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Permit i CITY OF TIGARD \ DEVELOPMENT SERVICES ELECTRICAL PERMIT �v C l r PERMIT # : ELC96 -0684 ._'�+ : 13125 SW Hall Blvd., Tigard, OR 97223 503 639.4171 DATE ISSUED: 10 / 25 / 96 PARCEL: 2S112DA -0 1,00 SITE ADDRESS...: 06640 SW REDWOOD LN SUBDIVISION ° MLP96 -0002 ZONING: BLOCK • LOT • Project Description: installing service feeders - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS ° 0 0 — 200 amp • 1 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 • 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 DCC.: Owner: FEES OREGON ELECTRIC GROUP type amount by date recpt 7400 SW UPR BOONES FRY RD PRMT $ 50.00 TAT 10/25/96 96- 285726 SPCT $ 2.50 TAT 10/25/96 96- 285726 DURHAM OR 97224 Phone #: 684 -4672 Contractor: OREGON ELECTRIC GROUP $ 52.50 TOTAL 17400 SW UPPER BOONES FERRY RD STE 230 REQUIRED INSPECTIONS DURHAM OR 97224 Ceiling Cover Elect'1 Service Phone #: 503- 684 -4672 Wall Cover Elect'1 Final Reg #..: 000203 This permit is issued subject to the regulations contained in the L— / rt.6&[ if Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Signature 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 more /.e.( lid( AI/H.L.W than 18e days. Issued By OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for E sale, lease, or rent. OWNER'S SIGNATURE: DATE: - - - -- CONTRACTOR INSTALLATION ONLY i SIGNATURE OF SUP R. ELEC' N : DATE: LICENSE NO: Call for inspection — 639 -4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # �l- C9(�C?� -g , ��rPl�tr 4) I Date Issued ;.) I Phone (503) 639 -4171 FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Oregon Business Park Number of Inspections per permit allowed Address 6640 SW Redwood Lane Service included: Items Cost(ea) Sum City /State /Zip Tigard, OR 97224 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 Name (or name of business) Portland Clinic Each additional 500 sq. ft. or portion thereof $25.00 Commercial © Residential ❑ 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 Oregon Electric Group 200 amps or less $60.00 2 Addressl7400 SW Upper Boones Fprryer3 #230 201 ampsto400amps $80.00 2 City Durham State OR Zip97224 401 amps to 600 amps $120.00 2 601 amps to 1000 amps $180.00 2 Phone No. 684 -4672 FAX 684 -4676 Over 1000 amps or volts $340.00 Job NO. 12 3 9 2 Reconnect only $50.00 2 contractor's license NO. 2F -A5r.. 4c. Temporary Services or Feeders Contractor's Board Reg. • 203 • _ . ■ Installation, alteration, or relocation Signature of Supr. Elec'n lrMMOIN VA! , 200 amps or less 50.00 2 License No. 29645 Phone No. 684 -4.72 201 empsto400amps $50.00 2 401 amps to 600 amps $75.00 Fax 684 -4676 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 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 n a l 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 $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 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 $ NOTICE 5% Surcharge (.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 2.50 5b. Enter of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF vi 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. worecomdevleko ❑ Trust Account # Prm.aPP Balance Due $ 52.50 • Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0684 OREGON ELECTRIC GROUP 06640 SW REDWOOD LN 05/13/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By -- -- --- --- - - - -- --- ELCC001 Application received / /• / / 10/25/96 PASS TAT 10/25/96 TAT ELCC003 Permit created / / / / 10/25/96 PASS TAT 10/25/96 TAT ELCC500 (F)Iseue permit / / / / 10/25/96 PASS TAT 10/25/96 TAT ELCC730 Elect'l Service 10/25/96 / / 10/31/96 no service rating on safety switch DIS MJR 11/01/96 MJR bond grounding to can • ELCC800 Caee Finaled / / / / 11/04/96 no meter PASS MJR 11/05/96 MJR • •