Permit CITY OF T PERMIT I #
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/25/96
13125 SW Hell Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 1S136CC -00100
SITE ADDRESS...: 11765 SW PACIFIC HWY
SUBDIVISION - ZONING:C —P
BLOCK • LOT •
Project Description: Installing one temporary branch circuit.
- -- 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: 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 - - --
GENERAL MOTORS INC. type amount by date recpt
11765 SW PACIFIC HWY PRMT $ 35.00 CJS 06/25/96 96- 280979
5PCT $ 1.75 CJS 06/25/96 96- 280979
TIGARD OR 97223
Phone #: 639 -6191
Contractor:
FRAHLER ELECTRIC CO $ 36.75 TOTAL
11860 SW GREENBURG RD
-- - - - - -- REQUIRED INSPECTIONS
TIGARD OR 97223 Wall Cover Elect' 1 Final
Phone #: 503 - 639 -4627 Elect'1 Service
Reg #..: 37410
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 c:,-/'( S
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: 1'Y►cc,lpci DATE: C-
L ICENSE NO:
Call for inspection — 639 -4175
[ TE11P0 - 6L2 - 711/967
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 46-180979
Permit # ELcc -nyi,
Ab4 I''� �ii� Phone (503) 639 -4171
1 -- � FAX (503) 684 -7297 Date Issued 6- As 96
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Char l6. s r.
Inspection (503) 639 -4175
1. Job Address: W.0.# 5 6 2 41 4. Complete Fee Schedule Below:
Name of Development GM TRAINING CENTER Number of Inspections per permit allowed
Address 1 1 7 6 5 S . W . PACIFIC HIGHWAY Service included: Items Cost(ea) Sum
City /State/Zip T I G A R D, 0 R 4a. Residential - per unit 4
1000 sq. tt. or less $110.00
-
Name (or name of business) BANNING CATERING Each additional 500 sq. ft. or
portion thereof $25.00
-
Commercial ® Residential ❑ Limited Energy $25.00 - Each Manul'd 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 F R A H L E R ELECTRIC CO. 200 amps or less $60.00 2
Address 11860 S W G R E E N B U R G ROAD 201 amps to 400 amps $80.00 2 -
City TIGARD G A R D State 0 R Zip 9 7 2 2 3 401 ampe to 600 amps $120.00 2 -
`7 601 amps to 1000 amps $180.00 2 -
Phone No. 639-4627 Over 1000 amps or volts $340.00 2
Contractor's License No. 34-13C Reconnect only $50.00 -
Contractor's Board Reg. No. 37410 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n , crf;/ 200 amps or less $50.00 2
License No. 2334$ P one No. 639- 6 2 7 201 ampe to 400 am $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
4d. Owner's Name New, Branch Circuits
w, alteration or extension per panel
Address a) The lee 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 fee. 2
not intended for sale, I :: r First branch circuit 1 $35.00 35.00 2
Each additional branch circuit $5.00
Signature . - . E
Owner's Si n
4e. Miscellaneous
�/, �
■ Ni/A /� ' V (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 $36.00
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 $ 35.00
5% Surcharge (.05 X total fees) $ 1 . 75
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. ❑ Trust Account # $
Balance Due $ 36.75
wodbdM.NN.epm.app
7/26/99 . Activities for Case #: ELC96 -00411
1:51:49 PM •
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 6/25/96 CJS RECD J'H 10/14/97
ELCC003 Permit created • 6/25/96 CJS PEND CJS 6/25/96
ELCC799 Elect'I Final 6/25/96 9/17/97 MJR PASS J*H 9/26/97
ELCC500 (F)Issue permit 6/25/96 CJS PASS CJS 6/25/96
ELCC800 Case Finaled 9/17/97 MJR PASS J'H 10/14/97
•
•
•
•
•
•
•
•
Page 1 of 1