Permit •
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT PERMIT #: ELC98-0402
~��~��~n���" "�"�~"�n SERVICES DATE ISSUED: 07/20/98
��� 13125 SW Hall Blvd., Tigard, OR 97223 (503 ) 639-4171
PARCEL: 2S111CD-09600
SITE ADDRESS... :09890 SW KIMBERLY DR
SUBDIVISION -KERWOOD ESTATES ZONING:R-4.5
BLOCK ^ LOT ^030 JURISDICTION: TIG
Project Description: Alterations to residence. Job No. 618-010.
---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: 1 IN PLANT ^ 0
�
601 — 100V9 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
BOSTWICK type amount by date recpt
9890 SW KIMBERLY DR PRMT $ 40.00 DLH 07/20/98 98-307460
TIGARD OR 97223 5PCT $ 2.00 DLH 07/20/98 98-307460
Phone #:
Contractor:
WEST SIDE ELECTRIC CO INC $ 42.00 TOTAL
1834 SE 8TH AVENUE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Rough—in Elect'l Final
Phone #: 231-1548 Elect'l Service
Reg #..: 000133
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 1:
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 952-vi1-0010 through DAR 952-001-1987 You may obtain a copy
of these rules or direct questions to DUNC by calling (50246-1987.
Permittee Signature: Issued By: /d1~
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease,, • or rent.
OWNER'S SIGNATURE: A DATE:
^'
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ��� y� DATE: �~^' '
LICENSE NO: _
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p.m. for an inspection needed the next . business day
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
CITY OF TIGARD
Electrical Pe - A pplication Plan Check #
13)25 SW HALL BLVD. By
Date 'd2 1-/74
,,P
TIGARD OR 97223 JUL 1 c 1998
c Date to P.E.
Phone (503) 639 -4171, x304
Inspection (503) 639 -4175
Print Type ,, ' Date to DST
p ( ) �t 11 111 : Wit la Permit # EG e?? - D yd �,
Fax (503) 684 7297 Incomplete or illegible will not be acce Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
f�
Name (or name of business) /�2" _547 /dA/ r7* Service included: Items Cost Sum
Address 9C90 5� � Or. 4a. Residential - per unit
/ 1000 sq. ft. or less $110.00 4
City /State /Zip 7 07" �-_. Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ 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 icen / 4b. Services or Feeders
Electrical Contractor P...5 -1 t � .• �/ C' /C Installation, alteration, or relocation
Address / 0' _ , ` Z- • `� , 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2 -
City o/" t. c State All Zip 'V 401 amps to 600 amps $120.00 2
Phone No. 2 / - /.S /'' 601 amps to 1000 amps $180.00 2
Job No. 6/g --O /U Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 26 - /J C Exp.Date 1a o i Reconnect onl $50.00 2 -
OR State CCB Reg. No. /3306 Exp.Date 3 ✓ 4c. Temporary Services or Feeders •
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
20 amps to or less $50.00 • 2
Signature of Supr. Elec'n ("-----
L 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
600 ams to
License No /CS .S Exp.Date fn/ /`9P O see "b" ab 1000 volts,
Phone Nc 23/ / S %/, /
4d. 3raowah Circi. t.
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 circui $5.00 2 -
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit / $35.00 2
The installation is being made on property I own which is not Each additional branch circuit / $5.00 C 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: L/D
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for
_ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Se c .3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Su total 2 $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Ll Trust Account # 1 3 3 y
TIME AFTER WORK IS COMMENCED. $ ( 2-
Total balance Due jej
,,,, :. I' :'rIr',11 ^I`I' 11...•:coo
Case Activity Listing 1/7 /2005
g 1:44:56PM
TIDEMARK Case #: ELC98 -00402
COMPUTER SYSTEMS, INC.
old;;, <, -,; ' ` is � 8;..,< B" „Not • s . � � �:':
�•• ate 1- Da D
Act><v�t : -,, D.escr i tton °
ELCA001 Application received 7/20/1998 None RECD DLH 7/20/1998
DLH
ELCA003 Permit created 7/20/1998 None DONE DLH 7/20/1998
DLH
ELCA730 Elect'! Service 7/20/1998 None 7/20/1998
DLH
ELCA500 (F) Issue permit 7/20/1998 None DONE DLH 7/20/1998
DLH
ELCA700 Rough -in 7/20/1998 None 7/20/1998
DLH
ELCA510 (F) Reprint permit 7/20/1998 None DONE DLH 7/20/1998
DLH
ELCA800 Case finaled 7/23/1998 None 7/23/1998
JT
ELCA799 Elect'! Final 7/20/1998 7/23/1998 None NOTE JMT 7/23/1998 CALL FROM DICK AT
JT WESTSIDE, HE'S LEAVING A
VOICE MAIL MESSAGE FOR
TOM P., TOM INSPECTED
PREVIOUS ELECTRICAL AND
THE WORK THAT WAS DONE _
ATTACHED TO THIS PERMIT,
WILL REQUEST TOM TO CASE
FINAL THIS PERMIT. JEANNE T.
7/23/98 E -MAIL FROM TOM P.,
OKAY TO CASE FINAL. JEANNE
T.
Page 1 of 1 CaseActivity..rpt