Permit CITY OF TIGARD ELECTRICAL PERMIT
in,.ei DEVELOPMENT SERVICES PERMIT #: ELC97 -0613
���� DATE ISSUED: 09/12/97
!�- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1O4BA -16100
SITE ADDRESS...:13696 SW LIDEN DR
SUBDIVISION -CASTLE HILL NO.3 ZONING:R -12 PD
BLOCK • LOT •191 JURISDICTION: TIG
Project Description : Install service /feeder and four (4) branch circuits to
existing SFD
- -- 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 • 1 W /SERVICE OR FEEDER: 4 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR -
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 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
BOB LIBBY type amount by date recpt
13696 SW LIDEN DR PRMT $ 80.00 GEO 09/12/97 97- 299197
TIGARD OR 97223 5PCT $ 4.00 GEO 09/12/97 97- 299197
Phone #:
Contractor:
HURF ELECTRIC $ 84.00 TOTAL
17038 S. CLACKAMAS RIVER DIVE
REQUIRED INSPECTIONS
OREGON CITY OR 97045 Rough —in Elect'l Service
Phone #: 631 -8700 Underground Cove Elect'l Final
Reg #..: 000381
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 188
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 -08118 through OAR 952-001 -1987. ou may obtain a copy
of these rules or direct questions to OUNC by calling p (503)246 -1987. /
Permittee Signature: I� �� DELI -ssued B • i e
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 SUPR. ELEC' N : (5 DATE: 0,0v3
LICENSE NO: /
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + ++
08/28/97 THU 11:55 FAX 503 598 1960 CITY OF TIGARD Z002
r CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Reed By
Date Rec'd
TIGARD OR 97223 Date to P.E.
Phone (503) 639-4171, x304 Date to DST
•
Inspection (503) 639 -4175 Print or Type Permit # k--(-C .7-7 _ '/3
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 4 Number of Inspections per permit allowed
_7"..6 4
Name (or name of business) 'ay _ Service included: Items Cost Sum
Address 13 616 S4) 4, de : .2e / _ 4a. Residential - per unit +'
1000 sq. ft. or less $110.00 4
City /StatelZp /�_ 44 tae• Each additional 500 sq. ft. or
-
Commercial 0 ( U/ Residential Limited Energy $25.00
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only: Feeder
(Attach copy of all ent licenses Installation Services ervi alteration Fe , or relocation
Electrical Contractor eG �G 200 amps or less / n o.co �' a0 2
Addre /70.1"1 el e Q�.cr Ake 201 amps to 400 amps sao.00 2 -
City_ /i State QO - ZJp - 401 amps to 600 amps $120.00 2
Phone Co-__ z/ -+�� 601 amps to 1000 amps $ $18080.00 2
Job No. X Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3 /D C- Exp.Date /o -7F- '7-7' only $50.00 2
OR State GCB Reg. No. S7/3.? Exp.Date teL f 40. Temporary Sotvices or Feeders
COT Business Tax or Metro No. /6)7 Date Q /-Q.P In soo on o lration. or relocation 2 - $50.00 201 amps to 400 amps 575.00 2
Signature of Supr. Elec'n "'WA - ( 401 amps to 600 amps ^ $100.00 2
Over 600 amps to 1000 volts.
License No. /44i sf Exp.Date /0 -/ - gf see "b" above.
Phone No. 1 0 3 / - s� 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 E ach br anch circuit tam 2A 2
Address b) The fee for branch circuits
City _ State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
Each additional branch circuit $5.00 - 2
The installation is being made on property I own which is not
intended for sale, lease or rent. 4e. Miscellaneous
(Service or (ceder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
,• Signal arwlt(s) or a limited energy
3. Plan Review section (if required). 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 41. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above $35.00
-
System over 600 volts nominal Per inspection $55.00
_ , Classified area or structure containing special occupancy Per hour 00
as described in NEC ___ Chapter 5 In Plant
* Submit 2 sets of plans with application whore any of the above apply. 5. Fees: 0.69
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 Se for $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Seca) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY 0 Trus Account #
TIME AFTER WORK 1S COMMENCED. $
Total balance Due
rwsislacee.APP Rev Wee
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0613
BOB LIBBY
13696 SW LIDEN DR
12/29/98 •
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
ELCA001 Application received / / / / 09/12/97 RECD GEO 09/12/97 GEO
ELCA003 Permit created / / / / 09/12/97 PASS GEO 09/12/97 GEO
ELCA500 (F) Issue permit / / / / 09/12/97 PASS GEO 09/12/97 GEO
ELCA700 Rough -in 09/12/97 / / 09/17/97 Rough -in bonding, conduit ok to cover. PART BRP 09/18/97 J *H
ELCA725 Underground Cover 09/12/97 / / 09/15/97 need additional bonding to awnings, NA MJR 09/16/97 MJR
downspouts, and HVAC
The pool light fixture is bonded
ELCA730 Elect'l Service 09/12/97 / / 01/27/97 Approved as noted: no signature label. PASS BRP 01/27/98 J *H
ELCA799 Elect'1 Final 09/12/97 / / 01/27/97 PASS BRP 01/27/98 J *H
ELCA800 Case finaled / / /. / 01/27/98 PASS BRP 01/28/98 J *H
ELCA920 Miscellaneous action / / / / 10/14/97 Talk to Ben P - the lower level bonding PASS MJR 10/15/97 J *H
was inspected earlier. Talk to Jim
Cooper - the part of bonding network
that was covered it continuous to slide
and rebar. Cement cover of electrical
bonding approved.
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