days. 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 s.
- - -- - - - -- CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. E LEG' N s ,DATE:
LICENSE NO:
Call for inspection - 639 -4175
- . ---- -_ - -
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: q h/ ` / Gr7
A.M. P.M. Entry J1
Address: / S7 %
Tenant: Ste: MST:
BUP:
Con /Own: f/14 E ' MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
r/1 0'c -2 (4, icy
•
Inspector: 741/ c•4,9 f' 7 f t -/e( Date: / 1"" / �f 7
APPROVED DISAPPROVED /CALL FOR REINSP. CO
c,.TY 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 D ate to DST
Print or Type ,
Inspection (503) 639 -4175 Permit # a �}� iaa 1
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development A / 41 . j. _ -L _ . A Number of Inspections per permit allowed
Name (or name ff of '' business) /+ Service included: Items Cost Sum
Address \ S i40 51� ("' )('S • \ 4a. Residential - per unit
, ., �,,�,, G�-� 1000 sq. ft. or less $110.00 4
City /State /Zip \\ \ (:)(7_ . t 1 Each additional 500 sq. ft. or
Commercial ❑ � v� Residential portion thereof $25.00 1
Limited Energy $25.00
� ` C9 1-..! raPNc.12_ Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy • - current license ) 4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor �a : •.% • e•u . +.e! .... 200 amps or less $60.00 2
Address _r ��� 201 amps to 400 amps $80.00 2
City � na State 0< Zip - 7-3 n 401 amps to 600 amps $120.00 2
Phone Nth) (a K . - itlf) 601 amps to 1000 amps $180.00 2
Job No. ■a .h-e._ us ____. '. -.?-L, • T Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Co t. Lice. No. I IL Exp.Date 10 ,
OR State CCB Reg. No. S Exp.Date 19- a3 17 4c. Temporary Services or Feeders
COT Business Tax or Metro No.97 -S1(ast Exp.Date / 31/i 7 Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec 'n 0 - 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 1 -1/ ( 4 6 S" Exp.Date see °b" above.
Phone No. (QW ''' ( /Q5 )
-,_ 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 circ $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 S.Soo 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 5B.
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. 5. Fees :
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ '• 7 S
NOTICE Subtotal $ ° ' 7
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 # 75-
Total balance Due $
1:1DSTS \ELC96.APP Rev 9/96