Permit CITY OF TIGARD ELECTRICAL PERMIT
1 ,�, DEVELOPMENT SERVICES PERMIT #: ELC98 -0731
6 4 i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/14/98
PARCEL: 2S112DD -00800
SITE ADDRESS... :15670 SW UPPER BOONES FERRY RD
SUBDIVISION ZONING :C -G
BLOCK LOT JURISDICTION: TIG
Project Description: Installation of temporary service, 200 amps or less.
- -- 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
CHEVRON USA PRODUCTS CO type amount by date recpt
6001 BOLLINGER CYN RD BLDG L -1114 PRMT $ 50.00 DEB 12/14/98 98- 311513
SAN RAMON CA 94583 5PCT $ 2.50 DEB 12/14/98 98- 311513
Phone #:
Contractor:
NORTHWEST PUMP & EQUIPMENT $ 52.50 TOTAL
2800 NW 31ST
REQUIRED INSPECTIONS
PORTLAND OR 97210 Elect'1 Service
Phone #: 227 -7867 Elect'1 Final
Reg #..: 000645
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 180
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 1, throug 4 0R 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling )246 -1987. • ,
r I . � _ �'!� 4 I .i /'
Permittee Signature:' J _ �1 _ I ssued B
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 SUP R. ELEC' N: `„ g/a Cf�� / D�d`J DATE:
LICENSE NO : 5 /cc-5
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
6 , 4 p el `e, ° 3`07
1, Community Development ELECTRICAL PERMIT APPLICATION
.. A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # e4c?e -67.3/
�;�ii'j Phone (503) 639 -4171 Date Issued /9. -It/ -9 e
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Q�
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 /� Number of Inspections per permit allowed
r
Address /66 6 SA.). u� 7:76'OAr'£S ¢ Service included: Items Cost(ea) Sum
City /State/Zip 7 / 07e_ 4a. Residential - per unit 4
1000 sq ft or less $110 00
-
Name (or name of business) ( iri E additional 500 sq ft or
portion thereof $25 00 1
Commercial Et Residential ❑ Limited Energy
- $25 00
Each Manuf'd Home or Modular 2
Dwelhng Service or Feeder $68 00
2a. Contractor installation only: 4b. Services or Feeders
� !retaliation, alteration, or relocation 2
Electrical Contractor ,() f,1') ,,Z,�„,D + eft ii-0 200 amps or less $60.00 2
-
Address x aD &tea 3! t- /ha 201 amps to 400 amps $80.00 2
I `+` 401 amps to 600 amps $120 00 2
City ��z �,�� State 01L Zip q7 �/ O 601 amps to 1000 amps $180 00 2 - Phone No. .47-787 Over 1000 amps or volts $34000
—
Contractor's License No. ,-. -R5o2e... Reconnect only $5000
- Contractor's Board Reg. No. 6415'(0 9 4c. Temporary Services or Feeders
g p / C476--
Installation, 20 amps or l or relocation 2
Signature of Su r. Elec'n [-�ws, /- 200 amps or less / bso 00 /O_ 40 2
S"rS' Phone No. 201 amps to aoo am $75 00 2
License No.
1 _2,..2,7-9867 401 amps to 600 amps $100 00
-
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The lee for branch circuits with
Ci State Zi purchase of service or feeder lee. 2
`7 p Each branch circuit $5 00
Phone No. b) The lee for branch arcurts 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. First branch circuit $35 00
Each additional 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 ins $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:
NOTICE 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ ,.2.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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. ❑ Trust Account # $
Balance Due $ 5 .2 . SO
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