Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00542
,r114. DEVELOPMENT SERVICES DATE ISSUED: 09/08/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S1346C -00401
SITE ADDRESS: 12442 SW SCHOLLS FERRY RD Weit-'
SUBDIVISION: 1
,/ ZONING: C -N
BLOCK: LOT : JURISDICTION: TIG
Project Description: Add four (4) branch circuits in an existing mechanical room.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: • Contractor:
SISTERS OF PROVIDENCE IN OR METRO ELECTRIC INC
BY STEVE FOSTER 2809 SE MYRTLEWOOD WAY
PO BOX 13993 GRESHAM, OR 97080
PORTLAND, OR 97213
Phone: Phone: 666 -2159
Reg #: LIC 00078173
SUP 2408S
ELE 26 -403c
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT DST 09/08/199. $53.55 99- 318167 Elect'I Final
5PCT DST 09/08/199 $3.75 99- 318167 ORIGINAL
Total $57.30
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY: '
OWNER INSTALLATION ONL
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: t" DATE: 9" - F 9
LICENSE NO: �
Call 639 -4175 by 7:00pm for an inspection the next business day
Ws 11 fs :1 tl'I' 1 -I: II.i I'-',' 503 FAS I9G0 Ul1Y (i1 - d e l) :?; U0'
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(CITY OF TIGARD Electrical Permit. _ _ Application F"snr.;r.eck#�_ __
Itccltloi'1
13125 SW HALL BLVD. kec'd By ______ ____ _ _
TIGARD OR 97223 Date Re,:- ___ .,
03ta to P E
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Ph le I L,03 , I'• 3':-4171, Y3C4 Da :_ to DST
In_ - -a::!: l: 639 -4175 Print of Type P rr,a# C - -e r z f j i �
7.--. V.--:::. 1960 Incomplete or illegible will not be ai:ceptc-d a. e" . -- -- -- ---
1. Job Address: ----
(( j 1 4. Complete Fee Sched�f :e Bcdcw: - -- -_
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Pi /u. (,) permit !ss, :! N is 'Cant; must provide c.intr.i:tor Ucr-rsc 4b S'c.rvir.es or Feeders
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, ntenied for S2 1e)Se •: ;k2'•1 tS...ic _ .
I O: ^,ner's S ana:ure _ _ . _
3. Plan Review section I ,f rr ...!.::Ire d):' % =” _ - — — -
Please check aputOror. to t, , ,_ n s r. '-3r3 ! 2t 6,-:h a_ - .. , Sf r - 1 • c I,.":1
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Class!fieci are:1 +.,r st _:t - ( , cir I . i . . ' °• r 1 5 . Fees:
descntedrnf�EG ct'.!'rr`. 13
Submit 2,sets of plans with app!,CaG•_n w( ' 4 „ , r ,,t,. • - .31,;-,i/ c ':• - ,' a. ” • i . '•' f S 7- r
' Not required for temporary construction services. i S ubtotal S - ._ —_
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PERMITS BECOME VOID IF WORK OR CONS IRUC`rION H U T HOR'ZED
Subtotal $ ___ - -. -
IS NOT COMMENCED WITHIN 160 DAYS, OR IF CONSTRUCTION OR — _,•�. - ,'^�
1 VJORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Acccunt # _ - -_ -- � r �,
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N ER WORK IS COMMENCED• __ . a •alance Due S -_ i r e _ _
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