Permit CITY OF TIGARD ELECTRICAL PERMIT
1V1; DEVELOPMENT SERVICES
PERMIT #: ELC98 -0059
I 1!1. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 02 / 10 / 98
PARCEL: 2S110AB -00200
SITE ADDRESS...:14411 SW PACIFIC HWY
SUBDIVISION -CANTERBURY PLACE ZONING:C —G
BLOCK • LOT •1 -3 JURISDICTION: TIG
Project De s c r i pt ion : Alteration of 201 to Wasp service, 30 branch circuits,
and additional inspection fee for second phase of job.
- -- 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: 30 PER INSPECTION • 1
201 — 400 amp • 1 ist W/0 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
ED GREEN type amount by date recpt
14411 SW. PACIFIC HWY PRMT $ 265.00 DRA 02/09/98 98- 303146
TIGARD OR 97223 5PCT $ 13.25 DRA 02/09/98 98- 303146
Phone #:
Contractor:
MY ELECTRICAL CONTRACTOR $ 278.25 TOTAL
HUYHN MY VAN
2193 SE 73RD AVE REQUIRED INSPECTIONS
HILLSBORO OR 97123 Ceiling Cover Elect'1 Service
Phone #: 591 -9694 Wall Cover Elect'1 Final
Reg #.. : 001111
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. ose rules are set forth in OAR 952 - 0011010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to n.'' by ailing (503)246 -1987.
Permittee Signature: 1 � �,.� / ,. , / Issued By: 'fth c�
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: O'V' / 9 (CJd r DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
ttttt -I--P 1 1 1
..... 1 1 1 t P 1 1 1 1 1 t1 1 F t htt i --F9-1 P 1 1 1 1 1 1 1 1 t P 1 1 -1 tai tttttttt +tttffttft +t ++
.. .
CITY OF TIGARD Electrical Permit Application Plan Ch- -
13125 SW HALL BLVD. Reid :y . _ RI .
TIGARD OR 97223 Date Rec • - " j
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST ' -
Print or Type
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit #
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ( Q2 -t hr tO" Sou.. a. Number of Inspections per permit allowed
n
Name (or name of business) S v' 6. (4Z Service included: Items Cost Sum
71
Address 1 7 / $i 1 10 4a. Residential - per unit
City/State/Zip /) q 0 O 9 3 1000 sq. ft. or less $110.00 4
ty p � ( 2 2 Each additional 500 sq. ft. or
Commercial 0 J Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
r CA'V 0 Dwelling Service or Feeder $68.00 2
2a. Contractor installation only : A v ia, �� JD 4b. Service • - • ders
(Attach copy of all current licenses) � r
Electrical Contractor y „ y Installatio alteration .r relocation .
Addre s ^� ►q3 S� - 3 64 ' 200 amps or ass $60.00 2
/� 201 amps to 400 amps $80.00 gO.O•• • 2
City dl State O i!? Zip C r -i..27 401 amps to 600 amps $120.00 2
Phone No. ✓Y /- Of 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. /1/153 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. xp. • . to Installation, alteration, or relocation
i ' / - 200 amps or less $50.00 2
201 amps to 400 amps - Signature of Supr. Elec'n A_lw • �. «�.�' 401 amps to 600 amps $100.0 2
-
Over 600 amps to 1000 volts,
License No._` - - S Exp.Date I- Oct r 98 see "b" above.
Phone No. 5 F re T €(
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 / Sb • � o 2
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 circui
$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 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 t 4f. Each additional inspection over
ce and feeder 225 amps or more o the allowable in any of the above S e,
System over 600 volts nominal `� ,,1 f,43) ti.� Per inspection / $35.00 3
Classified area or structure containing special occupanby i Per hour $55.00
as described in N.E.C. Chapter 5 P In Plant $55.00
c?r-Mm;t # eiP 97- 03 d'
* Submit 2 sets of plans with application where any of the above apply. S. Fees: �
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 # A
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
Page No. 1 CASE HISTORY FOR CASE NO.: ELC98 -0059
ED GREEN
14411 SW PACIFIC HWY
06/12/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
- - -- - -- -- - -- --- - --
ELCC001 Application received / / / / 02/09/98 RECD DRA 02/09/98 DRA
ELCC003 Permit created / / / / 02/09/98 DONE DRA 02/09/98 DRA
ELCC400 (F)Ready to issue / / / / 02/09/98 Contractor not updated w /CCB (late MEMO DRA 02/09/98 DRA
sending in renewal). Once update
received contact contractor, My Huynh at
727 -1972, to come in and pick up.
ELCC500 (F)Issue permit / / / / 02/10/98 PASS B 03/20/98 J *H
ELCC700 Ceiling Cover / / / / 02/13/98 PASS BRP 02/13/98 B *P
ELCC720 Wall Cover / / / / 02/13/98 PASS BRP 02/13/98 B *P
ELCC720 Wall Cover / / / / 03/03/98 PASS BRP 03/04/98 J *H
ELCC730 Elect'l Service / / / / 03/18/98 PASS BRP 03/20/98 J *H
ELCC799 Elect'l Final / / / / 03/18/98 PASS BRP 03/20/98 J *H
ELCC800 Case Finaled / / / / 03/18/98 PASS BRP 03/20/98 J *H