Permit CITY OF TIGARD ELECTRICAL PERMIT
. T DEVELOPMENT SERVICES PERMIT #: ELC99 -0117
� -• 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/25/99
PARCEL: 2S110BD -05600
SITE ADDRESS...:11904 SW VIEWCREST CT
SUBDIVISION -ASPEN RIDGE ZONING:R -4.5 •
BLOCK LOT •023 JURISDICTION: TIG
Proj ect Description : Installation of one branch circuit. Job No. 26096
- -- 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: 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
RICHARD BUNGE type amount by date recpt
11904 SW VIEWCREST CT PRMT $ 35.00 DEB 02/25/99 99- 313242
TIGARD OR 97224 5PCT $ 1.75 DEB 02/25/99 99- 313242
Phone #: 620 -9669
Contract or:
BECK ELECTRIC INC $ 36.75 TOTAL
9318 SE CHURCH ST
REQUIRED INSPECTIONS
CLACKAMAS OR, 97015 Elect' 1 Service
Phone #: 656 -7396 Elect' 1 Final
Reg #..: 000026
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 • ou to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 ',' 0 through OAR -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling 503)246 -1987.
Permittee Signature: 0,4 .,f/DO / Issued By: A4,
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 INSTALLATI N ONLY
SIGNATURE OF SUPR. ELEC' N: i 1/ 1 // %6 DATE:
LICENSE NO: 45026
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF„TIGARD Electrical Permit Application Plan C' eck #
13125 SW HALL BLVD. Rec'd :. •.1 7 r 1� ] /
n�h �1� Date Rec'd • - i 0
TIGARD OR 97223 "t Date to DST
(503) 639-4171, x304 -
Phone 503 639 -4171304 \k1i Date to P.E. r^
Inspection (503) 639 -4175 Print or Type Permit # E - D l 7
Fax (503) 684 -7297 v Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development --I -6 /l ,( A1 (/ Number of Inspections per permit allowed
Name (or name of b b�usi ' neess) Service included: Items Cost Sum
•
I
Address ii 7 0T l.() I_JL ?,1<) C/.Pfir Cr 4a. Residential - per unit
City/State/Zip � ja •e.d O/2.. 5 j 72 2 Each additional it or less $110.00 4
ty p Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residential
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all cent license � /fp, - , ' 4b. Services or Feeders
Electrical Contractor L X .cl L /G Installation, alteration, or relocation
Address 33 a uP" Ch u ✓ClL 200 amps or less 2 -
201 amps to 400 amps $80.00 2
City C -/4CK€ ✓ i 4 S State 0e... Zip 9 &S 401 amps to 600 amps $120.00 2
Phone No. 4057o 9 l 601 amps to 1000 amps $180.00 2
Job No. age a tacm,o Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. -SG Exp.Date /0--/
OR State CCB Reg. No. .2l0s?9 Exp.Date i/-/-00 4c. Temporary Services or Feeders
COT Business Tax or Metro No. j ..Da - Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n G , 'MA / 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
/� Over 600 amps to 1000 volts,
License No / - ,3 Exp.Date /0 -1-9 9 see "b" above.
Phone Nc 1nSTo - 7A9 to 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of _
Phone No. service or feeder fee. I 2 ov
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 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 sets of plans with application where any of the above apply. 5. Fees: -36700
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ f 7.S
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY c2 , 73 TIME AFTER WORK IS COMMENCED. El Trust Account #
Total balance Due $
I: \DSTS \ELC96 APP Rev 9/96