Permit *//'
CITY OF TIGARD
„ DEVELOPMENT SERVICES ELECTRICAL PERMIT 0 0 1 PERMIT #: ELC97 -0328
-' , .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/03/97
PARCEL: 15135CD -06700
SITE ADDRESS...:O9724 SW LONDON CT
SUBDIVISION -LONDON SQUARE NO.2 ZONING:R -25
BLOCK • LOT •19 JURISDICTION: TIG
Project Description: INSTL 1 BRANCH CIRCUIT / /JOB * 18941
- -- 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/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
LINDSEY type amount by date recpt
9724 SW LONDON CT PRMT $ 35.00 TAT 06/03/97 97- 295382
TIGARD OR 97223 5PCT $ 1.75 TAT 06/03/97 97- 295382
Phone #:
Contractor:
BECK ELECTRIC INC $ 36.75 TOTAL
9318 SE CHURCH ST
REQUIRED INSPECTIONS
CLACKAMAS OR 97015 Ceiling Cover Underground Cove
Phone #: 656 -7396 Wall Cover Elect'l Service
Reg #..: 000026
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permi S i gnat u
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 / At _1 .
than 180 days. I s u e d 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 / %G
SIGNATURE OF SUPR. ELEC' N :( / /f7 DATE: 1 S j
LICENSE NO: /
Call for inspection — 639 -4175
p
•
Community Development ELECTRICAL PERMIT APPLICATION
0 A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
/ill l Permit #
t*g7-
, 1l Phone (503) 639 -4171 Date Issued
CITY OF TIGARD FAX (503) 684 -7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below: ..
Name of Development ) �,� �1 p Number of Inspections per permit allowed
(
Address 11(y p) l.rl.J�1 l Ct . Service included: Items Cost(ea) Sum
City /State/Zip . t t O G "7 a a 4a. Residential - per unit 4
1000 sq. ft. or less $11 0.00
-
Name (or name of business) l.A,0 Each additional 500 sq. ft. o r
portion thereof $25.00 1
Commercial ❑ Residential rAl I Limited Energy $25.00 -
": \ � 1 Each Man S Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
- , Installation, alteration, or relocation 2 .
Electrical Contractor _ t i , _ i 1 1 (1 200 amps or less $60.00 2 -
Address 1 .?:)\ $ .., t C.)(1..x.,0\p ),r) 201 amps to 400 amps $80.00 2 -
City f^ 0 �Ck�;,�0„ e of State O Zip 910 1 5 601 amp s to 1000 $180.00 2 -
Phone No. (Q5(0 - 3q (P Over 1000 amps or volts - $340.00 2
Contractor's License No. - C Reconnect only $50.00
Contractor's Board Reg. No. aZ.C.Po1 i 4c. Temporary Services or Feeders
g p f / , � ) I a alteration, or relocation 2
Signature of Su r. Elec'n 200 200 amps or less $50.00 2
• (.9 --
201 amps to 400 amps $75.00 2
License No. \ ��(..P -� Phon., o. (p CO - 113 401 amps to 600 amps $100.00
-
Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
4d. Branch Circuits
Print 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 fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder 2
First branch circuit $35.00 35 - 2
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 $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 inspectio $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 $ ) 5
5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ Gj
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 $ 0.
COMMENCED. ❑ Trust Account # $
Balance Due $ 3k0:15
•
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� Case Activity Listing 12/27/2004
�� ase
T I D E M A R K Case #: ELC97 -00328 11:01:o6AM
COMPUTER SYSTEMS, INC.
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ELCA001 Application received 6/3/19 6/3/1997 None 6/3/1997
TAT
ELCA003 Permit created 6/3/1997 6/3/1997 None 6/3/1997
TAT
ELCA700 Ceiling Cover 6/3/1997 None 6/3/1997
TAT
ELCA720 Wall Cover 6/3/1997 None 6/3/1997
TAT
ELCA725 Underground Cover 6/3/1997 None 6/3/1997
TAT
ELCA730 Elect'l Service 6/3/1997 None 6/3/1997
TAT
ELCA799 Elect'l Final 6/3/1997 9/5/1997 None PASS GS 1/9/1998
JT
ELCA500 (F) Issue permit 6/3/1997 None PASS TAT 6/3/1997
TAT
ELCA800 Case finaled 1/9/1998 None 1/9/1998
JT
Page 1 of 1 CaseActivity..rpt