Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC97-0045 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 01/23/97
PARCEL: 25110DB -00703
SITE ADDRESS...: 15348 SW PACIFIC HWY
SUBDIVISION....: ZONING:
BLOCK • LOT •
Project Description: Installing three signs
, - -- 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..: 3
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/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
LES SCHWAB TIRE CENTERS INC type amount by date recpt
PO BOX 667 PRMT $ 120.00 B 01/21/97 97- 289157
5PCT $ 6.00 B 01/21/97 97- 289157
PRINEVILLE OR 97754
Phone #: 541 - 447 -9162
Contractor:
ES & A INC $ 126.00 TOTAL
1210 OAK PATCH RD
REQUIRED INSPECTIONS
EUGENE OR 97042 Elect'l Service
Phone #: 541 - 485 -5546 Elect'1 Final
Reg #.. : 111286
This permit is issued subject to the regulations contained in the M / &b . . /lI -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e i gnat ure
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 190 days of issuance, or if work is suspended for more 1
than 180 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 : P1(( 1» . DATE: 1 2-3 4- 7
LICENSE NO: I1
Call for inspection – 639 -4175
rec'A. 1- zi-1
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # ELC� 1-oote
,��r�mi,l Date Issued I -- 7.- 6 11
�i�1
�n Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: �igro P ,�� 4. Complete Fee Schedule Below:
Name of Development I S ,�.hwA -t, 71 e Number of Inspections per permit.allowed
S
I
Address 15 - 34 R u) Ppt. de Service included: Items Cost(ea) Sum
City /State /Zip - Tiro O� e 1 4a. Residential - per unit •
1000 sq. ft. or less $110.00 4
Name (or name of business) I. e .S ,SC.!-,t. 5 Each additional 500 sq. ft. or
portion thereof $25.00
Commercial Residential El Limited Energy $25.00 1
✓ ` Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Si lectrical Contractor "- J 6,-.) In stallation, alteration, or relocation
200 amps or less $60.00 2
Address /' ..fl2..5 Su.) (n1 1% I O`+' 201 amps to 400 amps $80.00 2
City � 401 am to 600 amps $120.00 2 ?ark- State DA_ Zip e t - 12:0, $180.00 2
Phone No. 59 8 1 `N 0 Over 000 or volts $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. `LP 5 u.. S 4c. Temporary Services or Feeders
Contractor's Board Reg. No. JC . Installation, alteration, or relocation
Signature of Supr. Elec'n` % 200 amps or less 2
/ 201 amps to 400 amps $50.00 2
License No.4955I Lr P•.ne N.. cc37 O 401 amps to 600 amps $75.00
2
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 tee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. Eaddch ca b $$5.00
Eac h a acdditional l 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 1 -LA r
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 d� scribed 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:
5a. Enter total of above fees $ l •7O
/ NOTICE 5% Surcharge (.05 X total fees) $ (0.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHO r IZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% w f ne A for
Plan Review if required (Sec.3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS $
COMMENCED. wurdcomdeNeiee- ❑ Trust Account #
prm.app
Balance Due (mac Dd
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0045
• LES SCHWAB TIRE CENTERS INC
15348 SW PACIFIC HWY
09/17/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
•
ELCC001 Application received 01/23/97 / / 01/21/97 RECD B 01/23/97 BON
ELCC003 Permit created 01/23/97 / / 01/23/97 PEND B 01/23/97 BON
ELCC500 (F)Issue permit / / / / 01/23/97 PASS B 01/23/97 BON
ELCC799 Elect'l Final / / / / 03/25/97 PASS MJR 03/31/97 MJR
ELCC800 Case Finaled • / / / / 03/25/97 PASS MJR 03/31/97 MJR
•
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•