Permit ELECTRICAL PERMIT
CITY OF TIGARD ELECTRICAL
C: EPE5-0664
DATE ISSUED: 12/29/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 25 102BD-
SITE ADDRESS...: 12760 SW PACIFIC HWY
SUBDIVISION • ZONING:
BLOCK • LOT •
Project Description: Add A/C and outlet on roof.
- -- 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 1 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
CASCADE ELECTRIC & MIANTENANCE type amount by date recpt
7725 SW CIRRUS DR PRMT $ 40.00 CJS 12/29/95 95 -27447
SPCT $ 2.00 CJS 12/29/95 95 -27447
BEAVERTON OR 97008
Phone #: 503- 641 -9208
Contractor: --
CASCADE ELECTRIC & MAINTENANCE $ 42.00 TOTAL
7725 SW CIRRUS DR
REQUI RED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect' 1 Service
Phone #: Wall Cover Elect'1 Final
Rea #.. .
This permit is issued subject to the regulations contained in the _ ___+ _____
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t ee Signature
applicable laws. All work will be done in accordance with
approved plans. This oer.it will expire if work is not started
within 160 days of issuance, or if work is suspended for more
than 160 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: _ - er, /ec( • _DATE: 1 - 29 957 _
LICENSE NO:
Call for inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
Alb 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 95' -a 79Q97
Permit # FG''95'- ra
Vii' ;� �l Phone (503) 639 -4171 Date Issued 1,2- a9
- 95
.4:
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by r s./,
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
j �
Name of Development t I I t`(, M ( Number of Inspections per permit allowed
Address ( L 0 J ) ' 4 ( ►/ Service included: Items Cost(ea) Sum
City/State/Zip 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Each additional 500 sq. ft. or 1
portion thereof $25.00
-
Commercial Residential w Limited Energy $25.00 -
Dt 4 • f♦] . Each Manufd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contr ctor installation only:
4b. Services or Feeders
C A 9 � - Installation, alteration, or relocation 2
Electrical Contractor JT& . ��. ' C 200 amps or less $60.00 2
Addr- s la 111111111 201 amps to 400 amps $80.00 2
• 401 amps to 600 amps $120.00 2
�
City - )1.,./ - MErdiollt t Zip 4101 601 amps to 1000 amps $180.00 2 -
Phone No. I =INgri 4 Over 1000 amps or volts $340.00 2
- Contractor's License No. - Alg L Reconnect only $50.00
Contractor's Board Reg. N Z ` 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of S • r. Elec'n ' �S�t t . 200 amps or less $50.00 2
License No. - > ,f7 Phone No. 201 amps to 400 amps $75.00 2 -
401 amps to 600 amps $100.00
-
• Over 600 amps to 1000 volts
2b. For owner installations: see •b' above.
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5.00
Phone No. b) The lee for branch circuits without /
The installation is being made on property I own which is purchase of service or feeder fee. y / 2
not intended for sale, lease or rent. First branch circuit / $35.00 � � 2
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 circun(s) or a limited energy 2
Please check appropriate item and enter tee 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: ) I,
NOTICE 5a. Enter total of above fees $ p -
5% Surcharge (.05 X total fees) $ 7.,
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 $ 1.12. 0 D
wordloanMNNwgm.epp
4/19/00 Activities for Case #: ELC95 -00664
5:52:00 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 12/29/95 CJS RECD TMP 12/29/95
ELCC003 Permit created 12/29/95 CJS PEND TMP 12/29/95
ELCC500 (F)Issue permit 12/29/95 CJA [ASS TMP 12/29/95
ELCC800 Case Finaled 3/19/96 MJR YES MJR 3/19/96
•
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service 411110110
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:
Date: 3 - I 9 - 1 (:, AR. P.M. Entry:
Address: I oZ 7 b O S W (1"
Tenant: Ste: MST:
BUP:
Con /Own: MEC:
cI b fs ' Ii S l U PLM:
ELC:
THE FOLLOW RECTIONS ARE REQUIRED: ELF 01 3 -6-1-4- libl'A. Fiz_c- 96 - 6. a
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pector: / Date: 6
APPROVED DISAPPROVED /CALL FOR REINSP. 4111. O