Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC98-0088
.d�e�, DEVELOPMENT SERVICES DATE ISSUED: 02/23/98
Blvd., Tigard, O
, ( ) 6394171
PARCEL: 2S1O2BC -01300
SITE ADDRESS...:1O23O SW WALNUT ST
SUBDIVISION -NORTH TIGARDVILLE ADDITION ZONING:R -4.5
BLOCK LOT •027 JURISDICTION: TIG
Pro Project Description : Add a first branch circuit to an existing single family
dwelling.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 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/O 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
TONEY ZIGLINSKI type amount by date recpt
10230 SW WALNUT PRMT $ 35.00 GEO 02/23/98 98- 303506
TIGARD OR 97223 5PCT $ 1.75 GEO 02/23/98 98- 303506
Phone #:
Contract or:
BECK ELECTRIC INC $ 36.75 TOTAL
9318 SE CHURCH ST
REQUIRED INSPECTIONS
CLACKAMAS OR 97015 Underground Cove Elect'1 Final
Phone #: 656 -7396 Elect' 1 Service _ •
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 law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
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
SIGNATURE OF SUPR. ELEC' N: ch/ - DATE:
LICENSE NO: 13,R -s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
ADI '
I C ommunity Development ELECTRICAL PERMIT APPLICATION
.. A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
I ., . Permit # fret Cl -f6$S-
i I I Phone (503) 639 -4171 Date Issued
� FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development --}} Number of Inspections per permit allowed
Address 10 &)O SL ) .f)C1, Q ,(1 kJ,/ -\- Service included: Items Cost(ea) Sum
City/State/Zi. .r,.( `I A rt 0 � • r • 4► _ 4a. Residential - per unit 4
I 1000 sq. ft. or lees $110.00
Name (or name of business) Each additional 500 sq. ft. or ,
portion thereof $25.00
Commercial ❑ Residentia Limited Energy $25.00
lX
Each Manufd Home or Modular 2
. Dwelling Senioe or Feeder $68.00
2a. Contractor Installation only:
4b. Services or Feeders
•
Installation, alteration, or relocation 2
Electrical Contractor -V Q.R.L. 0 I . ' 200 amps or less $60.00 2
Address 9 1 6 f 201 amps to 400 amps $80.00 2
City State C Zip q'701 h 401 amps to soo amps $120.00 2
601 amps to 1000 amps $180.00 2 -
Phone No. (450 - '1 CO t, Over 1000 amps or volts $340.00 2
Contractor's License No. ?, -,5 C Reconnect only E50.00
Contractors Board Reg. No. _ r •a q 4c. Temporary Services or Feeders
j� /4271°F Installation, alteration, or relocation
Signature of Supr. Elec'n �/i�i 200 am 2 $60.00 2 -
License No. \ (D (U - /' N.. (D r l a (1+ 401 anppsbx.6600ar s $100.00 2
Over 600 amps to 1000 volts
2b. For owner Installations: see 'b• above.
Print Owners Name 4d. Branch Circuits
New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder Ara 2
Each branch arced $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is Purchase of dMv'ice or feeder fee. 2
not intended for sale, lease or rent. Fast branch circuit $35.00 c35 - 2
Each additional branch arced • $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 circurt(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 565.0
-
In Plant $65.00
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 $ 35
5% Surcharge (.05 X total fees) $ 1. 15
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
Subtotal $ ,(D.7
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. ❑ Trust Account #
Balance Due $ 3(p.15
- raetara.M.bom.,a
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