Permit CITY OF TI G A R D ELECTRICAL PERMIT c
PERMIT #: ELC98 -0115
DATE ISSUED: 03/10/98
/t� DEVELOPMENT SERVICES
- '!! ' 13125 SW Hall Blvd., Tigard, OR 97223 (503)6394171 PARCEL: 1S134BC -00200
SITE ADDRESS•••:12186 SW SCHOLLS FERRY RD
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Project Description: PSETI jO8 #75304
- -- 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/0 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
PGE type amount by date recpt
121 SW SALMON PRMT $ 35.00 JSD 03/10/98 98- 303979
PORTLAND OR 97201 SPCT $ 1.75 JSD 03/10/98 98- 303979
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 36.75 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS - - - - --
PORTLAND OR 97214 Ceiling Cover Elect' 1 Service
Phone #: 234 -9900 Wall Cover Elect'1 Final
Reg #..: 203
This permit is issued subject to the regulations contained in the Ti r Municipal ode, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approve pl. s. Thi mit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 day A ION: 1 ..on law requires you to follow e rules adopted by
the Oregon Utility Notification Center. Those rules .r. set f• th i OAR 952 -0010 through OAR 952- ' I may obtain a copy
of these rules or direct questions to OUNC b a ' g 5031 .: 1987 //
/ _ `
Permittee Signature : am Issued By: _ _ l�
I I fr
OWNER INSTALLATION ONLY
The installation is being made on property I on 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
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMI PPLICATIO
A 13125 SW Hall Blvd. r ? -O/f
Tigard, OR 97223 Permit # 6�tr
,�� rlfl � il 1 ..� Date Issued /
; ,� i Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development PrR Number of Inspections per permit allowed
Address 12186 SW Scholls Ferry Rd. Service included: Items Cost(ea) Sum
City /State /Zip Tigard , Oregon 97 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) PGE Tigard Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial Dt Residential ❑ Limited Energy $25.00
Each Manurd 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 E1 er l ri a r;rnttp 200 amps or less $60.00 2
Address 1010 SE 11th Ave. 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City Portland State OR Zip 97214 601 amps to 1000 amps $180.00 2
Phone No. 502/214 -9900 Over 1000 amps or volts $340.00 2
Job NO. 75304 Reconnect only $50.00 2
contractor's license NO. 26 - 95C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. It 1 Installation, alteration, or relocation 2
Signature of Supr. Elec'n - Q. / .1 200 amps or less
201 amps to 400 amps $50.00 2
License No. 28418 Jo' hone •• 23 .' 900 401 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 $5.00
Phone No. b) The fee for branch circuits withou
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. Eat ddial br br 1 $$5.00 35.00
Ea
a additi onnal 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 $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
Chapter 5 Per inspection $35.00
as described in N.E.C. Cha
p 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 $ 35.00
NOTICE 5% Surcharge (.05 X total fees) $ 1.75
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 36. 75
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. wo,ecomdn eleo- ❑ Trust Account # $
prm.app
Balance Due $ 36.75
l
3' ' I / 5 1
I CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: //-- 3-13 % DD g �� __ A.M. P.M. MST:
Location: I? /8 (9 SC,/ —0 / i BUP:
Tenant: PG—E ' .4 • I Suite: Bldg: MEC:
,d am ' 7k� > 978
Contractor: ,0 . Phone: PLM:
Owner: Phone: ELC: ?p p
— 0 115
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL LECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover Sewer /Storm
Footing Roof UndFl/Slab Rough -hi Ceiling 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 Approv • Approved
Appr /Sdwlk Not Approved Not Approved Not Approved cr..._. . .. ved Not Approved
FINAL FINAL FINAL FIN • FINAL
O /5 /mi e . L-
/ A 5- s
O Call for reinspection \ ^ O Reinspection fee of $ required before O Unable to inspect
Inspector: i' T Dat 3 3 Page of