Permit i
,, ,,, CITY OF TIGARD ELECTRICAL PERMIT
hni , ;t\ DEVELOPMENT SERVICES PERMIT #: ELC98 -0671
ii DATE ISSUED: 11/10/98
!+L = 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135DD -03301
SITE ADDRESS...:11945 SW PACIFIC HWY #202
SUBDIVISION •HOFFARBER TRACTS NO.1 ZONING:C —G
BLOCK • LOT :002 JURISDICTION: TIG
Project Description : Electrical for installation of 1 permanent wall sign.
- -- 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..: 1
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/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
CASH STORE type amount by date recpt
11945 SW PACIFIC HWY PRMT $ 40.00 DLH 11/05/98 98- 310582
SUITE 202 5PCT $ 2.00 DLH 11/05/98 98- 310582
TIGARD OR 97223 .
Phone #:
Contractor:
HEATH & COMPANY LLC $ 42.00 TOTAL
4644 SE 17TH AVE
EXPIRED RECUIRED INSPECTIONS
PORTLAND OR 97202 Ceiling Cover
Elect'l Service
Phone #: 232 -2620 Wall Cover Elect'l Final
Reg #..: 127870
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 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 OAR 952 -001 -1987. You nay obtain a copy
of these rules or direct questions to OUNC by calling (503) 46 -1987. S
Permittee Signature: `�M,,. , slued B ° d ` fmmilb_
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S p S I E: DATE:
-fK CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUP R. ELEC' N : C4IS' 16 DATE: / / —/ O 7
LICENSE NO: /O/✓
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY' OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By 3
TIGARD OR 97223 ' ,J / -/ yam' Date Rec'd ///519
Date to P.E.
Phone (503) 639 -4171, x304 � Date to DST
Inspection (503) 639 -4175 Print or Type Permit # EL C q
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called G�a�2C W91
G
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development / i 9 a S 1 1 Ft 7- a Number of Inspections per permit allowed
Name (or name of business) 7 - J)e `AA -Sin Hui Service included: Items Cost Sum
,
Address /f 9 TS S W p PC I c 1"fui y 0 4a. Residential - per unit I .
T i QAn 1000 sq. ft. or less $110.00 4
City /State /Zip / 4 0 IR.C= Each additional 500 sq. ft. or
Commercial V1 Residential El portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: 4 06 V Dwelling Service or Feeder $68.00 2
(Attach copy of all cu rent licenses 17 4b. Services or Feeders
Electrical Contr ctor a µ'
In stallation, alteration, or relocation
200 amps or less $60.00 2
Address I-7 1 201 amps to 400 amps $80.00 2
City pot2t State C tae Zip c11 7 401 amps to 600 amps $120.00 2
Phone No. a viz - ,9 'K -I !74 f � 601 amps to 1000 amps $180.00 2
Job No. Irv'/ Over 1000 amps or volts $340.00 2 -
�0 Reconnect only $5 2
-
Elec. Cont. Lice. No.. - gg5i 1 -5 Exp.Dat It)1
OR State CCB Reg. No./218 Exp.Date I "2-1-40 4c. Temporary Services or Feeders
COT Business Tax or Metro No.O ji, 24L 7Exp.Date l - / 99 Installation, alteration, or relocation
6/ / 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec n . Ii d _ . u.A 401 amps to 600 amps $100.00 2
8-.. Over 600 amps to 1000 volts,
License No 6/ S.t4 Exp.Date l0- /- of see "b" above.
Phone Nr "3 D. J. 9 o F.-f- l 7 y
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
EXPIR
feeder f purchase . of
Each branch circuit $5.00 2
i service or
Print Owner's Name D feeder fee.
Address acranc cr cu -
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 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 44 d. 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: 4 G s
Not required for temporary construction services. 5a. Enter total of above fees $ �.
5% Surcharge (.05 X total fees) $ -
NOTICE Subtotal $
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 # �1
"
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96