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Permit
CITY OF T D /aA, „ ELECTRICAL PERMIT o , ,„ DEVELOPMENT SERVICES PERMIT #: ;�LCR7 -0516 �l�� DATE ISSUED: 07/.31 /?7 _ = -.. _13125 SW Hall Blvd., Tigard, OR_97223 (503)639-4171_ • _ __ _ _ _ _ PARCEL: 25103CB -01600 SITE ADDRESS...: 12320 SW JAMES ST yd�p y SUBDIVISION. n . . :WILLAMETTE 7ON I NG: R -4. 5 BLOCK........... LOT ............. :41 JURISDICTION: URB Project Descript ion: installing service or feeder to 200 apps and two branch circuits -- RESIDENT I AL UN I T - - -_ -- -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 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......: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION.....: 0 201 -• 400 amp......: 0 1st W/O SRVC OR FDR.: 0 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 - - -- ,.-- --- -- MARILYS WALKER type amount by date recpt . 12320 SW JAMES ST PRMT $ 60.00 B 07/31/97 97- 297331 TIGARD OR 97223 SPCT $ 3.00 B 07/31 /97 97- 297831 Phone #: Contractor: -- - •-- - - - - -- MILLENNIUM BUILDING SERVICES I $ 63.00 TOTAL DBA OREGREEN ELECTRICAL CONST CO - 1414 N MASON - - -- REQUIRED INSPECTIONS PORTLAND OR 97217 Rough—in Elect' l Final Phone ##: 281 -1949 Elect'l Service _ Reg #..: 003635 This peroit 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 peroit will expire if work is not started within 180 days of issuance, or if work is suspended for pore than 180 days. A TENTICN: Oregon law requires you to fallow the rules adopted by the Oregon Utility Notification Center. Those rules .t fort'.. OAR 952-0014010 through OAR 952 -001 -1987. You pay obtain a copy of these rules or direct questions to OUNC by ___,..., :0317 -' ° . sued By :k 4 ---J _ Ilr ------ .---- _-------- .----- - - - - -- 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: 1)� _/ or• �J L« _ DATE: __ LICENSE NO +-l--i ++-t--1--1 + +++ ++++++ ++-l--a-i••-l--1 -++ +-i + +-3-+-i•• + ++ +++ + ++ ++ ++-F•-f +++++++++ +++++-i--i- ++ +-l--t--t- ++ + + ++ ++ Call 639-4175 by 6 :00 D. m. for an inspection needed the next business day -F +- i -++ ++ - ++ ++ + + ++ + + + +++ ++-I-+ : -t--( + + ++ ++ ++ ++ ++ +-F-:.-l--l--i• + ++ +-I--:•-i--l-++ +-I + + +-f + +++ ++ +-4--1-r` + + ++ Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. /� t" - Tigard, OR 97223 - - Permit -# "/ 7- 05-(co ,A,,,„,,,44,,, Date Issued 1'' 3 I - 1'7 _�� �� Phone (503) 639 -4171 CITY OF TIGARD FAX (503) 684 -7297 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 / 3 .2 0 �' IL) - -7 /-} -Flis e �o' Service included: Items Cost(ea) Sum City /State /Zip 77 Ci /442 0 0 1 9 /7 Z 4a. Residential - per unit //'' / 1000 sq. ft. or less $110.00 4 Name (or name of business) A/4/ ER__ Each additional 500 sq. ft. or portion thereof $25.00 Commercial 17] Residential R Limited Energy $25.00 Each Manufd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Cnstallation only; p /� n : M , / Contractor ,v A , , 4 ,r., ((dd S I, e . '7 4b. Services or Feeders Electrical Contractors ftC" R £ -' t /L& .. Co e4.s.7 k , I alteration, or relocation 2 Z 200 amps or less $60.00 Address / 4/14 3©N s7" 201 amps to 400 amps $80.00 2 City R°tL State C' 12. Zip 9 �� 401 amps to 600 amps $120.00 2 y ' Ply - p 601 amps to 1000 amps $180.00 2 Phone No. „Z,Y,F- / c 6 Over 1000 amps or volts ' $340.00 2 Job NO. Reconnect only $50.00 2 contractor's license NO. 3 4" S6 4c. Temporary Services or Feeders Contractor's Board Reg. No. • Installation, alteration, or relocation s 2 Signature of Supr. Elec'n', W2r 200 amps or less 201 amps to 400 amps $50.00 2 License No. �G,( S' Phone No.`2 cs'."/ - y • 401 amps to 600 amps $75.00 2 Over 600 amps to 1000 volts $100.00 . 2b. For owner installations: see "b" above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per pane Address a) The fee for branch circuits with purchase of service or feeder fee. d e 2 City State Zip Each branch circuit $5.00 / Phone No. b) The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 2 Each additional circuit brt $$5.00 not intended for sale, lease or rent. Each additional branch circuit $5.00 Owner's 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 one structure Minor 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 Chapter 5 Per inspection $35.00 as described in N.E.G. Cha p 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: 0 5a. Enter total of above fees $ NOTICE 5% Surcharge (.05 X total fees) PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ -- 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. word\comdeNeIec- ❑ Trust Account # $ - prm.app 6 Balance Due $ 6 /6 /00 Activities for Case #: ELC97 -00516 2:28:19 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCA001 Application received 7/31/97 B PASS DST 7/31/97 ELCA003 Permit created 7/31/97 B PASS DST 7/31/97 ELCA700 Rough -in • DST 7/31/97 ELCA730 Elect'I Service 8/1/97 . MJR PASS J *H 8/3/97 Temporary Service approved. ELCA799 Elect'I Final 8/1/97 • MJR JT 8/18/97 • ELCA500 (F) Issue permit 7/31/97 B PASS DST 7/31/97 ELCA800 Case finaled 8/18/97 JT 8/18/97 case final per mike r. • • • • • Page 1 of 1