Permit _ ELECTRICAL PERMIT
' CITY OF TIGARD PERMIT #: ELC96 -0437
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/05/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S104BB -03700
SITE ADDRESS...: 14104 SW LIDEN DR
•
SUBDIVISION CASTLE HILL ZONING:R -12 PD
BLOCK LOT •030
Project Description: Installing a branch circuit for an A/C unit.
- -- 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/0 SRVC OR FDR.: 1 PER HOUR • 0
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
ROBERT BRYAN type amount by date recpt
14104 SW LIDEN DR PRMT $ 35.00 CJS 07/05/96 96- 281356
5PCT $ 1.75 CJS 07/05/96 96- 281356
TIGARD OR 97223
Phone #:
Contractor:
GRF ELECTRIC $ 36.75 TOTAL
15460 SE PARADISE LN
- -- REQUIRED INSPECTIONS
MULINO OR 97042 Wall Cover Elect'1 Final
Phone #: 503- 829 -4146 Elect'1 Service
Reg #..: 101543
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started j
within 180 days of issuance, or if work is suspended for more (h /2 r
than 180 days. Issued 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 SUPR. ELEC' N : Moiled DATE: �� /J6
LICENSE NO:
Call for inspection — 639 -4175
,r- O.�N��� Community Development ELECTRICAL PERMIT APPLICATION
. -- . 13125 SW Hall Blvd.
®
,. .0�� Tigard, OR 97223 Planck/Rec. # 9h ,8 /356
, �, }F I'.,� Permit # E/_Cgs - » q37
• .� I i Phone (503) 639 -4171 Date Issued r 5 / 9.'
t '` ` "" FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by C c z (- /6.5 r,
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development /H/1)L# 5 W L 1()Leh Number of Inspections per permit allowed
Address I) r, Service included: Items Cost(ea) Sum
City /State/Zip �[ ^ i a 1 - d 4 7 2Z3 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) Each additional 500 sq. N. or 1
portion thereof $25.00
Commercial ❑ Residential Limited Energy $25.00
- Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
n /�� D Installation, alteration, or relocation 2
Electrical Contractor G LF f_ ) C> 200 amps or less $60.00 2
Address 5/P 0 S, f A rte ; S C
201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00 2 - City M u I ; 1-1. n State b re , Zip 9 -) pt � I pL $01 amps to 1000 amps $180.00 2
Phone No. 4 r- -
q tl Li. (P Over 1000 amps or volts $340.00 2
Contractor's License No. ) (. - «) Q-C. Reconnect only $50.00 -
Contractor's Board Reg. No. / OI S 3 4c. Temporary Services or Feeders
/� I alteration, or relocation 2
, Signature of Sur. Elec'n U r 200 amps or less $50.00 2
$75.00 2
License No. 01)1- S hone N ��9 ^ 201 amps to 400 amps
- hl�F(P 401 amps to 600 amps $100.00
Over 600 amps to 1003 volts •
2b. For owner installations: see - b• above.
Print 4d. Branch Circuits
rint 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 fee. 2
Each branch circuit $5.00 •
Phone No. b) The lee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. /� 2
not intended for sale, lease or rent. • First branch circuit / $35.00 3 5 i 2
Each additional branch circuit $5.00
Owners Signature . 4e. Miscellaneous
(Service or feeder not included) • 2
Each pump or irrigation circle $40.00 .2
3. Plan Review section (if required): 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:
NOTICE 5a. Enter total of above fees $ 3 $ /.
5% Surcharge (.05 X total fees) $ ___Lj '7
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) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ 3 (e.) 5
wordbpndMNso m.app
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 /F1r /Slab Plbg. Top Out Insulation dVP
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
4
Other: J P
Date: / �
' M. Entry
4-- 7 Address: / /d'- ° .! -.. J
Tenant: Ste: MST:
— 447 OZ BUP:
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Con /Own: MEC:
PLM:
Q. a.-0 ELC: 4
THE FOLLOWING CORRECT! NS ARE REQUIRED: ELR:
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Inspector: �� / �✓ - .� — ■ � _ Da te: o � .9'
X APPROVED _ DISAPPROVED /CALL FOR REINSP. CO
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