Permit CITY OF T ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0060
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02 / 09 / 98
PARCEL: 1S134BC -00600
SITE ADDRESS...:1239O SW SCHOLLS FERRY RD
SUBDIVISION •MLP93 -0006 ZONING:C —G
BLOCK LOT •002 JURISDICTION: TIG
Project Description: Install a temp. 200 PMI' service for a new proposed carwash.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 1 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 : 0 W /SERVICE OR FEEDER: 0 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
THOMPSON & DAVIDSON LEASE type amount by date recpt
12475 SW MAIN STREET PRMT $ 50.00 GEO 02/09/98 98- 303165
TIGARD OR 97223 5PCT $ 2.50 GEO 02/09/98 98- 303165
Phone #:
Contractor:
RURAL ELECTRIC INC $ 52.50 TOTAL
5285 NE ELAM YOUG PKWY
REQUIRED INSPECTIONS
HILLSBORO OR 97124 Elect'1 Service
Phone #: 648 -6696 Elect' 1 Final
Reg #..: 000474
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -010 through OAR 952 - 001-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)2' .-I987. �/
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 /� CJ
SIGNATURE OF SUPR. ELEC' N : � DATE: ,, '% - /
LICENSE NO: • V L� S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +4
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Community Development ELECTRICAL PERMIT APPLICATION
, A
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # t� q9 -na nd
Date Issued
�.) I 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 Devgigpment Pacific Carwash Number of Inspections per permit allowed
Address <1:23;18 SW Scholls Ferry Rd Service included: Items Cost(ea) Sum
City /State /Zip Tigard, Or 4a. Residential - per unit
1000 sq ft or less $110 00 4
Name (or name of business) Each additional 500 sq ft or
portion thereof $25.00 1
Commercial El Residential El Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor Rural Electric, Inc. 200 amps or less $60 00 2
Address 5285 NE Elam Young Pkwy #A900 201 amps to 400 amps $80 00 2
401 amps to 600 amps $120 00 2
City Hillsboro State OR Zip 97124 601 amps to 1000 amps $180.00 2
Phone No. 648 -6696 Over 1000 amps or volts $340.00 2
Job NO. 8006 Reconnect only $50.00 2
Contractor's license NO. 34 -82C 4c. Temporary Services or Feeders
Contractor's Board Reg. No Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less S50.00 2
License No. 4062 —S Phone No. 648 -6696 201 amps to 400 amps $50 00
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 without
The installation is being made on property I own which is purchase of service or feeder fee. 2
Each
not intended for sale, lease or rent. Eac brancn additional nal br $ 00
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 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E C. Chapter 5 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 $ $50.00
NOTICE 5% Surcharge (.05 X total fees) $ 9 50
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 52.50
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) $ 0
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 52 _ 50
COMMENCED. ,...a.r.iwel.o- ❑ Trust Account #
$ 0
p,m app
Balance Due $ 52 . 50
F
RECEIVED
FEB 0 9 1998
COMMITY DEVELOMENT