Permit o e. CITY O F T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00207
�Ij;� DEVELOPMENT SERVICES DATE ISSUED: 4/9/99
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 102 C B -00 302
SITE ADDRESS: 13285 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT : 033 JURISDICTION: TIG
Proiect Description: Installing one branch circuit
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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: &e JL i etlei
ALADDIN MOTOR INNS /
10155 SW CAPITOL HWY .5t q b _ aUI u
PORTLAND, OR 97219 S Olt 97O(.
Phone: Phone: (09.0
Reg #: 24
FEES Required Inspections
Type By Date Amount Receipt Elect'l Sery
Elect'l Final
PRMT BON 4/8/99 $35.00 99- 314342
5PCT BON 4/8/99 $1.75 99- 314342
Total $36.75
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laves.
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.
Permit Signature: 0n k (AM Issued By: u�
V " ` � 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: ( l( c ar . DATE:
LICENSE NO:
Call! 639 -4175 by 7:00pm for an inspection the next business day
•
•
RECEIVED
Al 0 8 1999 Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
COh1 UNITY D VELOPMENT Tigard, OR 97223 Planck/Rec. #
Permit # EL,C� i 7
1 1 - Phone (503) 639 -4171
_14,1;-;41 !, ; Date Issued 1 i Al
FAX (503) 684 -7297 • ,,
CITY OF TIGARD TDD No. (503) 684-2772 Issued by fx�r"
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development r�' Number of Inspections per permit allowed •
Address / -3 P5 .3w / C� /t G Service included: Items Cost(ea) Sum
City /State/Zip i /9 Q/€ c 0 /e 7 722-3 4a. Residential - per unit 4
1000 sq. h. or less • $110.00
/
Name (or name of business) 600 4/ / IG Vl ci / rl/ Each additional 500 sq. ft. or
portion thereat $25.00 1
Commercial Residential ❑ Limited Energy $25.00
g
Each Maned Home or Modular 2
. Oweling Seuvioe or Feeder $88.00
2a. Contractor Installation only:
• 4b. Services or Feeders
• �^^ �1 /
Electrical Contractor e)e-- - &%(.�G7Y/ Installation. alteration, or relocation 2
200 amps or less $60.00 2
Addre 43 / 2 6E Gl[ Lt r A.... 201 amps to 400 amps $80.00 2
( �[
401 amps to 600 amps $120.00 2
City Q C kG r'vi 4 S State (ix_ Zip_9 70!-R- 601 amps to 1000 amps $180.00 2
Phone No. /57o- Over 1000 amps or voles • $340.00 2
Contractors License No. 3-5- Reconnect only $50.00
Contractors Board Reg. No. ,2
�• , 4c. Temporary Services or Feeders
Sig P M �� Installation, alteration, or relocation 2
, Si nature of Sur. Elec'n / 200 amps or less $50.00 2
License No. / ..2(.7 P ne No. / ,- 7 /- 201 amps to 400 woo $75.00 2
/ '' 401 ampsiteL800 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: sea 'b• above. •
4d. Branch Circuits
Print Owners Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service ar 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 reader lee. / 36-7 0-0
First brarch Omit / $35.00 2
not intended for sale, lease or rent. Each additional branch circuit
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 arcue(s) or a limited energy 2
Please check appropriate item and enter fee in section 58. panel, alteration or extension $40.00
4 or more residential units in one St ucture Mi nor Labels (10) $100.00
Service and feeder 225 amps or more inspection over 4f. Each additional ins
System over 600 volts nominal P
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:
' mil
NOTICE 5a. Enter total of above fees $ 3J •
5% Surcharge (.05 X total fees) $ /- 7S
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 $ 3(0- 7J-