Permit CITY OF TIGARD
��• DEVELOPMENT SERVICES ELECTRICAL PERMIT
I . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: ELC96 -0683
DATE ISSUED: 11/05/96
PARCEL: 25110DB -00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING:C —G
BLOCK • LOT :10
Project Description: Installation of 3 feeders and 69 branch circuits.
- -- 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 • 2 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 1 EA ADD'L BRNCH CIRC: 69 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
CARL KARCHER ENTERPRISES type amount by date recpt
800 MELLON AVENUE PRMT $ 585.00 DRA 10/25/96 96- 285713
PLCK $ 146.25 DRA 10/25/96 96- 285713
MANTECA CA 95337 5PCT $ 29.25 DRA 10/25/96 96- 285713
Phone #: 823 -9251
Contractor:
ST JOHNS ELECTRIC INC $ 760.50 TOTAL
3202 NE 65TH ST
REQUIRED INSPECTIONS
VANCOUVER WA 98663 Ceiling Cover Underground Cove
Phone #: 360 - 693 -5100 Wall Cover Elect'1 Service
Reg #..: 43135
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This permit is issued subject to the regulations contained in the 10 � . ■
Tigard Municipal Cade, State of Ore. Specialty Codes and all other i t' ee Si inat e
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not starte I
within 180 days of issuance, or if work is suspended for more . /' 4 & :.l S
than 180 days. I s --d 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 : DATE:
LICENSE NO:
Call for inspection — 639 -4175
irr). EP POO cµ IL. !o-6,/0-6,5-c
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # 62C 940- o1P 8 3
h l en Date Issued A*•
q, -- Phone (503) 639 -4171 R T /SSu£: i/ '/ - ‘ 04_ -
FAX (503) 684 - 7297 ( .,, n w � � �� e
CITY OF TIGARD TDD No. (503) 684 -2772 Gam c/t• #44t 0
Inspection (503) 639 -4175 n , w - ^ oZ l�S P�
�"�, "� 7 lL✓
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Co r \ 'S .1 ` Number of Inspections per permit allowed
Address I55.2a J to Pn rw/i.r, A/u1y Service included: Items Cost(ea) Sum
City /State /Zip 7/7, 4 ri O (J 9 7,2 .2 y 4a. Residential - per unit
n 1000 sq. ft. or less $110.00 4
0
Name (or name of business) 0,0y- Is �2 Each additional 500 sq. ft. or
,,--� portion thereof $25.00
Commercial I�Q 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
• Installation, alteration, or relocation
Electrical Contractor _ , IIIP, . . , , / _ . 200 amps or less o 2 $60.00 /JO, 00 2
Address yy/ S if /E yr) in ' ✓ r Ian ,4n „S . 201 amps to 400 amps $80.00 2
City ,/ /Y11'.p�rv/ State d A - Zip 9,P 66/ 401 amps to 600 amps / $120.00 /.D,0 O 2
�l 601 amps to 1000 amps $180.00 2
Phone No. 360 - 693 -5/00) Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. A 7-35 G 4c. Temporary Services or Feeders
Contractor's Board Reg. No. , , 1 t. Installation, alteration, or relocation
Signature of Supr. Elec'n /6.� 200 amps or less 2
Lice No. ,306 / S Phone No. 7 / - 9. -5 /OO 201 amps to 400 amps $50.00 2
401 amps to 600 amps $
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
City State Zip purchase of service or feeder fee. 2
y Each branch circuit L $5.00 ,q 00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First additional circuit $35.00
not intended for sale, lease or rent.
Each additional 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 $4o.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:
5a. Enter total of above fees $ 595, 00
NOTICE 5% Surcharge (.05 X total fees) $ a 9. ;15
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ /y• .1
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $ /HG a5
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 7G D . 5 O
COMMENCED. wordkomdeNeko- ❑ Trust Account #
$
pim.wp
Balance Due $ ']c, o. 50
Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0683
CARL 1ARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code • Sent Done Done Date By
ELCC001 Application received 10/25/96 / / 10/25/96 PASS DRA 10/25/96 DRA
ELCC003 Permit created 10/25/96 / / 10/25/96 PASS DRA 10/25/96 DRA
ELCC115 Routed to Plans Examiner 10/25/96 / / 10/25/96 PASS DRA 10/25/96 DRA
ELCC120 Plans Approved /Routed to DSTs 10/25/96 / / 10/30/96 letter follows PASS MJR 10/30/96 MJR
ELCC400 (F)Ready to issue / / / / 11/04/96 PASS DRA 11/04/96 DRA
ELCC500 (F)Issue permit / / - / / _11/05/96 PASS DRA 11/05/96 DRA
ELCC700 Ceiling Cover 10/25/96 / / 02/05/97 PASS MJR 02/06/97 MJR
ELCC720 Wall Cover 10/25/96 /. / 01/07/97 PASS MJR 01/08/97 MJR
ELCC725 Underground Cover 10/25/96 / / 11/05/96 PASS MJR 11/06/96 MJR
ELCC725 Underground Cover / / / / 12/18/96 PGE's trench cover approved PASS MJR 12/18/96 MJR
ELCC725 Underground Cover / / / / 01/15/97 landscape - PASS MJR 01/16/97 MJR
ELCC730 Elect'l Service 10/25/96 / / 01/07/97 PASS MJR 01/08/97 MJR
ELCC799 Elect'l Final 10/25/96 / / 02/11/97 need permit on pay telephone PASS MJR 02/12/97 MJR
ELCC800 Case Finaled / / ' / / 02/11/97 see final PASS MJR 02/12/97 MJR
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