Permit CITY OF TIGARD ELECTRICAL PERMIT
/490/, A DEVELOPMENT SERVICES PERMIT #: ELC97 -0458
�1 DATE ISSUED: 07/14/97
. I : - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135DD -00600
SITE ADDRESS...:11831 SW PACIFIC HWY
SUBDIVISION °HOFFARBER TRACTS NO.2 ZONING:C -G
BLOCK • LOT •40 JURISDICTION: TIG
Project Description: instl 4 branch circuits w /out feeders // 5040/J'..
- -- 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: 3 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
YOUNG'S FUNERAL HOME type amount by date recpt
11831 SW PACIFIC HWY PRMT $ 50.00 TAT 07/14/97 97- 297069
TIGARD OR 97223 5PCT $ 2.50 TAT 07/14/97 97- 297069
Phone #:
Contractor:
BACHOFNER ELECTRIC, INC. $ 52.50 TOTAL
55 SE MAIN
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Underground Cove
Phone #: 233 -2006 Wall Cover Elect'l Service
Reg #..: 000445
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 188
days of issuance, or if work is suspended for more 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 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
//--)
Permittee Signature:: , Issued By: Lam. ././ .1ii4LAr
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: / 7b9 . DATE: % � 97
LICENSE NO: .1 IJ7 glt i ,60
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
rd
Community Development ELECTRICAL PERMIT APPLICATION .
' 13125 SW Hall BNd.
r. Tigard, OR 97223 Planck/Rec. #
Permit # 'L 1 ,°11 - b •
' "` ` E %' i� i Phone (503) 6394171 Date Issued - ) - X 17
:' FAX (503 68,4 -.7297 � Issued b
CITY OF TIGARD TDD No. (503) 684 -2772 by .
Inspection (503) 639 -4175 .
P
1. Job Address:
4. ,Complete Fee Schedule Below:
Name of Development -' _ • • . . - - - - . Number of Inspections per permit allowed
Address 11831 SW Pacific FJ. Service included: Items Cost(ea) Sum
City/State/Zip Tigard , 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) vr-kg' -' >:+,r i rT sq. ft. « $2500
1
Commercial ® • Residential 0 , linked Efl5f ? $25.00
'Each Manuld Home or Modrlar 2
Denting Service or Feeder $68.00
2a. Contractor Installation only: .. 4b. Services or Feeders
Installation. alteraton, or relocation 2
Electrical Contractor I nfimr F 1pr- trig -, Tm 200 amps or less $60.00 2
-
Address 55 SE Main 201 amps to 400 amps $80.00 2 -
7d State Q2 Zip 97214 401 amps to 600 amps $120.00 2 -
City P 601 amps to 1000 amps $180.00 2 -
Phone No. (503) 233 -2006 Over i0O0ens or volts $340.00 2 -
Contractors License No. 26 -451C , Reconnect only $50.00
- Contractor's Board Reg. No. 4456$9 4c. Temporary Services or Feeders
Installation. alteration, or relocation « 2
Signature of Supr. Elec'n 200 amps lase $5 2
201 amps to 400 amps $75.00
2
License No. 1376W; Phone No. 2006 I 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see "If above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address • • a) The lee for brand, circuits with 2
City State Zip Each branch circuit or �.e r $5.00
Phone No. b) The lee for branch circuits without
The installation is being made on property I own which is Pete or service or Isedef lbs. $�355�0000 2 2
not intended for sale, lease or rent. � Fist brarrcn circuit 1 $5s.00 -$TSO�
Each addliorel branch circuit _ T $5.00
Owner's Signature 4e. Miscellaneous ,
(Service or feeder not included) 2
3. Plan Review section .{if required): Each pump «irrigation awe $40.00 2
Fadr sign or Wine Salting $40.00 •
Signal ciieut(s) or a limited energy 2
Please check appropriate item and enter fee In section SB. panel. alteration or extension $40.00
4 or more residential units in one structure Minor labels (to) $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 sspecbon $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 $ 50.00
NOTICE 5% Surcharge (.05 X total fees) $ 2.50
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 52.E
Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
Plan Review if required (Sec.3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # • $
Balance Due $ _5n ,
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 0 I 1 1 19'1 A.M. P.M. MST:
Location: / / ?j / /0 �1 -
� J .,____.> - BUP:
Tenant: Suite: Bldg: MEC:
Contract •/ ,L %�� i 4 _ , Phone: 3 3 — 2,0067 PLM:
Owner I Phone: ELC: 5 7 6 4 1.�G
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFUSlab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved . - .. oved Not Approved
FINAL FINAL FINAL LN' FINAL N.
. e ��� c- f j 1 s Id' / I a Al ei
b
O Call for reinspection O Reinspection f -- of $ required before next inspection 0 Unable to inspect
/
Inspector: .&• 4 .i L • r Date: CT // 1 7 2 Page / of _ /