Permit A, CITY OF TIGARD
ELECTRICAL PERMIT
1 ra '
DEVELOPMENT SERVI PERMIT
ISSUED: E C O6/O6097
PARCEL: 2S11ODB -00200
SITE ADDRESS...:15199 SW ROYALTY PKWY
SUBDIVISION •WILLOWBROOK FARM /ARBOR HEIGHTS ZONING:R -25
BLOCK • LOT •8 JURISDICTION: TIG
Project Description: P8E pole #2393
- -- 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 : 1 W /SERVICE OR FEEDER: 1 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 OCC.:
Owner: FEES
ARBOR HEIGHTS PHASE 1 type amount by date recpt
PRMT $ 65.00 JSD 06/06/97 97- 295590
SPCT $ 3.25 JSD 06/06/97 97- 295590
Phone #:
Contractor:
ANDERSONS INTEGRITY ELECTRIC $ 68.25 TOTAL
13018 SW LAURMONT DR
REQUIRED INSPECTIONS
TIGARD OR 97223 Underground Cove Elect'l Final
Phone #: 524 -6017 Elect'l Service
Reg #..: 000914
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Si.na Fe
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. Issued By
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:
Call for inspection — 639 -4175
"3a eL, eArb.rz %O.A. C-a-- - o✓ t a- pC Pdt.a- t4 .... IF z
, , �• Community Development ELECTRICAL PERMIT APPLICATION
..: 13125 SW Hall Blvd. 9 v
Tigard, OR 97223 Planck/Rec. # � r $0
• Permit #
1''M; gill Phone (503) 639 -4171 Date Issued c) ( -b!°
'` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 \IA Issued by -
Inspection (503) 639 -4175
1. Job Address: °- 4. Complete Fee Schedule Below:
igtoSor 6k Name of Development tS 400 , LQ I. O_ • 9 AUL, Number of Inspections per permit allowed
Address t S y CYO W t. tY9'i'1/4--A'p'2. Service included: Items Cost(ea) Sum
- pow ee,( a5I late, -2.4
City /State/Zi 1 ( w-,1 4a. Residential - per unit 4
$110.00
e.1 �� t5; 1000 sq. ft. or less
1
Name (or name of business) �� h add "�"�' Soo sq. n. or 1
portion thereof $25.00
Commercial Z Residential ❑ Limited Energy $25.00 2
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 2to-- 4b. Services or Feeders 2
Installation, alteration, or relocation r/
Electrical Contractor a ,,, , 4 IrAl�� ♦ _ 1 ' i' 200 amps or less I $60.00 W 0 2
fi -3 W Q / - - • 201 amps to 400 amps $80.00 2
Address • 401 amps to 600 amps $120.00 2
Cit±i)a (d State Zip Q70 7..„ 601 amps to 1000 amps 8180.00 2 ■
Phone No. SZ C(' l( f Over 1000 amps or volts $$50.00 2
-
Contractor's License No. ( -1 - 3(.13 v Reco only 850.00
Contractor's Board Reg. No.c1 I U 1 T emporary Services or Feeders
I lation, alteration, or relocation 2
Signature of Supr. Elec'n ' l' 200 amps or less $50.00 2 -
Li No. `5" 11 D 5 Phone No. S2f.{-�i Oa) 201 amps to 400 amps $75.00 - 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: ci I �1 see - b• above.
VV\IP C rl 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. ( c 2
Each branch circuit l $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 branch circuit $35.00 2
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 Classified area or structure containing special occupancy
as described in N.E.C. Chapter 5
4f. Each additional inspection over
the allowable in any of the above
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 $ /
� I NOTICE 5% Surcharge (.05 X total fees) $ =
I 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 $
1 COMMENCED. ❑ Trust Account # $
(nom Balance Due $
radbanWNWcVm ipp
•
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0400
ARBOR HEIGHTS PHASE 1
15199 SW ROYALTY PKWY
05/08/98
Action Description Reg/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
•
ELCC001 Application received 06/06/97 / / 06/06/97 PASS JSD 06/06/97 JD
ELCC003 Permit created 06/06/97 / / 06/06/97 PASS JSD 06/06/97 JD
ELCC500 (F)Iesue permit / / / / 06/06/97 Permit issued while computer was down. PASS JSD 06/06/97 JD
jed
ELCC799 Elect.' Final 06/06/97 / / 06/17/97 PASS BRP 07/11/97 JT
ELCD800 Case Finaled / / / / 06/17/97 PASS BRP 08/27/97 J*H
•
•
7/27/99 Activities for Case #: ELC97 -00400
1:56:45 PM •
Assigned " Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 6/6/97 6/6/97 JSD PASS JD 6/6/97
ELCC003 Permit created, 6/6/97 6/6/97 JSD PASS JD 6/6/97
ELCC799 Elect'l Final 6/6/97 • 6/17/97 BRP PASS JT 7/11/97
ELCC500 (F)Issue permit 6/6/97 JSD PASS JD 6/6/97 Permit issued while computer
was down. jsd
ELCD800 Case Finaled 6/17/97 BRP PASS J *H 8/27/97
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