Permit ELECTRICAL PERMIT
CF1Y OF TIGARD DATE 09 /`4/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 839 -4171 PARCEL: 1 S 136CC- 00200
SITE ADDRESS...: 08332 SW PFAFFLE ST
SUBDIVISION....: ZONING:R-25
BLOCK........... LOT •
Project Description: Installing one service or feeder to 200 amps.
- -- RESIDENTIAL LJNIT - - -- - -- -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 - 1 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp ° 0 ist W/O SRVC OR FDR.: 0 PER HOUR ° 0
401 - 600 amp • 0 EA ADD' L BRNCH C I RC : 0 I N 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 -- -- --
CARRIAGE HOUSE C� \ ° type amount by date recpt
8300 SW PFAFFLE ST. PRMT $ 60.00 CJS 09/24/96 96- 284303
SPCT $ 3.00 CJS 09/24/96 96- 284303
T IGARD OR 97:23
Phone #:
Contractor: - - -• - -- ------
JARMER ELECTRIC INC $ 63.00 TOTAL
5105 SW 45TH
-• REQUIRED INSPECTIONS --- - - -- --
PORTLAND OR 97221 Elect' i Service _ ___ ry ___ - __
Phone #: 503-246-5381 Elect'''. Final _
Reg it..: 6924
This persit 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 e Si gnat ure
applicable laws. All work will be done in accordance with
approved plans. This persit will expire if work is not started L�;C����
within 180 days of issuance, or if work is suspended for sore ______
than 180 days. I s s u e 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 SUP R. EL.EC' N : . fJ)G. l l ___ DA TE : � t.� .A-`' - 4 F'
Call for inspection - 639 -4175
' Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 96--
Permit # /C96-0 LISA
il `"' ' �' iI'i Phone (503) 639 -4171 Date Issued L.)- r c1
�'�' � I -' C(- a FAX (503) 684 -7297
Issued by C
CITY OF TIGARD TDD No. (503) 684 -2772 G, G r le s �, n, ;4/7'
910 Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address R 3 ozs S (.3 Q9 Service included: Items Cost(ea) Sum
a. Residential - unit 4
2lp � D 0 R 9 73,401.1 Par
�' ? Each additional 00 sq. ft. or $110.00
Name (or name of b iness) portion thereof $25.00
1
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
1040.einti) Installation , alteration, or relocation 2
Electrical Contractor /YY�A / n 200 amps or less 1 $60.00 (s fl 2
A : 1 r . ) `) 1-5 a4 201 amps to 400 amps $80.00 2 - W p q r, l 401 amps to 600 amps $120.00 2 - City ‘. I _ . � State OR- Zip / ) 601 amps to 1000 amps $180.00 2
Phone No. ,Q /'C. - 3 ) over l000 amps or volts $340.00 2
-
Contractor's License No. . (o - )SGT Reconnect only $50.00 -
Contractor's Board Reg. No. (o q,4 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Sup r. Elites ~ 200 amps or less $50.00 2 -
License No. N (t g gS Phone 0 3 I 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.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
purchase of service or feeder lee. 2
City State Zip Each branch circuit $5.00
i 1 } 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 lee. 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
-
a 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 M inor 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 inspectio $35.00 -
Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above
e apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ ( C) 0
5% Surcharge (.05 X total fees) $ A ,
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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 $ (03
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