Permit 4, . . CFTY OF TIGARD ELECTRICAL PERMIT
tA., A DEVELOPMENT SERVICES PERMIT #: ELC97 -0559
—N.- 7.— 13125 SW Hall Blvd., Ti ard,OR97223 503 639 -4171 DATE ISSUED: 08/18/97
PARCEL: 2S104DB -03100
SITE ADDRESS...:13003 SW ROCKINGHAM DR
SUBDIVISION •AMESBURY HEIGHTS ZONING:R -4.5
BLOCK LOT °31 JURISDICTION: TIG
Project Description : MOVE SERIICE /FEEDER (200 AMPS OR LESS) AND TEMP
SERVICE /FEEDER 50'.
- -- RESIDENTIAL UN - - -- -- -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 • 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
OWNER t ype amount by date recpt.
PRMT $ 110.00 GEO 08/18/97 97- 298395
5PCT $ 5.50 GEO 08/18/97 97- 298395
Phone #:
Contractor:
EVANS ELECTRIC INC $ 115.50 TOTAL
11867 SW WILTON AVE
REQUIRED INSPECTIONS
TIGARD OR 97223 Underground Cove Elect' Final
Phone #: 579 -1224 Elect' 1 Service
Reg #..: 001048
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 for h in OAR 952-001 -0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to,1,;,111 -h ing (50312'. -1987.
1
Permittee Signature �.iL �I A Issued By• - ��.�,,�,✓
i
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 : DATE:
LICENSE NO: f 2R 5 5
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + ++ + + + + + + + + + ++ + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an i nspPct inn nPPrieri the next hiisi npss Hay
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
I
Community Development ELECTRICAL PERMIT APPLICATION v 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # -05's
/ 0 ii, 1 ( Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297 ;1
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by �_ _ "
Inspection (503) 639 -4175
1. Job Address: X8-0 iet''/ 4 - 4. Complete Fee Schedule Below:
Name of Development r Number of Inspections per permit allowed
Address /10 • 0 ' ® ' Ls• A 04 . Service included: Items Cost(ea) Sum
City/State/Zip I j n (1 CDC , L1 2x]"�-'' c 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Each additional 500 sq. ft. or 1
portion thereof $25.00 -
Commercial ❑ Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
-
2a. Contractor installation only:
_ P
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor
a L L ■ 200 amps or less $60.00 „ 2
i 201 amps to 400 amps .4 .0 �, �rati ►� ps $80.00 2
City , _IL State • . Zip •% 2 1
401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. !p 3 ® Over 1000 amps or vote $340.00 2 -
Contractor's License No. 1 pWCQ,I, Reconnect only $50.00
Contractor's Board Reg. No. 7)A-I -'465C 4c. Temporary Services or Feeders
Installation, alteration, or relocation
Signature of Supr. Elec'n 200 amps or less 11 $50.00 2
License No. ,Z(/L2) Phone N . « -55-0/ 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
City State Zip purchase of service or feeder fee. 2
Phone No. Each branch circuit $5.00
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
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
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
apply. Not required for temporary construction services. 5. Fees:
NOTICE
5a. Enter total of above fees $ //Q
5% Surcharge (.05 X total fees) $ 7 g
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 $ /J 5^ J 0
wordkeend.vlolocprm.app
c4 • CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: d` — 9 7 A.M. P.M. MST:
Location: 6 3 00 3 / "e .(/Y.. /2 BUP:
Tenant: Suite: Bldg: MEC:
Contractor: � l jQ M/3' Phone: 6 3 9- ( 7 PLM:
Owner: Phone: ELC: 7 -Q5S7
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cove ervice Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceil Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved (pprov Approved
Appr /Sdwlk Not Approved Not Approved Not Approved 1W Not Approved
FINAL FINAL FINAL FINAL FINAL
/`A. ) c •
,E - 0 7 i'
•
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O Call for reinspection einspection fee of $� required before next inspection CI Unable to inspect
Inspector: Date: U 2. `? 7 Page of