Permit '~ . ��
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� ��� OF TIGARD ELECTRICAL PERMIT \�'���� � �K PERMIT #: ELC96-0334
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/28/96
13125 SW Hall Blvd. Tigard, Oregon e7223°8199 (503) 639~*171
PARCEL: 25112DC-00200
SITE ADDRESS...: 07342 SW KABLE LN
SUBDIVISION....: SP TIGARD INDUSTRIAL PARK ZONING:I—L
BLOCK..........: LOT.............:3
Project Description: Installing five branch circuits.
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---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 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: 4 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 -----
WOOD WINDOW DIST type amount by date recpt
7342 SW KABLE LN PRMT $ 55.00 CJS 05/28/96 96-279867
5PCT $ 2.75 CJS 05/28/96 96-279867
TIGARD OR 97223
Phone #:
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Contractor: ---- — —
JOHANSEN ELECTRIC INC $ 57.75 TOTAL
1130 NE 174TH .
REQUIRED INSPECTIONS --
PORTLAND OR 97230 Wall Cover Elect'l Final
, Phone #: 503-252-4881 Elect'l Service _ __
Reg #..: 51539
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 180 days of issuance, or if work is suspended for moro � ___
than 18N 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: �
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CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N: ���� � � DATE: ��-
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LICENSE NO: ____ ____ . __ ______
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Call for inspection — 639-4175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # &LC46-- 033 L/
ASO 4ii ll��i����1�`� Date Issued 5- a8- 96
Phone (503) 639 -4171
° " __.. FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
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1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 01 131 1 Sil-��ness ` T Q 1& Number of Inspections per permit allowed
Address / 5 1'V K8LG s 1_ Iv Service included: Items Cost(ea) Sum
Cit y/St ate/Zip - ri3 a,rci 0 I .,_ 6 77 Z. 4a. Residential - per unit
J� �n/�/� I' 1 /�� (� f` 1000 sq. ft. or less $110.00 4
Name (or name of business) VV Vo/I ( I rid/�es(" �1 J . Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ,.ig Residential ❑ Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
/ Installation, alteration, or relocation 2
Electrical C]ontractorfo i , i I.4 ig, _ - L iC Mc. 2 00 amps or less $60.00
Address ' ? O . - I 'lL4 th ! U' 201 amps to 400 amps $80.00 2
City P€.)Q rL A 'J b State 0 Zip c 7.37) 401 amps to 600 amps $120.00 2
c/ 601 amps to 1000 amps $180.00 2
Phone No. a. 5c q d - f Over 1000 amps or volts $340.00 2
Job NO. rt�� Reconnect only
$50.00 2
contractor's license NO. /3 - p 4�3 C_, 4c. Temporary Services or Feeders
Contractor's Board Reg. No. ' i ' Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less 2
License No. �(,� � '?, S Phon o. - �$$ i ' 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00 00
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. 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
not intended for sale, lease or rent. 1
First branch circuit $35.00 3S
Each additional branch circuit $5.00 2 - 0
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required E ach pu or irrigation circle $40 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
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:
5a. Enter total of above fees 6 6 r
NOTICE 5% Surcharge (.05 X total fees) $ -Q 15
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 \comdev\ ❑ Trust Account #
$
pm app
Balance Due $ S q 5"