Permit •
- CITY OF TIGARD PE RMIT C L PERMIT
PERMIT #i . ELCSC_ 2 11-9
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 03/06/96
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 8394171
PARCEL; `Si* 10AR -0 ; =210
CITE fDCORES 14297 SW PACIFIC HWY
SUBDIVISION - CANTERBUL RY PLACE ZG'NING :C - -G
l?1_3C!' 2 r 1T *1-3
Project Da scri pt i on :
--RESIDENTIAL UNIT---- - TEMP CRVC /FEEDERS- - - -- -- --MISCSLLp.N6 CUS
1000 SF OR LESS 0 0 - 200 ar;i p • 0 PUMP /IRRIGATION - 0
E*•C! ADD' L EOOSF...: 0 201 -- 400 amp - 0 SIGN /OUT LINE LTC..: 0
_:':SITED EN7RSY...... 0 401 - 600 amp • 0 SIGNAL /PANEL 0
'1 CIF HM/ O'JO /.-D ti.. . 11 6014 -amps Ion vc l'. =.. o 1INOR LABEL (10) ...: 0
- - - • -- SERVICE /FEEDER- - - - - -- . -• - -- BRANCH CIRCUITS - -- • -ADD' L INSPECTIONS —•
0 • 200 ap. . . . . . . 0 W/SERVICE OR =ED ER; I SF C 1 . . . .. °
s..f ICE �„ "r�CC: 0 PER 3'J �1- �_�TIC'h�. - 0
202+1 - 400 amp • 0 1st W/O ORVC OR FDR.: 1 PER HOUR 0
401 - - f'00 an p....., .: t EA ADD' L DRNCH C I R . C : 7 I N PLANT.. - 0
60 -- 1000 amp 0 - .. - - - - -- -PLAN '- _V EW SECTION----------------
1000' amp/ >=4 0 >_ RES UNITS _. . ` 600 VOLT NOMINAL-
Reconnect cn :y ` 0 SVC /FDR }= 225 AMPS..: CLASS AREA/SPEC OCC. :
FEES ......_...
DE `aNGELO' S CATERERS type amount by date recpt
14297 SW PACIFIC HWY PRMT $ 70.00 BON 03/06/96 96-76-S
5PCT $ 3.50 DON 03/06/96 96-27(1
T ICAR2 O R rr722- -
Phpne #: •
Con t ract o
.� � � y �E ....1'.IC 9' Tv. S 4_' TOTAL P 0 SOX .450
- - - - - -- REQUIRED I N3PECT I ONC --- _._. -_.
TILLAMOOR OR 97141 C=eiling Cover Elect' 1 Servic_
Wall Cover Elect' 1 Fira:.
This permit is issLed subject to the regulations contained in the C/
Tigard ` ni:ipal Code, State of Ore. Specialty Codes and all other Perm i tt e e Signature
applicable laws. (111 work will be done in accordance with
approved plans. This permit will expire if work is not started
Within 180 days of issance, or if work is suspended for more e1/1/ / /LJ /
than _S2 ea Issued By
--• - - _. -OWNER INSTALLATION ONLY-
The ilts:;allation is being made on property I own vvh :ich is not intended for
sale, Pease, or rent.
OWNER'S SIGNATURE: DATE :
•- - --CONTRACTOR INSTALLATION ONLY -- -- .._..__.._ _. - _ - -- -
CIS !ATURE OF SUPR. ELEC'N: 44A OT DATE:
LICENSE NO ,.
Call for inspection ... 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. I
Tigard, OR 97223 Permit # EL_1 (o. 211/ (D9
,�� Date Issued -(o - 1(0 1111 i{ Phone (503) 639 -4171
`"''` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
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1. Job Address: 4. Complete Fee Schedule Below:
Name of Development f) I Cx 2, .Q I O s (co -V-et Number of Inspections per permit allowed
s 1.4 Addres / 5. ( t...3 Pao (c - `' � Service included: Items Cost(ea) Sum
City /State /Zip . 'f(t 0 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
2'...---- portion thereof $25.00 1
Commercial Residential El Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
C I ' Installation, alteration, or relocation
Electrical Contractor
I'PL� 200 amps or less $60.00 2
Address 4.S3 ). S .6-) 4p-vi ry c r' 201 amps to 400 amps $80.00 2
City (x � Spr�tLe _ State �rR Zip 7 401 am to 600 amps $120.00 2
601 Q� 0 Z $180.00 2 mps F Phone No. 6 a Over 00 offs $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. A -t 78 4c. Temporary Services or Feeders
Contractor's Board Reg. No. !-f ClIti , x• Installation, alteration, or relocation
11. 2
Signature of Supr. E c'n 200 amps or less 2
S Pho ne No. t'n rl 3v 201 amps to 400 amps $50.00 2
License No. PA LI 401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. I OO 2
not intended for sale, lease or rent.
First additional c br $35.00 3
Each additional branch circuit - 14 - -7 $5.00 a
Owner's Signature 4e. Miscellaneous 1
(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 circuit(s) or a limited energy 2
Please check appropriate item and enter fee 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: 00
5a. Enter total of above fees $ 7 n.
NOTICE 5% Surcharge (.05 X total fees) $ 3- S C
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. wordiwmdeNeieo- ❑ Trust Account # $
Prm wP L O
Balance Due $ 1 3 .7
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing ��� -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation V2 J`'_" - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 7 /-- ( ! p A.M. P.M. Entry:
Address: 1 D 9 i !. 14 i
Te + rt.Y1 Ste: MST:
BUP:
Con /Own: l a g Z. 1336 M EC:
PLM:
ELC: 1 (p 0 ( 31
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
/ Ad1P .4
7
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1 q! efik/ / .iri =i - r_
Inspector: i id -.. A 4 A AO Date: 2: -. i
X APPROVED _ DISAPPROVED /CALL FOR REINSP. QV CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain over Service FINAL:
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 1 a-f' A.M. P.M. Entry:
/
Address: i 'f,-q
Tenant: Ste: MST:
�n - BUP:
Con /Own: 84-' c C-4 MEC:
6 SZ _ / 33 tj PLM:
ELC: 7 0
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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e cz /, f
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A Inspector: A C' ■ � -� Q Dat
APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO
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