Permit /A CITY OF TIGARD
i��,.yi \ DEVELOPMENT SERVICES ELECTRICAL PERMIT
��T�IIi� PERMIT #: ELC98 -0272
y - 13125 SW Hall Blvd.,Tlgard,OR97223 (503)6394171 DATE ISSUED: 05/22/98
PARCEL: 1S136AD -04000
SITE ADDRESS...:11535 SW PACIFIC HWY
SUBDIVISION •VILLA RIDGE ZONING:C —G
BLOCK • LOT •007 JURISDICTION: TIG
Proj ect Descript : Add seven (7) branch circuits to a commercial tenant.
- -- 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 INSPECT -
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 OCC.:
Owner: FEES
TIGARD FAMILY BILLIARDS type amount by date recpt
11535 SW PACIFIC HWY PRMT $ 65.00 GEO 05/22/98 98- 305965
TIGARD OR 97223 5PCT $ 3.25 GEO 05/22/98 98- 305965
Phone #:
Contractor:
ALLIANCE ELECTRIC INC $ 68.25 TOTAL
19590 SW 51ST
REQUIRED INSPECTIONS
TUALATIN OR 97062 Ceiling Cover Underground Cove
Phone #: 691 - 2222 Wall Cover Elect'1 Service
Reg #..: 000787
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 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952- 001 -1987. You say obtain a copy
of these rules or direct questions to OUNC by ca .l in (503)246 -1987. ,
Permittee Signature: d���..i ,i Issued B Al 4 _
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: ✓� �I- D`
LICENSE NO: 'XOR / -
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
,I
' CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # ;Le 0 R-7..7
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Tigard F a m i l y B i l l i a r d s Service included: Items Cost Sum
Address 115 3 5 SW Pacific Hwy: 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip T i g a r d, oR 9 7 2 2 3 Each additional 500 sq. ft. or
Commercial Residential El Limited thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor A l l i a n c e F 1 p r t r i r Installation, alteration, or relocation
200 amps or less $60.00 2
Address 19590 SW 51st 201 amps to 400 amps $80.00 2
City T u a l a t i n State R Zip 97062 401 amps to 600 amps $120.00 2
Phone No. 691-2222 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3- 310C Exp.Date 10 - 1 - 98 Reconnect only $50.00 2
OR State CCB Reg. No 7 R 71 3 Exp.Date 1 ? - 2 4 - 9 R 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 3 45 0 Ex .Date 9 _ 1 _ 9 8 Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Sur. El: !a 'Aar 201 amps to 400 amps $75.00 2
g p / 401 amps to 600 amps 2
Over 600 amps to 1000 volts,
License No. 2 n 2 1s Exp.Date 1 0 -1 - 9 R see "b" above.
Phone No. 691-2222
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 feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City_ State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 _15....4.Q_ 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
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 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
-
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 6 5 nn
5% Surcharge (.05 X total fees) $ 3.25
NOTICE Subtotal $ b ti . 2 5
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 68.25
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
Page No. 1 CASE HISTORY FOR CASE NO.: ELC98 -0272
TIGARD FAMILY BILLIARDS
11535 SW PACIFIC HWY
08/05/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
l Sent Done Done Date By
ELCA800 Case finaled / / / / 06/09/98 29 drop in fourescent fixtures, 4 exit PASS CD- 06/18/98 J•H
signs, strip lighting, outdoor eve.
ELCC001 Application received / / / / 05/22/98 RECD GEO 05/22/98 GEO
ELCC003 Permit created / / / / 05/22/98 DONE GEO 05/22/98 GEO
ELCC500 (F)Issue permit / / / / 05/22/98 PASS GEO 05/22/98 GEO
ELCC700 Ceiling Cover / / / / 06/08/98 PASS CD 06/08/98 CD
ELCC700 Ceiling Cover / / / / 06/10/98 29 FLOURSCENT FIXTURES INSTALLED - PASS CD 06/10/98 CD
4 -EXIT LIGHTS - OUTDOOR STRIP LIGHTS
ELCC799 Elect']. Final / / / / 06/10/98 PASS CD 06/10/98 CD
•