Permit CITY OF TIGARD ELECTRICAL PERMIT
a�
DEVELOPMENT SERVICES PERMIT #: ELC57 -0830
NPAd6'i'�I� DATE ISSUED: 12/18/97
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25114BC -00700
SITE ADDRESS...:1O185 SW RIVERWOOD LN
SUBDIVISION °PICKS LANDING NO.1 ZONING:R -4.5
BLOCK..........: LOT •062 JURISDICTION: TIG
Proj ect Description : Installation of one (1) service or feeder at 200 amps or
less to existing SFD.
- -- RESIDENTIAL UNIT - - -- -- -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 1st W/O 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.:
Owner: FEES -
PAT FROST type amount by date recpt
10185 SW RIVERWOOD LN PRMT $ 60.00 TJH 12/18/97 97- 301888
TIGARD OR 97224 SPCT $ 3.00 TJH 12/18/97 97- 301888
Phone #:
•
Contractor:
TUALATIN ELECTRIC $ 63. TOTAL
PO BOX 655
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 Rough -in Elect' Final
Phone #: .682 -2955 Elect ' Service
Reg #..: 000656
. 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 952-001-10 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: .t''T / s..,. `. ,,7,� / , � : / , slued By: Mt, ea -
OWNER INSTALLATION ONLY •-
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' SIGNATURE: • DATE:
CONTRACTOR INSTALLATION ONLY J
SIGNATURE OF ,SUPR. ELEC' N: / t ! , y DATE : /7/14/
LICENSE NO: 3 4.9 35
++++++++++++++++++++++++++++++++++++++++++++ +++ +++ +++++++ + + +++ + + + + +- h+++ +++ 4 ++ ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Ia - . - . - .
CITY OF TIGARD Electrical Permit Application Plan Check # t
13125 SW HALL BLVD. Rec'd By 1 i - 0
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST lai1 4
Inspection (503) 639 -4175 Print or Type Permit # g(,C d1 3U
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called Qtd
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1700-- � r / Number of Inspections per permit allowed
Name (or name of si business) F bS 1 Service included: Items Cost Sum
Address 101 a ) C• g \\ einN0Oct t--1 4a. Residential - per unit
City /State /Zip ■d► OR On Z 1000 sq. ft. or less
24 Each additional 500 sq. ft. or $110.00 4
4J portion thereof $25.00 1
Commercial ❑ Residential
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current l li _ icenses) L, C 4b. Services or Feeders
Electrical Contractor 1 _&Gt . ,� \n E`(,tal t. Installation, alteration, or relocation
Address 0 F) (t? 55 200 amps or less $60.00
t 2
201 amps to 400 amps $80.00 2
City tr.11 ivy `1 1 11e, State C Zip 0 1'1O' 7 O 401 amps to 600 amps $120.00 2
Phone No.. 7 155 601 amps to 1000 amps $180.00 2
Job No. 2002.0 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No.?) 02 G Exp.Dat- ■ Reconnect only $50.00 2
OR State CCB Reg. No. - . 0 , Exp r 1-- 4c. Temporary Services or Feeders
COT Business Tax or Metro No.' ;�i� >ys9 =7• a -te Installation, alteration, or relocation
gff 200 amps or less $50.00 2
Signature of Su r. Elec'n 201 amps to 400 amps $75.00 2
g p / 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No.3L1 -S xp.Date see "b" above.
Phone No.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installati • s: a) The fee for branch circuits with
purchase of service or
Print Owner's Name pai- t' feeder fee.
Address IO IA5 6:A N) ca_wey NNiOod L.-V-1 Each branch circuit $5.00 2
City - it CkrOt State Zip _91 7-7-4___ b) The fee for branch
of
h circuits
without purchase
Phone No 5()3 ` (pr3L- 2 c-S service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: cx=>
Not required for temporary construction services. 5a. Enter total of above fees $ & r
5% Surcharge (.05 X total fees) $ M
NOTICE Subtotal $ W.
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 693 .O
Total balance Due $
I: \DSTS\ELC96.APP Rev 9/96
•
RECENEr
DEC 1 8 1997
CONItillIN11‘
5/23/00 Activities for Case #: ELC97 -00830
2:17:15 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 12/18/97 TJH RECD TJH 12/18/97
ELCA003 Permit created 12/18/97 TJH PASS TJH 12/18/97
ELCA799 Elect'I Final 12/24/97 BRP. PASS B *P 12/24/97 Service was installed approx.
one year ago,no permit.
Appears to meet the minimum
code requirements.Panel needs
to be tapped for installing a
cover mounting screw. Owner
will verify if done.
ELCA500 (F) Issue permit 12/18/97 TJH PASS TJH 12/18/97
ELCA800 Case finaled 12/29/97 JT 12/29/97
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