Permit r
a .
CITY OF TIGARD l L.E(1R1.c:,ftl... PERMIT
Areso DEVELOP MENT SERVICES PERMIT $ :: I:::L..C:`:,c� -c, . >.:L'� jli iUt1 (•I::: :CCi;aL11:::I) : C���r"c:'. °. "'1`:if�
4. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: c''Ea:I.:i 2I)C-- (cl(jd'c'(<1Gx
SITE f1OORESS......: (') 73.42 SW KABL.L LN
SUBI)iVi :G :I :(:)N..... :SOUTHERN PACIFIC T :I:GARD :I.NDUST ZONING N.i. •1...
Bl...00K................ „ :: LOT.. a ................... :( 0:3 7'URISX)I - T• :I :("a
- 'rca,j .re•t. I)e .c•ript:i.can:: Electrical TI
---RESIDENTIAL UN:rr- .._....__. __........TEMP SRVC /FEEDERS._- _.._.... --MISCELLANEOUS--
ELLANEOUS_......__.._....
l.(W)O sr OR LESS....: G 0 -- ROO amla...........: 2 PUMP/IRRIGATION....: Cc)
EACI -I ADD" I... 50€SI :......: 0 2(1 °- 400 amp.......: 0 SIGN/OUT LINE 1_.TO....: C:l
LIMITED ENERGY..........: (J 401 -• 600 amp.......: () SIGNAL/PANEL..,.....: 0
MAN F. NM/ SVC /FDR...: t%) 601+amp s- • :LoGLd volts.: () MINOR (_.ABEL (10)...: (t)
----SERVICE/FEEDER---- ----BRANCH CIRCUITS- __- _ -._..- -- .-- _- A:o:o' L_ :I :NSPECTIONcy...._...._
0 •• -- 200 amp............: Cf) W /SERVICE OR FEEDER: 10 PER INSPECTION.....: (
i?C% 1 -•• 4C')() amp..........: (d) 1st W/O SRVC OR I DR.: 0 PER HOUR..................: 0
401 - 600 amp.........: 0 EA ADD "L BRNCH CIRC: 0 IN PLANT......•.......... :: c
601 -- 1000 am:p.......: C) _._..._.__- _._...._..m- -- -._- __11._(11'1 REVIEW SE- :C f'I GIN _____._.- __.._- ...___..w___..
1000+ amp/volt.....: 0 > -4 RES UNITS........: > GGC) VOLT NOMINAL.....:
Reconnect 7ec•t: only......: 0 SVC/FDR >:::: 225 AMPS—: :: CLASS AREA/SPEC 0CC. :
Owner:: F E E S _.. _ _ ___. ............._..__....__.._ -.._
PACIFIC REALTY ASSOC type amount by date rr•.•>cp•t
15350 SW SEQUOIA PKWY I :'RITI $ :L5(.0 B ()4/27/98 98-305283
SST I::. 300 SPCT $ 7.50 B 04/27/98 98-305283
T I GARI) OR 97224-0000
f:'tycane # #:
Contractor: -- •_....- ...._.
COMMERCIAL ELECTRIC CORP :'.. $ 157.50 TOTAL..
10)928 NE I: :l:I_.LING SWORTH
------- REQUIRED INSPECTIONS -----
PORTLAND OR 97220-1097 Cell i. n g Cover Elect " ]. Service
1 :'hone # #: 255- Wail Cover Elect"). Final
Reg ## ...: 000061
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 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 881-0810 through CAR 952- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (583)246 -1987.
... a s Si • s s•• u
Perm rm �. 1, tc e .a a ntx l rte :lb-CA.4117.1.----
Issued l ey :: _..
m.,,,,
_..._.._.._-._..__._......___._..___ ____..___- __- __- ..__-- --OWI INSTALLATION ONLY ____.._ _..._._ .._ ...._ ...___._.w..__......___.._...._
The installation is hewing made on prope ?r••ty I own wh :i.cl•: is not Intended for
sale, lease, or rent. OWNER'S SIGNA'T•UREa :. _ . - DATE:
_....__..__........_ .... _...._.._ ..........__.... _ ...__....__..._._..c: :ONTRACTOR INSTALLATION ONLY---.._ ..__---_......_....._._..._ _- .__._..._.__........_........
SIGNATURE OF cit.)pp. E:l_.EC" N: 641 / 0 t __... DATE:
I
LICENSE NO:
+.+••+•-+••+••+•+•+-+•+-•+-•+-•+..+•+++.+.4-4.4-4-4.+••+.4-4 -+• +-•+•- +-- +•- a• +- + +.•a-:+ + +•a ++•+-•+••+•++•+•+•+..+.•+. .+- -+•+ + +-+-++ + + + +-+••+• + +•+..+ •+- ++.•+.. - 4-4 -4+•
Call 639....4 :L75 by 7:0€i p.m. for an inspection i.c)n needed the next business day
-+.. +.•+..+- •+- •+- - +•-+•• • +•+• + +•+• +• +- + +•+• + +•+-•+-+ •++- o-•++•++-+..+..+..+ +..+.•+.++•+•-+•+•+••+•+•+..+..+..+..+..+.+..+.+•+•-+•-+•+•+••+•++++• a++ ..+.. +..+••+.. +..+- . +.. +..+..+.
Community Development ELECTRICAL PERMIT APPLICATION
A /A 13125 SW Hall Blvd.
Tigard, OR .97223 Planck/Rec. #
Permit # 7PLI
' +i; Phone (503) 639 -4171 Date Issued L1
- ?--'° FAX (503) 684 -7297 R , .
. CITY OF TIGARD TDD No. (503) 684 -2772 Issued by V
Inspection (503) 639 -4175
1. Job Address: ` 4. Complete Fee Schedule Below:
Name of Development /I Rf f`�R Number of Inspections per permit allowed
Address 734/2 - , n S4) /48/E love Service included: Items Cost(ea) Sum
City/State /Zip / / 9 rJ� ORE 4a. Residential - per unit 4
! r 1000 sq. ft. or less $110.00
Name (or name of business) �J" /pj � Each additional 500 sq ft. or
( ) portion thereof $25.00 1
Commercial Residential ❑ Limited Energy $25.00
Each Manut'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor COMMERCIAL ELECTRICAL CORP. 200 amps or less $60.00 2
Address 10928 NE KILLINGSWORTH 201 amps to400amps $80.00 2
401 amps to 600 amps $120.00 2
City PORTLAND State OR Zip 97220 sot amps to 1000 amps $180.00 2
Phone No. 2 5 5-9 8 2 2 Over 1000 amps or volts $340.00 2
Contractor's License No. 26-33C Reconnect only $50.00 -
Contractor's Board Reg. No. 6145 �� 4c. Temporary Services or Feeders
C^ vcC � Irst0a alteration, or relocation 2
Signature of Supr. Elec'n, � 200 0 amps or less 2 $50.00 ADO.Oct 2
License No. /07 0 . ' Phone No. 25'5 -9822 201 ampsto400amps $75.00 2
401 amps to 600 amps $100 00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder tee' 2
Each branch circuit /0 $5 00 Q. 00
Phone No. b) The tee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00 2
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
as described in N.E.C. Chapter 5 Per ins $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:
NOTICE 5a. Enter total of above fees $ /5 ) , G
5% Surcharge (.05 X total fees) $ 1, 3 0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ /47...
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. ❑ Trust Account # $
Balance Due $ /c7.3
womf∎co Mavwbcprm.app