Permit CITY OF TIGARD
ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: E L C OI/ O 17/97
PARCEL: 1S136DB -02601
SITE ADDRESS...: 11610 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK LOT •
Project Description: instl 1 servic /feeder & 2 branch circuits
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 1 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: 2 PER INSPECTION ° 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 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
WAFTER ASSOCIATES INC type amount by date recpt
11610 SW PACIFIC HWY PRMT $ 70.00 TAT 01/17/97 97- 289086
5PCT $ 3.50 TAT 01/17/97 97 -- 289086
TIGARD OR 97223
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 73.50 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
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitn Signature
applicable laws. All work will be done in accordance with
7.
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. 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: DATE:
LICENSE NO:
Call for inspection. — 639 -4175
_ /01111111.11
M Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. � �
Tigard, OR 97223 Permit #
Date Issued c,W ���7- (,� ,�" •
h,, , , �., l I / 1 1/9 7
I'll �
., 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 c ?3\ Number of Inspections per permit allowed
Address \ \Lp \0 CIULD A-(-1G -k -.1) 1 Service included: Items Cost(ea) Sum
City /State /Zip \\S . C- 91 -a -- 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business)k . ..ln "C', Each additional 500 sq. ft. or
portion thereof $25.00
Commercial j4, Residential ❑ Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 1 ^^
Electrical Contractor C pr C;r A 200 amps or less 1 $60.00 t (1( ). n4C, 2
Address - / ;1c1 5 j \ \ ( "t)X 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City � , r),\rr� S 1 tg e _ Zip oi) -1_s�3 601 amps to 1000 amps $180.00 2
Phone IY9 ( 1.9 " �� Over 1000 amps or volts $340.00 2
? $50.00 2
Job NO. �U��,� 1 7 Reconnect only
contractor's license NO. .54 - )C- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. S - Installation, alteration, or relocation 2
Signature of Su r. Elec'n 200 amps or less
g p 201 amps to 400 amps $50.00 2
License No.� f / yD1' one No. 2� = 31p1�U 401 amps to 600 amps $75.00 2
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 10.0
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
not intended for sale, lease or rent. First branch circuit $35.00
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 $ 7O 0
NOTICE 5% Surcharge (.05 X total fees) $ rZ
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. wordkomdevleka ❑ Trust Account #
am.
$
Balance Due $ f 3,
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cov- Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Fir /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I I l
Date: \ l ZZ l C( / A.4 ®M ntry:
Address: ! d in / ./—e . 1 +r
Tenant: Ste: MST:
/ c BUP:
Con /Own: C� 1 MEC:
PLM:
ELC: 7 r cc) 3
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
ptc:1(='1' f>ecee-e-c C_.6 erN
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r-orir
Inspector: /, r a — / . Date: 1 -- 77
X APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
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 4121'
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: . �
Date: \U o o I1 A . P.M. E
Address: / 1 e 0 �
Tenant: W C.'(.U/ � ntry: 7
te: MST:
P QQ M U C :
Con /Own: v MEC:
_ 4 PLM:
ELC:
THE FOLLOWING f CTIOrARE REOUIFj�D :F
41-ecfri'c ICn CD
/ 2,1fe U .e._4
, ‘ ,,,,
. - .
, . Date: / 7
Inspector: I , 7
X APPROVED _ DISAPPROVED /CALL FOR REINSP. 41110 CO