Permit A CITY OF TIGARD •
� DEVELOPMENT SERVICES ELECTRICAL PERMIT
1 PERMIT #: ELC97 -0049
"•� 1.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 01/28/97
PARCEL: 1S136AD -04300
SITE ADDRESS...: 11477 SW PACIFIC HWY
SUBDIVISION • VILLA RIDGE ZONING:C —G
BLOCK • LOT :2
Project Description: INSTL 2 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: 1 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
JOHN BANNING type amount by date recpt
11477 SW PACIFIC HWY PRMT $ 40.00 TAT 01/28/97 97- 289570
SPCT $ 2.00 TAT 01/28/97 97- 289570
TIGARD OR 97223
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 42.00 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 503- 684 -3600 Wall Cover Elect'1 Service
Reg #..: 2647
This permit is issued subject to the regulations contained in the -4 (klQ d J
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permit a Signat
applicable laws. All work will be done in accordance with / in
approved plans. This permit will expire if work is not. started /Q ��
within 180 days of issuance, or if work is suspended for lore ,lJ U._ h/" -CC
t 188 days. I s 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
SIGNATURE OF SUPR. ELEC' N : DATE :
LICENSE NO:
.Call for inspection — 639 -4175
d
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
,�x� Date Issued 1 7497
6.� (i 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 Developmen YN\v s -, o A\1-C --� Number of Inspections per permit allowed
Address \\ 7 S �' e. \ �\I Service included: Items Cost(ea) Sum
•� Q
City /State /Zip �� �� .6 1 . ' -3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
\ 4� Each additional 500 sq. ft. or
Name (or name of b usiness) C���� "� a'
portion thereof $25.00
COmmerci Residenti ❑ Limited E ne rgy $25.00 1
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
h
Electrical Contractor O . %q,.. le 20 0 amps or less $60.00 2
dress�l - 9 �� . - s _ 201 amps to 400 amps $80.00 2
City -D._ ,,--,\. Staten Zip iblat 401 amps to 600 amps 2 2
(�() 601 amps to 1000 amps
Phone ( y 11 - \ 2 Over 1000 amps or volts $340.00 2 0.00 2
Job NO. h-'- � Reconnect only
contractor's license NO. - 4c. Temporary Services or Feeders
Contractor's Board Reg. No. �. Installation, alteration, or relocation
Signature of Supr. Elec'n i" r u 200 amps or less 2
2
• 201 amps to 400 amps
$50.00 2
License No.C� / L�/ 'hone No.:>• r 401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip 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 fee. 2
First additional circuit \ $35.00
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 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 6 'DO
NOTICE 5% Surcharge (.05 X total fees) $ ..111'
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ NE
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. wurdlwmdmAeIeu ❑ Trust Account #
$
prm.app 2-1-(
Balance Due $ -00
3/22/00 Activities for Case #: ELC97 -00049
5:57:36 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 1/28/97 1/28/97 TAT 1/28/97
ELCC003 Permit created 1/28/97 1/28/97 TAT 1/28/97
ELCC799 Elect! Final 1/28/97 2/5/97 MJR PASS MJR 2/6/97
ELCC500 (F)Issue permit 1/28/97 TAT PASS TAT 1/28/97
ELCC800 Case Finaled 2/5/97 MJR PASS MJR 2/6/97
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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 /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: / 1 < f Y? A. P.M. Entry:
Address: �,r �,
Tenant: tS e: MST:
BUP:
Con /Own: , 1 /. MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
- ----T-- (-- --. - .—C.c7-( L f( - f( C rt r ( ‘ ‘5
°--- / ( <--7�- �440./Y04,
Inspecto974 C - / R. Q ( Date: 7 / 7
APPROVED _ DISAPPROVED /CALL FOR REINSP. CO