Permit CITY OF T E
T393
DATE ISSUED: 06/19/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S 1 1 EDD -00701
SITE ADDRESS...: 15800 SW UPPER BOONES FERRY RD
SUBDIVISION • ZONING:I —P
•
BLOCK • LOT
Project Description:
- -- 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: 1 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
INSTY PRINT type amount by date recpt
15800 SW UPPER BOONES FERRY RD PRMT $ 40.00 CJS 06/19/96 96- 280753
SUITE# 120 5PCT $ 2.00 CJS 06/19/96 96-280753
TIGARD OR 97223
Phone #:
Contractor:
BEAR ELECTRIC $ 42.00 TOTAL
PO BOX 389
28085 BUTTEVILLE RD NE REQUIRED INSPECTIONS
DONALD OR 97020 Wall Cover Elect'1 Final
Phone #: 503- 678 -1355 Elect'1 Service
Reg #..: 20919
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 Dore Char le S 5.
than 18® days. 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 --
SIGNATURE OF SUPR. ELEC' N : fy)&t (ed DATE:
LICENSE NO:
Call for inspection — 639 -4175
'r
Community Development ELECTRICAL PERMIT APPLICATION
4 ' 7 %01' 4 . �
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # FL(06-OI
Date Issued 6- )
ei 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: 02EGoN iguS /NESS P•4 2 K 4. Complete Fee Schedule Below:
Name of Development / NS1Y PR IN r- Number of Inspections per permit allowed
Address /590o 5W UPPE/7 P✓QOt/a f4/1RY /7.0 Service included: Items Cost(ea) Sum
City /State /Zip /Gi,t4.O ORELofV 7722- 4a. Residential - per unit
1000 sq ft or less $110 00 4
Name (or name of business) INS 7' P2/wr - SUITE 1W Each additional 500 sq ft or
portion thereof $25.00
Commercial ® Residential ❑ Limited Energy $25.00 1
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor g(Arz 6[..EGT2l G, 2NC , 200 amps or less $60.00 2
Address Pa. 5X 3 $ $80 00 2 201 amps to 400 amps 2
City D
401 am to 600 amps $120.00
oNA 1.- State Ok Zip , 7 , 92.-o $180.00 2
601 amps to 1000 amps
Phone No. to le - /3 Sr Over 1000 amps or volts $340.00 2
Job NO Reconnect only $50.00 2
/
contractor's license NO. / / �`/ - /O 6 4c. Temporary Services or Feeders
Contractor's Board Reg. No. /f1 /� .o - - Installation, alteration, or relocation
Signature of Supr. Elec'n if ' /�� %I 200 amps or less 2
License No. 2-73 Phon - No. 678 --/35T 201 am to 400 amps $so 00 2
401 amps to 600 amps $75.00
/ Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above
4d. Branch Circuits 69LTEnMfiDN / ,fOlifio,v - 2 Grua sr)
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
First branch circuit /
not intended for sale, lease or rent. $
$ 5 00 3S, ao 2
Each additional branch circuit '7 $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or imgation circle $40.00 2
Each sign or outline lighting $40 00
Signal circud(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:
NOTICE 5a. Enter total of above fees $ 4 /0 ,00
5% Surcharge (.05 X total fees) $ 2 • o o
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ la, o0
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) $ _Z___
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ y? , Do
COMMENCED. wmdkomdMako- ❑ Trust Account # $ X
KM aPP
Balance Due $ 4 /2-. 00
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.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other
Date: Q /a 5 A.M. P.M. Entry:
Ma Address: I 00 i _• /. 44, iiAA
/
Tenant: - Ste: / 2 MST:
BUP:
Con /Own: MEC:
PLM:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: ELC:
■
Inspector ?k r f(w(®.. 1 g, -2- 5' - -
X APPROVED _ DISAPPROVED /CALL FOR REINSP. CO
_-.1-- mr7