Permit CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
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PERMIT #: ELC96 -0754
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' .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/26/96
PARCEL: 1S136CC -CHOO1
SITE ADDRESS...: 08376 SW PFAFFLE ST
SUBDIVISION • CARRIAGE HOUSE APARTMENTS ZONING:R -12
BLOCK • LOT •
Project Description: Recreation room for Carriage House apartments
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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: 20 PER INSPECTION • 0
201 - 400 amp ° 2 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.:
Owners: FEES
ANDREWS MANAGEMENT, LTD type amount by date recpt
4000 SW KRUSE WAY #270 PRMT $ 220.00 B 12/23/96 96- 288066
PLCK $ 20.00 B 12/23/96 96- 288066
LAKE OSWEGO OR 97035 SPCT $ 11.00 B 12/23/96 96- 288066
Phone #: 699 -8645
Contractor:
JARMER ELECTRIC INC $ 251.00 TOTAL
5105 SW 45TH
REQUIRED INSPECTIONS
PORTLAND OR 97221 Ceiling Cover Underground Cove
Phone #: 503- 246 -5381 Wall Cover Elect' 1 Service
Reg #..: 6924
This pervit is issued subject to the regulations contained in the it L,
Tigard Municipal Code, State of Ore. Specialty Codes and all other P e r m i tee - • nu r e
applicable laws. All work will be done in accordance with U
approved plans. This perxit will expire if work is not started
within 188 days of issuance, or if work is suspended for yore _%�
than 188 days. Iss .-day
OWNER INSTALLATION ► Y --------
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
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
i�� �� f Permit # E�.CM 2- 015
, �t�I Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175 c&Li 1k I t-2 7 -11(0
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development LA-22..1 A-4 � Me- Number of Inspections per permit allowed
�;
Address 9)3 )6 £ � C) )4„a Service included: Items Cost(ea) Sum
City/State/Zip I ) G� A 4a. Residential - per unit 4
V 1000 sq. n. or less $110.00
Name (or name of business) 1-eC,.- to t l,(1i. Each additional 500 sq. ft. or 1 -
portion thereof $25.00
Commercial ❑ Residential ❑ Limited Energy $25.00
Each Manufd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders 1Z
• Installation, alteration, or relocation 1 2
Electrical Contractor } 1 ► , _ .1‘. 200 amps cr less $50.00 2
Address �5 �tZ�i a • ► , r • 201 amps to 400 amps $80.00 -
7W! Staten e Zip k' 401 amps to 600 amps $120.00 2
r•
City g 11 601 amps to 1000 amps $180.00 2
`�I i � �.
Phone No. 3 • Over 1000 amps or volts $340.00 2
Contractor's License No. ../Q At (q � 4 G Reconnect only $50.00
-
Contractor's Board Reg. No. Ca 9 ;4 4c. Temporary Services or Feeders
Installation, ion, or relocation 2
Signature of Supr. Elec'n 200 200 amps or less or less $50.00 2
-
License No ��S Phone Nit ayL -,g31s 1 201 amps to 400 amps $75.00 401 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 Ash j l �.cJ� 2
Each branch circuit L $5.00 l�C/
10 0 Phone No. b) The fee for branch circuits withou
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
Owners 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 inspectio $35.00
Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above
4 apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ 'Z Cs
5% Surcharge (.05 X total fees) $ )
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 2.-S )
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. o
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) 9i c /� $ '-
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal / 1
COMMENCED. ❑ Trust Account # $
Balance Due $ 25 ,o°
■acherndwAsiscpm.app
Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0754
ANDREWS MANAGEMENT, LTD
08376 SW PFAFFLE ST
04/25/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Cod Sent Done Done Date By
ELCB001 Application Received 11/26/96 / / 11/22/96 RECD B 11/26/96 BON
ELCB003 Permit created 11/26/96 / / 11/26/96 PEND B 11/26/96 BON
ELCB115 Plans Approved /Routed to DSTs / / / / 11/26/96 APPR MJR 11/26/96 BON
ELCB400 (F) Ready to issue / / / / 11/26/96 PASS B 11/26/96 BON
ELCB700 Ceiling Cover 11/26/96 / / 04/08/97 PASS MJR 04/08/97 MJR
ELCB720 Wall Cover 11/26/96 / / 04/08/97 PASS MJR 04/08/97 MJR
ELCB725 Underground Cover 11/26/96 / / 07/09/97 pool bonding okay PASS BRP 07/30/97 J *H
ELCB730 Elect'l Service 11/26/96 / / 04/08/97 PASS MJR 04/08/97 MJR
ELCB799 Elect'l Final 11/26/96 / / 08/05/97 pool not complete DIS MJR 08/15/97 B *P
wet niche lighting fixtures
UL listed ok.
ELCB799 Elect'l Final / / / / 08/15/97 PASS MJR 08/20/97 MJR
ELCB800 Case finaled / / / / 08/15/97 PASS MJR 08/20/97 MJR
ELCB920 Miscellaneous action / / / / 08/06/97 grounding for ladders and pool equipment GRND MJR 08/06/97 MJR
approved
ELCC500 (F)Iesue permit / / / / 12/26/96 PASS JSD 12/26/96 CTR
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