Permit _ CITY OFTIGARD
a„ EVELOPMENT SERVICES ELECTRICAL_ PERMIT
li PERMIT t: ELC96 -0655
...,--#44- 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 DATE ISSUED 10/18/96
PARCEL: ' 251O4 BC- 01.600
SITE ADDRESS..,: 12420: SW KNOLL DR , .
SUBDIVISION... : :. T.IGARD.,IA TERRACE • • . . . •I • Z » »ON.ING :R -4.5
BLOCK LOT........ ..... :1
Project Description :'.ADD'SERVICE °FEEDERS & BRANCH CIRCUITS
- -- RESIDENTIAL UNIT - - - -- -- -TEMP SRVC /FEEDERS - - -- - - --- -- MISCELLANEOUS
1000 SF OR LESS....: 0 0 - 200 amp.....:.: 0 PUMP /IRRIGATION....: 0
EACH ADD' L 500SF ..: 0 201 . -- . 4®O L am pa ......: 0 , SIGN /OUT LINE LTG..: 0
LIMITED ENERGY.....: 0 401 - 600 amp ° 0 SIGNAL /PANEL.......: 0
MANF. HM/ S'V,C /FDR . 0 •, 60.11-amps 1.000„ vo.l.t s°.: 0. MINOR LABEL (10) ...: 0
----SERVICE/FEEDER---- - - - -- BRANCH CIRCUITS --- -ADD' L INSPECTIONS--
.. a .- amp. '.' ?.' : 1',,. W /SERV I,CE :OR FEEDER , 2r.. ' ' PER I NSPEC.T I ONo 0
201 - 400 amp......: 0 1st W/0 SRVC OR FDR.: 0 PER HOUR °. 0
401 _ 600 amp.....'..:.' 0 EA ADD' L. BRNCH C I RC: . 0 . IN PLANT......... ': 0
601 - 1000 amp.....: 0 -- -. - --- -PLAN REVIEW SECTION -
1000+ amp/volt,...':. 0 > =4 RES UNITS. ,.......1 ,.> 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: -•- ---- -• . FEES
WEST SIDE ELECTRIC type amount by date . recpt
7518 SW MACADAM AVE .. • . • PRMT, $ 70,00 TAT 10/16/96 96- 285215
5PCT $ 3.50 TAT 10/16/96 96- 285215
PORTLAND OR 97219
Phone'' #: 24a-3385 .. .
,
Cont r or: - .,
WESTSIDE ELECTRIC $ 73.50 TOTAL
7518 SW MACADAM AVE,
REQUIRED INSPECTIONS - --
PORTLAND OR 97219 Ceiling Cover Underground Cove
Phone #: 503 -245 -3385 Wall Cover Elect'1 Service
Reg #... 13306
This permit .is' issue&subject to the regulati .'ons' dontaineth in the • C.4 _ _
Tigardh Municipal Code,. State -of Ore. 'Specialty Codes and all other • ..Perm i t t ee S i gnat ur -
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 'issu rk
ance, 'or �if wo. :is.. suspended for more ..at. .,,,. .,r_, s. ' :art .4.
than 180 days. Issues 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:
- - - -- CONTRACTOR INSTALLATION ONLY- --- - -- -
SIGNATURE OF SUPRA. EL:EC' N :. DATE :.
LICENSE NO:
Carl �1 for -i n s p ect on„ _ 63:9- -4175 - -
Community Development ELECTRICAL PERMIT APPLICATION
....
,�
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued ''.1-e.-9/°-.4765-5 ''.1-e.-9/°-.4765-5 /O /t' Z,
( �"�I i1∎ Phone (503) 639 -4171 /
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 - 4175/ 611 61660
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address /2 5u /e 47
. Service included: Items Cost(ea) Sum
City /State /Z / / ae 922 4a. Residential - per unit
``'�� /' 1000 sq. ft. or less $110.00 4
Name (or name of business) (0 /.S Z/4 // � '`'1 Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ❑ Residential Q----- Limited Energy $25.00 1
Each Manned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
/IA- ` f Installation, alteration, or relocation
Electrical Contractor to � >, � / / $60.00 6 2
!-/ m 200 amps or less
Address 7S < , 2'a f-C[ 7 q 'z - e_ 201 amps to 400 amps $80.00 2
City /4i fr't State ()/2 Zip 972199 401 amps to 600 amps $120.00 2
Phone No. 2YS -33 yr 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
Job NO. /1)09-0/0 Reconnect only $50.00 2 '
contractor's license NO. 2A- /3S -C., 4c. Temporary Services or Feeders
Contractor's Board Reg. No. / 06 Installation, alteration, or relocation
Signature of Supr. -� E - le r c 2
License No. /S , �J Pho No. 2YJ , �.iJ - 201 amps to 400 amps $50.00 2
401 amps to 600 amps $7
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 Z $5.00 /0 J
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
First branch circuit $35.00
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 $4 0.00 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 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 7Q
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) $ r(j
-A PERIOD OF 180 DAYS AT ANY TIME AFTER- WORK-IS - Subtotal_ $ --
COMMENCED. "� U
word�comaav\e�ac- C Trust Account # 7�
. $
prm.app
Balance Due $
04/25/2000 Activities for Case #: ELC96 -00655
8:38:30 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001'Application received 10/18/1996 TAT RECD TAT 10/18/1996
ELCA003 Permit created 10/18/1996 TAT PASS TAT 10/18/1996
ELCA500i (F) Issue permit 10/18/1996 TAT PASS TAT 10/18/1996
ELCA800 Case finaled 10/18/1996 MJR PASS MJR 10/21/1996 electrical installation (furnace &
AC)
•
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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 Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: / tw o
Date: ll/ I e/‘ A.M. P.M. Entry:
Address: 1 a Q '.e OA-)
Tenant: Ste: MST: 3
1 1 BUP:
Con /Own: . MEC:
��^ PLM
. `-'� l LC: >
THE FO LOWING CORRECTIONS ARE REQUIRED: ELR:
4 c5----4. _
Inspector / ( n !" e7 .r A Date: /) I '—
APPROVED DISAPPROVED /CALL FOR REINSP. CF CO