Permit A n' CITY OF TI GAR D ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97 -0335
L u � " �z'���'I DATE ISSUED: 06 / 17/97
i- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DA -01300
SITE ADDRESS...:O664O SW REDWOOD LN #303
SUBDIVISION •MLP96 -0002 ZONING:I —P
BLOCK • LOT • JURISDICTION:
Project Description : Tenant Improvement: Physical therapy clinic JOB #18042
- -- 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 • 1
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.: 1 PER HOUR • 0
401 — 600 amp : 0 EA ADD'L BRNCH CIRC: 20 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.:X
Owner: FEES
SISTERS OF PROVIDENCE type amount by date recpt
9205 SW BARNES PRMT $ 175.00 DRA 05/27/97 97- 295115
PORTLAND OR 97225 PLCK $ 43.75 DRA 05/27/97 97- 295115
5PCT $ 8.75 DRA 05/27/97 97- 295115
Phone #:
Contractor:
OREGON ELECT CONSTRCTN /GRP INC $ 227.50 TOTAL
1010 SE 11TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'l Final
Phone #: 234 -9900 Wall Cover
Reg #..: 036359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 ugh OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by Bing •)246 -1987.
Permittee Signature: _ems Issued By.
0.40
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: T""112-- C�-r �6'•"" DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Cd
c(7,,,0-?v P c� o5 /.� /� 1
10 0 Community Developme • - ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. 7' S !� ,_ 0-3 - 31 -.
a - Tigard, OR 9722 j� ' ermit # /
Oxrre �l)l�l ' I 44U Phone (503) 639-41 o Date Issued /
AKA
e I I � FAX (503) 684 -7297 �p � /
CITY OF TIGARD TDD No. (503) 684 -2772 . .
Inspection (503) 639 -4175 / ` C...ee, p6iG 5 ` P , T 1�, 5:4,✓ '
1. Job Address: 4. Complete Fee Schedule Below:
OREGON BUSINESS PARK
Name of Development PROVTT)ENCE HEAT,TA M. _ R Number of Inspections per permit allowed
i
Address 6640 Redwood Lane e 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) 3rd Fl. Tenant /Physice 1 Each additional 500 sq. ft. or
portion thereof $25.00
Commercial ® Residential ❑ TheraPy 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
Address 1010 SE 11TH 201 amps to 400 amps $80.00 2
City Portland State OR Zip 97214 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. (503) 234-9900 Over 1000 amps or volts $340.00 2
Job NO. 18042 Reconnect only $50.00 2
- contractor's license NO. 26 -95C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. t', • 3 / Installation, alteration, or relocation
Signature of Supr. Elec'n 741 .„ 200 amps or less 2
201 amps to 400 amps $50.00 2
License No. 2841S P one No. 234-9,40 401 amps to 600 amps $75.00 2
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 20 $5.00 100.00
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
Ea
addltional br
not intended for sale, lease or rent. Eat ddch ca br 1 $$5.00 35.00
anch 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 1 $40.00 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
X 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 $ 175.00
NOTICE 5% Surcharge (.05 X total fees) $ R. 7 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 183.75
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) $ 43.75
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 227.50
COMMENCED. word,comde i& c. ❑ Trust Account # $
prm.app
Balance Due $ 227.50
MEMORANDUM
CITY OF TIGARD, OREGON . _ .
TO: Finance
FROM: Jim Duckett
DATE: June 5, 1997
SUBJECT: Receipt #97-295115
The subject receipt was entered with an indication that $227.50 went to ELPLCK 23- 0000 - 433040.
The correct entries should be as follows:
ELPRMT $175.00 23- 0000 - 431510
ELPLCK $43.75 23- 0000 - 433040
TAX $8.75 10- 0000 - 230010
TOTAL $227.50
Thank you
•