Permit CITY OF T I G A R D ELECTRICAL PERMIT
P ERMIT #: ELC1999 -00668
i e c DEVELOPMENT SERVICES DATE ISSUED: 11/08/1999
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BD -02600
SITE ADDRESS:. 12965 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT : 037 JURISDICTION: TIG
Project Description: Install 4 branch circuits to existing commercial building.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS • MISCELLANEOUS
1000 SF OR LESS: • 0 - 200 amp: PUMP /IRRIGATION: •
EACH ADD'L 500SF: • 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: . 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 • IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: -
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: • Contractor:
EMERY, ROSEMARIE TRUSTEE DYNALECTRIC
BY KIM, ROBERT + HAE LIM 2904 SW FIRST AVE.
1360 SW WOODWARD WAY PORTLAND, OR 97201
. PORTLAND, OR 97225
. Phone: Phone: 503- 226 -6771 O R I G I N AL
Reg #: LIC 066793
SUP 2950S
ELE 00026 -59
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT KJP 11/08/199c. $53.55 99- 319618 Elect'l Final
5PCT KJP 11/08/199c. $4.28 99- 319618
Total $57.83
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. � `
•
PERMITTEE'S SIGNATURE iyl G -� - i L 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: GG DATE: r 78/99
LICENSE NO: ___ a 7 S o S
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD EI trical Permit Application Plan Check #
13125 SW HALL BLVD. K ECEIVED Rec'd By
T IGARD OR 97223 Date Rec'd
Phone (503) 639 -4171, x304 P 11 N OV 0 4 1999 Date to P.E.
Date to DST
Inspection (503) 639 -4175 pprrIn of Type Permit # L. G/ fig-004e
Fax (503) 598 -1960 COMMUNITY OEVELO Called
Incomplete or illegible will not be accepted
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 a.5 r /vC FS Number of Inspections per permit allowed
Name (or name of business) ffalleij It gll.f llie, /f fel Service included: Items Cost Sum '
Address f2- 1 S- w- P444 /1-64fup / 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City /State /Zip / bee- Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial Er Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base);_ Installation, alteration, or relocation
Electrical Contractor 4 ley Ill ALE /7k= 200 amps or less $ 64.25 2
Add S 2.90 UTAi 1* Aug 201 amps to 400 amps $ 85.50 2
City �R4 - 15R4 State OR Zip 4 401 amps to 600 amps $ 128.50 2
ry p 601 amps to 1000 amps $ 192.50 2
Phone No. Zit- 6771 Over 1000 amps or volts $ 363.75 2
Job No. I -139 I Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2.10 59C. Exp.Date 10109 loiuG . 4c. Temporary Services or Feeders
OR State CCB Reg. No. / e Lo - i ?. Exp.Date 5 3 2000 Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
�c / 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n a_ :__"( 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. 2 /5 Exp.Date / 0/01 /0 / v \ see "b" above.
Phone No. 22-6- 6.77 / - 'Zyf 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee. 37 10
Phone No. First branch circuit / $ 37.50
Each additional branch circuit 3 $ 5.35 /b.(,-
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 53.5
* Submit 2 sets of plans with application where any of the above apply. %pi Surcharge (.05 X total fees) $ Z
Not required for temporary construction services. Subtotal $ 1 . 2 3
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $
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