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Permit CITY OF TI G A R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00367 r41? DEVELOPMENT SERVICES DATE ISSUED: 6/22/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 636 1 1 PARCEL: 1S133DC-08600 SITE ADDRESS: 13255 SW SHORE DR ��,,JJ ! 'NAC SUBDIVISION: WINTER LAKE ZONING: R -7 • BLOCK: LOT : 016 JURISDICTION: TIG Project Description: • Installation of one branch circuit. 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: 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: LITVIN, BORIA + GRF ELECTRIC KHVOYNITSKAYA, ELEONORA 15460"SE PARADISE LN 13255 SW SHORE DR MULINO, OR 97042 TIGARD, OR 97223 Phone: Phone: 503 - 829 -4146 Reg #: LIC 001015 SUP 3003S ELE 26 -878C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 6/22/99 $37.50 99- 316309 Elect'I Final 5PCT DEB 6/22/99 $1.87 99- 316309 Total $39.37 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 opted by - • regon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain •• ales of these rules direct questions to OUNC at (503) 246 -1987. Permit Signature: ` o / 1 j Issue. By: / alia.6' 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: N -d 4 4' DATE: 4 4.0 9 % 4' 9 LICENSE NO: 3065 5 . Call 639 -4175 by 7:00pm for an inspection the next business day 06/18/1999 15:54 5038295747 GRF ELECTRIC PAGE 01 RECEI"ED CITY' OF TIGARD JUN 21 1999 Electrical Permit Application t d 13125 SW HALL BLVD. Rec' TIGARD OR 97223 COMMUNITY DEVELOPMENT Date Recd to -Ai-1-9 Date to P.E. '� Phone (503) 639 -4171, x304 Print or Type %et Date to DST Inspection (503) s3s� -4i 7s Incomplete or illegible will not besa epted Permit Er.�IR 99 -0030 Fax (503) 684 -7297 cased 1. Job Address: 4. Complete Fee Schedule Below: m ent 13 Q _, Name of Development L T - r P � l � / Number of Inspections per permit allowed (or name of business) S / Stn " i a V Service Included: Items Cost Sum Address "1 4,,t,►°� i7 Z 2-3 Pr-4 4a. Residential - per unit Ciry /Stater p T 1003 sq. n, or less $110.00 4 Each additional 500 sq. ft. or Commercial ❑ Residential Ponion thereof $25.00 1 I ^ U mlted Energy $25.00 c.�c� Each Marwt'd Home or Modular 2a. Contractor Installation only: AR._ Desiring Service or Feeder $68.00 2 (Attach copy of all current II ) 4b. Services or Feeders Electrical Contractor Installation, alteration, or relocation Address _ 1 200 amps or less $00.00 2 1 /' Z rl+l t_Q. 201 amps to 400 amps - $80.00 2 CiCity /Vl k _ f A a f State i p ^ u 5F 401 amps to 800 amps $120.00 2 Phone No. 25 2 4 - fyl t f tp. 901 amps to 1000 amps - $180.00 . 2 Job No. r Over tool amps or volts - $340.00 _ 2 Elec. Cont. Lice. No. Z.(o - Cr.. Exp.Date Reconnect only $50.00 2 OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Fowlers COT Business Tax or Metro No. _ Exp.Date I alteration, or relocation 200 amps or less $50.00 2 Signature of Supr. Elec'n i � �'L/ 201 amps to 400 amps - $75.00 2 401 amps to 800 amps $100.00 2 - Over 800 amps to 1000 volts, License No. CR9 3 --...s Exp.Date see "b" above. Phone No. i 7 4 - 1/ 1 IP 44, Branch Circuits New, alteration or extension per panel 2b. For owner Installations: a) The tee for branch circuits with purchase of service or Print Owners Name feeder fee. , Address, Each branch circuit $6.00 2 b) The fee for branch circuits City _ State Z10 without purchase of 3 7 , Sa Phone No. sonice or feeder. First branch circuit __ $ 35 . 03 ----..44.1-- 2 The installation is being made on property I own which Is not Each addhonal branch circuit $5.00 2 Intended for sale, lease or rent. 4e. Miscellaneous Owner's Signature (Service or feeder not Included) 9 Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (If required):" Signal ciroult(s) or • limited energy panel, alteration or extension $40.00 2 Minor labels (10) $100.00 Please cheek appropriate Item end enter fee In section 68, 4 or more realdential units in one structure 41. Each additional Inspscdon over Service and feeder 225 amps or more the allowable In any of the above System over 800 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 este of plans with application where any of the above apply. 5. Fees: 31 Not required for temporary construction services. Ga. Enter total of above fees $ 5% Surcharge (.06 X total fees) v 7 $ NOTICE Subtotal 1 , $ 6b. Enter 25% of line 6s for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If r ad (Sec.3 ) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK 6 $ -_._ is SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY lo/5V3 3 7 TIME AFTER WORK IC COMMENCED. 000unt p Total betimes Due s 9 ' $ CITY OF TI G A R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00367 r41? DEVELOPMENT SERVICES DATE ISSUED: 6/22/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 636 1 1 PARCEL: 1S133DC-08600 SITE ADDRESS: 13255 SW SHORE DR ��,,JJ ! 'NAC SUBDIVISION: WINTER LAKE ZONING: R -7 • BLOCK: LOT : 016 JURISDICTION: TIG Project Description: • Installation of one branch circuit. 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: 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: LITVIN, BORIA + GRF ELECTRIC KHVOYNITSKAYA, ELEONORA 15460"SE PARADISE LN 13255 SW SHORE DR MULINO, OR 97042 TIGARD, OR 97223 Phone: Phone: 503 - 829 -4146 Reg #: LIC 001015 SUP 3003S ELE 26 -878C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 6/22/99 $37.50 99- 316309 Elect'I Final 5PCT DEB 6/22/99 $1.87 99- 316309 Total $39.37 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 opted by - • regon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain •• ales of these rules direct questions to OUNC at (503) 246 -1987. Permit Signature: ` o / 1 j Issue. By: / alia.6' 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: N -d 4 4' DATE: 4 4.0 9 % 4' 9 LICENSE NO: 3065 5 . Call 639 -4175 by 7:00pm for an inspection the next business day