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Permit CITY OF TIGARD ELECTRICAL PERMIT %� iltilii DEVELOPMENT SERVICES PERMIT ISSUED: C 6/►ZSr B PARCEL: 291 1 `CC -10700 SITE ADDRESS...:O8323 SW LANGTREE ST SUBDIVISION....:L.ANGTREE ESTATES ZONING:R -12 BLOCK..........: LOT........ ..... :039 JURISDICTION: TIG Project Description : Alteration to electrical for single family residence. - --- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- • MISCELLANEOUS 1000 SF OR LESS....: 0 0 - 200 amp ° 0 PUMP /IRRIGATION....: 0 EACH ADD' L. 5O0SF...: 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 C I RC : 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 -- __._______ _- ERIC THOMAS type amount by date recpt 8323 SW LANGTREE ST PRMT $ 35.00 DLH 06/08/98 98- 306340 TIGARD OR 97223 SPCT $ 1.75 DLH 06/08/98 98- 306340 Phone #: Contractor: -- NORTHWEST ELECTRICAL SPECIALT $ 36.75 TOTAL ROYAL EDWARD STEARNS II 616 SE 69TH CT REG!UIRED INSPECTIONS HILLSBORO OR 97123 Rough -in Elect'l Final Phone #: 848 -8678 Elect' 1 Service Reg #..: 001213 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 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- 001 -' 10 through OAR 952- 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 -1987. Permittee Signature: .0/>f /9'�/ /tn Iss +_ied 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: /�f ft DATE: -- - - - -_. - - -_ -_ / CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: U7J AP/ ic47- 7 ©/f DATE: / LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + +++ ++ + + + + + ++ + + + + ++ + ++ + + ++ CITY OF TIGARD Electrical Permit Applicatka IVED Plan Check # 13125 SW HALL BLVD. Reid By .z. Z-N TIGARD OR 97223 c� Date Rec'd 6/4/?F Phone (503) 639 -4171, x304 JUN 0 19 cP D a e to P.E. Print or Type ate to DST Inspection (503) 639 -4175 Incomplete or illegible will no COMMUNITY DEMO + tN T Permit # �LC9f �d3 iy Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or nacne-oftUmess - -__ : is Service included: Items Cost Sum • / - .. A I ddress ■ r S _ 11,_ _ 4a. Residential -per unit 1000 sq. ft. or less $110.00 4 City /State /Zip - .a ireir..1. II AILMIIMMIIIIIMIM Each additional 500 sq. ft. or Commercial El � Limited portion thereof $25.00 1 0 mied Energy $25.00 Each h Manuf'd Home or Modular �� Dwelling Service or Feeder $68.00 2 2a. Contractor installati n only: nly: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor /`(..iA. ) l 4E(9 CAL-SPFpf )6) Installation, alteration, or relocation Address. (j/Le S/ -A -1'h_ 200 amps or less $60.00 2 L 201 amps to 400 amps $80.00 2 City f -h d) S , .-, State (- Zip 4') lag- 401 amps to 600 amps $120.00 2 Phone No. r`-t r--Pi 0^11 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. 0- 1 4- (90C.- Exp.Date IO /i 1? • OR State CCB Reg. No. / a-( .3 a P) Exp.D to .i //� 1. 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp. ate Installation, alteration, or relocation 200 amps or less $50.00 2 201 amps to 400 amps Signature of Supr. Elec'n +� ' 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. 4V, - Exp.Date Jd / / //r see "b°° above. Phone No. 9�S ,3-r 3 4d. Branch Circuits 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 circuit $5.00 2 b) The fee for branch circuits City State Zip without purchase of b Phone No. service or feeder fee. / (2 First branch circuit ! $35.00 �,r 2 The installation is being made on property I own which is not Each additional branch circ $5.00 2 intended for sale, lease or rent. 4e. (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: � 0 Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ L_L� NOTICE • Subtotal $ 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ - NOT WITHIN 180` DAYS OR IF Subtotal - - $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ c3( 7s Total balance Due I: \DSTS \ELC96.APP Rev 9/96 fl g Tl S - /q a C