Permit r CITY OF TIGARD
ELECTRICAL PERMIT
^ i M i �� DEVELOPMENT SERVICES PERMIT
TSSUED� 9/98
PARCEL: 2S 101 BC- 0020x0
SITE ADDRESS...:08E05 SW HUNZIKER ST
SUBDIVISION....: ZONING:I —L
BLOCK........,,: LOT.............: JURISDICTION: TIG
Project De scr i pt i on : Add first branch circuit to an existing commercial tenant.
- -- RESIDENTIAL UNIT - - -- ----TEMP SRVC/FEEDERS--- • MISCELLANEOUS
1000 SF OR LESS....: 0 0 -- .200 amp.......: 0 PUMP/IRRIGATION....: 0
EACH ADD' L 5IZ+0SF...: 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 — 1 000 amp : 0 - - - - -- PLAN REVIEW SECT I ON- -__ —_.
1000+ amp /volt.....: 0 > =4 RES UNITS........: > 600 VOLT NOMINAL..:
Reconnect only . 0 SVC /FDR > = 225 AMPS..: CLASS AREA /SPEC OCC. :
Owner: _- —
POWER
POWER RENTS type amount by date recpt
8205 SW HUNZIKER PRMT $ 35.00 GEO 06/09/98 98- 306380
TIGARD OR 97223 SPCT $ 1.75 GEO 06/09/98 98- 306380
Phone #: _� �.- „/4„,--,_
_.
Contractor: �'
ALLEN JOHNSON ELECTRIC $ 36.75 TOTAL
P O BOX 411
REQU I RED I NSPECT I ONS ---
AURORA OR 9700E Elect' 1 Service
Phone #: 551 -3101 Elect'l Final
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Reg #..: 000348
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 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 958 - 001 -0010 through OAR 958 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5031846 -1987. #7 /
Permittee Signature: 25: 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 INSTALL ION ONLY --
SIGNATURE OF SUPR. ELEC' N : , DATE: _4 j
LICENSE NO: ,76 -S' _ ___
++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + ++ ++ + + + + + + + + ++ + + + + + + + +++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + ++ + + + ++ + + + + + + + + + + ++ + + + ++
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CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Reed
Date to P.E.
Phone (503) 639-4171, x304 Print or Type Date to DST
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit # Q� - O 3/F--
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development � � Number of Inspections per permit allowed
-
Name (or name of business) t2 4 Zolon0 Service included: Items Cost Sum
Address c?rZ S 5'1` / /./42• N J ! i�Z 4a. Residential - per unit v
1000 sq. ft. or less $110.00 4
City/State/Zip 7 � / � p� / � 2_2_3 Each additional 500 sq. ft. or
Commercial ® Residential ❑ portion 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 / a current licenses) .i . 4b. Services or Feeders
Electrical Contra to -47//n,- s ice' GG //L, `6_ Installation, alteration, or relocation
200 amps or less $60.00 2
Address ®/ o X A -��i 4-4- a2 97 4, ° _ 'Z 201 amps to 400 amps $80.00 2
City . f 7,1i / State eiC. Zip 77 1- Z.3 401 amps to 600 amps $120.00 2
Phone No. 6 <1- 3 /ca/ 601 amps to 1000 amps $180.00 2
Job No. •-' Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 02 "/ ;�� e Exp.Date I/0 /- RP' Reconnect onl $50.00 2
Y
OR State CCB Reg. No. 3 7,'/7 Exp.Date - 9e 4c. Temporary Services or Feeders
COT Business Tax or Metro No. / o `! 9 Exp.Date 7"/ - 17 Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 0 .rni,_.� 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 ...-1-6 o Z S Exp.Date / ®' C 0 see "b" above.
Phone Nc .4, 31 v I
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. v✓
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 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
l/ 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 $ 7
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
sb. 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 # $ LZ.,
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
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7/18/99 Activities for Case #: ELC98 -00317
6:08:02 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 6/9/98 GEO RECD DST 6/9/98
ELCC003 Permit created 6/9/98 GEO DONE DST 6/9/98
ELCC500 (F)lssue permit 6/9/98 GEO PASS DST 6/9/98
ELCC799 Elect'I Final 6/11/98 CD PASS J *H 6/11/98 wiring to propane dispenser
ELCC799 Elect'I Final 6/11/98 CD PASS J *H 6/11/98
ELCC800 Case Finaled . 1/13/99 JT 1/13/99
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