Permit CITY OF TIGARD ELECTRICAL PERMIT
Li DEVELOPMENT SERVI PERMIT
PARCEL: ES102BA -00501
SITE ADDRESS...: 09740 SW TIGARD ST #1
SUBDIVISION ° NO °TIGARDVILLE ADDITION AMEND. ZONING :I -P
BLOCK. °. °. ° ° ° ° °° LOT ° ° °. ° °. ° ° °.. ° :60
Project Description: inst]. 6 branch circuits
- -- 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: 5 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
DANNEL SNYDER type amount by date recpt
9740 SW TIGARD PRMT 60.00 TAT 01/17/97 97- 289084
SPCT $ 3.00 TAT 01/17/97 97- 28908+
TIGARD OR 97223
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 63.00 TOTAL
PO BOX 230547
REQUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Underground Cove
Phone #: 503 -624 -3631 Wall Cover Elect'1 Service
Reg #° ° : 000750
This peroit is issued subject to the regulations contained in the p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permi S i gnat ur
applicable laws. All work will be done in accordance with
approved plans. This peroit will expire if work is not started /� " `J �
within 180 days of issuance, or if work is suspended for :ore
than liM da I s s e d B y 9 /�'
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 for inspection - 639 -4175
- -
1
; Community Development ELECTRICAL PERMIT APPLICATION
, �
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued 7_-e1,97-67)31/,
'/ 7/9 7
�(i'C 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 D a Arty- / S/V y e ` i o,t Number of Inspections per permit allowed
Address 0 1 7- `{ 0 so (j 5 t D 4- Service included Items Cost(ea) Sum
City /State /Zip I i S Pk fi n 0 .^ % ? Z Z3 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
Commercial K. Residential ❑ Limited Energy $25 00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
4b. Services or Feeders
1 *HP ( 9
Electrical Contractor • i i 4 M �1 >' c i 4.c_ /a' C_ Installation, alteration, or relocation $60.00 2
200 amps or less
Address PB Zo..� 23
201 amps to 400 amps $80.00 2
�- 4 01 amps to 600 amps $120 00 2
City / i et- State�/C Zip f�� k / $180 00 2
601 amps to 1000 amps
Phone Nof. & 2J( - 36 3 / Over 1000 amps or volts $340 00 2
Job NO. 5Y94, Reconnect only $50 00 2
contractor's license NO. 3 `l ' "Z.8 C___ 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Jl 4 SW" S ---- ' / Installation, alteration, or relocation 2
Signature of Sur. Elec'n /..tL,a�vt« 7 -. 201 amps to 400 amps $50 00 .,--- 200 amps or less 2
License No. /W S t 5 Phone No. bay SL - c/
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. S — 2
not intended for sale, lease or rent. First branch circuit $
Each additional branch circuit r� $5.00 S
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 circui(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 $ ( ol)
NOTICE 5% Surcharge (.05 X total fees) $ 3 U `
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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) $
/
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. word komde weo- ❑ Trust Account #
prm app
Balance Due co ,
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone. 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 4 7 1- /r) L ! 91 A.M. P.M. E try:
Address: Q - 7 40 l Sfi
Tenant: Ste: MST.
—� BUP:
Con /Own: 1 JJ y X o , E• MEd:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
J r
/ ( -Q— 1 _ C �,
3 _
4 .)f- 2'1-GP ( iatfi
Inspector: I ( c . „ . . -. ( Date? L/-.'
X APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO