Permit ' -
CITY OFTIGARD
` DEVELOPMENT ELECTRICAL PERMIT
|� ===~��~u�~�. .°.m�.� . SERVICES -������� PERMIT #: ELC96-0776
�+ ' ��~ /3/2;SN/ Hall Blmd.,7��oi�R�72�� �U3 ����7/
Tigard, ' DATE ISSUED: 12/10/96
• PARCEL: 2S101BC-02800
SITE ADDRESS.— : 08250. SW HUNZIKER RD ' • •
•'' '^ • • • • --'' • • ''° • • •• , • • ZONING:I -L
'BLO0K.. ...... ..: LOT.............:
Project-Description: Installing first branch circuit and two add' 1- circuits
---RESIDENTIAL UNIT---_ ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS
'1000' •SF OR LESS. . . 6 : 0 0 - 200 amp. . . . . . . : 0 ^ PUMP/IRRIGATION. . . . : 0
EACH' ADD' L 0 • ' 201 - 400 amp; . . . . 0 SIGN/OUT LINE LTG.:. : 0
LIMITED ENERGY. — : 0 401 - 600 amp....... : 0 SIGNAL/PANEL....... : 0
MANF. • HM/ •• 601+amps-,1000 volts. ' MINOR LABEL (10). .
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
0 - 200 amp. —.•... : 0.v W/SERVJCE ORFEEDER:. 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.: • 2 IN PLANT.., ^ 0
601 - 1000 amp.....: 0 PLAN REVIEW SECTION
1000+ amp/ 0 �� ' >.=4,,RES . >^ 600' VOLT NOMINAL.. :
Reconnect only..,..: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
� ,
WESTSIDE DRYWALL type amount by, date recpt
^ 8250 :SW. HUNZIKER RD �� ��r' �"� ', ' ',��^�. ^v-`,!�RMT^$. .~ 45~00: .�2110/96 96-287482'
5PCT $ 2.25 B 12/10/96 96-287482
TIGARD, OR 97223
Phone #:
•
Contractor: - --- -
ALAN FITCH ELECTRIC $ 47.25 TOTAL
25973 S MOEHNKE.
„ ` ` REQUIRED INSPECTIONS
BEAVERCREEK OR 97004 Ceiling Cover Underground Cove
- � � -Wall Cov-r ' Elect Geo^vioe
Reg #..: 001068 .
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\^ ^ �
This permit *�
is is�oed jectto the�egulat�nuc D
ontaioed,�~ ho.
Tigard PlunicipalAode, State )of Ore Sodes 'other,' , Perm ittee Signature
applicable laws. All work will be done in accordance with
approved plams.' This permit Will expire 'if''work.is*ot'stant�d.^,,, '
within 180•ays of iosoance,'or if work is sospendodIor:more''' %A Ai J� ' ' 1--
than 18N davu' • • Issued Byi„_i
OWNER INSTALLATION ONLY
The installation is being ,mad:p' property,-,I own which is�not�in�ended�for
sale, lease, or rent.
OWNER SIGNATURE••, ~ ' • •• ' ' ., � DATE _, :
CONT INS °L| ONLY-------------
^
/ � -��
SIGNATURE' OF. SUPR. ELEC'N: ,
• ~� ���� � ' w�/� DATE: ^' ->[n
LICENSE NO:
• • • `. � `.` ` Cal for , i.n spect
w
eITY OF TIGARD Electrical Permit Application Plan Check
13125 SW HALL BLVD. Rec'd By t.--
TIGARD OR 97223 Date Recd Z I?
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # E -C 67 - - Y - G`7
Fax (503) 684 -7297 p g Called 6. /1
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development . Number of Inspections per permit allowed
Name (or name of business) UV ` .-5 T 5 \ 6 e ) � o A-1.. i__ Service included: Items Cost Sum
Address $ r--`)0 S .w . 1-1 .1 A ;
-c -1 1� - r' -- +��Dr, ? 4a. Residential - per unit v
1000 sq. ft. or less $110.00 4
City /State /Zip 1 I c ) J am b 0 2 _ Cl }Z . 3 Each additional 500 sq. ft. or
El Limited thereof $25.00 1
Commercial EC Residential
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses)
N p - . - `c-- - ( - N F--1.,Q r,, Installation, alteration, or relocation
Address 7 - 5 . 1M v �i-} ►J 1'-E_ CT, 20 amps to or less $60.00 2
201 amps to 400 amps $80.00 2
City'5e-,A -‘) -C, u -t - State Ott_ Zip 1 1.- 401 amps to 600 amps $120.00 2
Phone No. • to' 7 - 4 - 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3-3 &1-C- Exp.Date t% -1 -9 Reconnect onl $50.00 2
OR State CCB Reg. No. o 10 t_oT g-z- Exp.Date to h `I 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 41,21/17 Exp.Date 1.1- -lo -0 t. -- Installation, alteration, or relocation
� ( P 200 amps or less $50.00
$75.00 2
Signature of Supr. Elec'n tCJ "t\cA .../ / / 201 amps to 400 amps 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 3q'2...-\5 Exp.Date 1.17 -) - 1 `6 see "b" above.
Phone No. b 3 L -4-1-8
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.
First branch circuit l $35.00 357 2
The installation is being made on property I own which is not Each additional branch circuit 2 $5.00 I n . - 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 $ 45-,
5% Surcharge (.05 X total fees) $ Z • 2'5-
NOTICE • Subtotal $ y • q"• zS
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. El Trust Account # $ r 1 , Z "
Total balance Due ' l
1: \DSTS \ELC96.APP Rev 9/96
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 /Flr /Slab Plbg. Top Out Insulation3
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: , IA / / L =2_0/ y, 10P
Date: I 1 A.M P.M. try:
Address: 0 ! �/1 Q
Tenant: .y - 1:- -/ Ste: .0 MST:
/ - � BUP:
Con /Own: �� ✓/ �, MEC:
PLM:
ELC: I,O AY -
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
-/9 - ? 7 A-' - rice
r 7
Inspector: C CMG e- I �l Lt /".�� Date --1° —r 7
/APPROVED DISAPPROVED /CALL FOR REINSP. CO