Permit CITY OF T PERMIT I #: ELC96
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/30/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S104BA —C3133
SITE ADDRESS...: 13733 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO. 3 ZONING:R -12 PD
BLOCK • LOT •133
Project Description: Install 7 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 — 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: 6 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 DCC.:
Owner: FEES
PHAN NGO type amount by date recpt
10615 SW COTTONTAIL PL PRMT $ 65.00 JSD 05/30/96 96- 280015
SPCT $ 3.25 JSD 05/30/96 96- 280015
BEAVERTON OR 97008
Phone #: 620- 9400X3328
Contractor:
OWNER $ 68.25 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Elect' 1 Final
Phone #: SEE ABOVE Wall Cover
Reg #..
This permit is issued subject to the regulations contained in the 2//41
�/
Tigard Municipal Code, State of Ore. Specialty Codes and all other P rm i ee Signatu �
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. I sued 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: DATE:
LICENSE NO:
Call for inspection — 639 -4175
•
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. -:L_ C n -G - 5 V(r)
Tigard, OR 97223 Permit # �
,��, t ,,,l, , 1. Date Issued t ---_-.50,'(,. iI Phone (503) 639 -4171
°'` �.� FAX (503) 684 -7297 •
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address /3 7" //er;t�/C! L 2 )' ---- - Service included: Items Cost(ea) Sum
City /State /Zip 72 9J ' /}-2-T. 9 7-P' 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) E additional 500 sq. ft. or
portion thereof $25.00
Commercial ❑ Residential Limited Energy $25.00 1
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor
200 amps $60.00 ps or less 2
Address 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City State Zip 601 amps to 1000 amps $180.00 2
Phone No. Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$50.00 2
contractor's license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less 2
License No. Phone No. 201 amps to 400 am $50.00 2
401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
Print Owner's Name �//i9A/ /Vi 6 4d. Branch Circuits per P
• ,, / A 7 New, alteration or ext er ate
Address / i5�' /_� S . i- ! �O TTCUT/7 // Z.- e) The lee for branch circuits with 2
City - .2,477 P3 ) State GO? Zip �f O purchase of service or feeder fee.
� Each branch circuit $5.00
Phone No. IA /# 6.-1) - fr r a F.xT1 Zl. - y c, b) The fee for branch circuits without 2
The installation is being made on property I own Ich Is purchase of service or feeder fee. / .---1 2
First branch circuit $ 35.00
not intended for sale, lease or rent. Each additional branch circuit 6 $5.00
Owner's Signature ��� 4e. Miscellaneous
• (Service or feeder not included) 2
3. Plan Review section (if required): Each pump or Irrigation circle $40.00 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 $ CO -
NOTICE 5% Surcharge (.05 X total fees) $ S,z"
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 7(
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. wordicomdeWekc• ❑ Trust Account # /
m.
prepp $
Balance Due $ 7)._E c
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:
Date: `d , --)25 3 " -- 7____ A.M. P. Entry:
Address: J 3 ? , J L-_ \. -C-ri
Tenant: Ste: MST:X^6/0
BUP:
Con /Own: MEC:
PLM:
ELC.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
7 - 4.-e . , h ®e..e.D ai -g) r-5
-/( 'Q( (5 — •
pr
Inspector: j` 1 < <A -P ( Rct r S Date / �� - -- G4
K APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO