Permit CITY OF TIGARD
ia.,. eiH. 9�+;,, ff`j DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC97 -0144
11- 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 03/12/97
PARCEL: 1S136CC -CHOO1
SITE ADDRESS...: 08376 SW PFAFFLE ST
SUBDIVISION....: CARRIAGE HOUSE APARTMENTS ZONING:R -12
BLOCK..... .....° LOT ..............
Project Description: Installation of temporary service
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- ------ MISCELLANEOUS - - -- --
1000 SF OR LESS 0 0 - 200 amp • 1 PUMP /IRRIGATION....: �21
EACH ADD' L 5O0SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY.....: 0 401 - 600 amp.. ° .. , .: 0 SIGNAL/PANEL °
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/O SRVC OR FDR.: 0 PER HOUR... ..... k:
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
ANDREWS MANAGEMENT LTD type amount by date recpt
4000 SW KRUSE WAY #270 PRMT $ 50.00 DMA 03/12/97 97- 291555
SPCT $ 2.50 DRA 03/12/97 97- 291555
LAKE OSWEGO OR 97035
Phone #: 639 -3645
Contractor: -- --
JARMER ELECTRIC INC $ 52.50 TOTAL
5105 SW 45TH
-- -• - - -- REQUIRED INSPECTIONS -- --- . - -__-
PORTLAND OR 97221
Phone #: 503- 246 - 5381
Reg #... 6924
This permit is issued subject to the regulations contained in the � Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e eS i ghat u -6
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 pare "IL./ / `.d .r�
than 180 days. I ued 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
5
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
ZI 'lli?' Permit # ELC� y7 -0/99
Phone (503) 639 -4171 Date Issued 3'/? ?
__.. FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by (&).41).
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development (A ( l ,-6 !-L rt 6+.`v..- Number of Inspections per permit allowed
Address n 117 dew T � f'T1'LL Service included: Items Cost(ea) Sum
J 4 72-P-3 4a . Residential - unit 4
City /State/Zip (Olq'� per
1000 sq. ft. or less $110.00
Name (or name of business) Each additional 500 sq. ft. o 1
portion thereof $25.00
Commercial ❑ Residential ❑ Limited Energy $25.00
- Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
�n n - Installation, alteration, or relocation 2
Electrical Contractor a dl/yr ,t E.Qap -t^ yK, ` t'c • 200 amps or less $60.00 2
Ad. ' s ..l • • 201 amps to 400 amps $80.00 2 -
_
City ZO P State ZI 401 amps to 600 amps $120.00 2 -
�, . 1 � P //� %� • 601 amps to 1000 amps $180.00 2
_
Phone No. f„ - ? I Over 1000 amps or vote $340.00 2
Contractor's License No. r9 co - )f1 Ll C. Reconnect only $50.00
Contractor's Board Reg. No. , l ./ 4c. Temporary Services or Feeders s
/, Installation, alteration, or relocation 1 Sr) 2
Signature of Supr. Elec'n 200 amps or less $50.00 v 2 -
License No. ?, 4CSS'S Phone No. 1". - • 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above.
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip Purchase of service or feeder fee. 2
Each branch circuit $5.00
11 ? 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
not intended for sale, lease or rent. First branch circuit $35.00 2
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 $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 - 1 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:
NOTICE 5a. Enter total of above fees $ (
5% Surcharge (.05 X total fees) $ .'
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ -- A - 76)
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 $ ,5A.
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