Permit CITY OF TIGARD ELECTRICAL PERMIT
,' ;,x DEVELOPMENT SERVICES PERMIT #: ELC98 -0455
�af DATE ISSUED: 08/05/98
" � � .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 25111AD -06800
SITE ADDRESS...:08875 SW SCHECKLA DR
SUBDIVISION •SCHECKLA PARK ESTATES ZONING:R -4.5
BLOCK LOT •022 JURISDICTION: TIG
Project Description: Turzillo job 898 -887
- -- 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 : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp : 0 1st W/O SRVC OR FDR.: 1 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
DAVID TURZILLO type amount by date recpt
88 DW OR 97224A DR EXPIRED SPOT 3 1.7 JSD 08/05/98 98- 308017
TIGARD OR 97224
Phone #:
Contractor:
ELECTRIC GROUP INC, THE $ 36.75 TOTAL
4726 SE MILWAUKIE AVE
REQUIRED INSPECTIONS
PORTLAND OR 97202 Rough —in Elect' 1 Final
Phone #: 232 -2499 Elect'1 Service
Reg #..: 000438
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Cod : and all other
applicable laws. All work will be done in accordance ith approved plans. This permit will expire if work is not s :rted within 180
days of issuance, or if work is suspended for lore th 180 day ATTENTION: Oregon law requires you to folio ' adopted by
the Oregon Utility Notification Center. ose r les re set f in OAR 952-001 -0010 through OAR 952-80 ain a copy
of these rules or direct que s t C!�' :lli g c 03 1987. !OderArs
/ Alif Permittee Signature: 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 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++
CITY OF TIGARD R /vE lectrical Permit Application Recd B ,
13125 SW HALL BLVD. y !� t
A0 Date Re
TIGARD OR 97223 " ' cd _ Ulf/
C 1996. Date to P.E.
Phone (503) 639 -4171, x3�4"M0N��,
Inspection (503) 639 -4175 viyf .r Print or Type Date
t S � J
Fax (503) 684 -7297 I `ofnplete or illegible will not be accepted Called `YL
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development J Number of Inspections per permit allowed
Name (or name of business).�47U40 ThRz // Service included: Items Cost Sum
Address 1"S &7.S SG) .. 4A-C -4 1/d 4a. Residential - per unit
City/State/Zip 7'7d2a€6 C90 g 7zz y locoad additional 500 $110.00 4
ty P Each additional 500 sq. ft. or
l portion thereof $25.00 1
Commercial ❑ Residentia
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 licenses) 4b. Services or Feeders
Electrical Contractor , - - - , 't �.. _ • _ II Installation, alteration, or relocation
AddreAs q ' SE /y;1 1w.)?�k. 4 - 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City pr- +b,.,.d State 2'Z- Zip 4 ' 2.1.).... 401 amps to 600 amps $120.00 2
Phone No. 3a- R.4 99 601 amps to 1000 amps $180.00 2
Job No. .Fg sly Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. a 10 yy5G Exp.Date ID -1 -10
OR State CCB Reg. No. y 3R S i Exp.Date )f - i t - 9R 4c. Temporary Services or Feeders
COT Business Tax or Metro No. : „ Exp.D -te 9 J_ /-9A Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 4�� - 201 amps to 400 amps $ 5.00 2
f 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No aO S 5 $' Exp.Date see "b" above.
Phone Nr ...___a:__3 Z z y 9 �' EXPIRED /� 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. 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. S. Fees: 35---
Not required for temporary construction services. 5a. Enter total of above fees $ / �-
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ ' b9�
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 # / ^
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96