Permit CITY OF T' G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00322
- 13125 , DEVELOPMENT H B rMENTSERVICES 639 -4171 DATE ISSUED: 06/14/2000
Tigard. PARCEL: 1S126C0 -01403
SITE ADDRESS: 09483 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Branch Circuit
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MAY DEPT STORES COMPANY, THE J + J ELECTRIC INC
ATTN: PROPERTY TAX DEPT PO BOX 813
611 OLIVE STREET ALBANY, OR 97321
ST LOUIS, MO 63101
Phone: Phone: 541 - 928 -7695
Reg #: SUP 3252S
LIC 00000322
ELE 22 -3C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT JMT 06/14/200C $37.50 002932 Elect'l Final
5PCT JMT 06/14/200C $3.00 002932 d•�� �a..,
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY: p �� -6
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 639 -4175 by 7:00pm for an inspection the next business day
01/19/00 WED 17:37 FAX 503 598 1960 CITY OF TIGARD IA 002 1
CITY OF TIGARD Electrical Permit Application V Plan Check 0 e
. • 1 SW HALL BLVD. Rec'd By WI I/!7 ,
TIGARD OR 97223 RECEIVED Date Rec'd
Phone (503) 639 -4171, x304 Date to P.E.
inspection 603 639 -417b
Date to DST
ins Fn�
P ( ) Print of Type MAY 2 4 2000 Permit if de. 14°0 - 0032.-•
Fax (503) 598 -1960 Incomplete or Illegible will not be accepted Called
COMMUNITY OFVFI OPMENT
1. Job Address: 4. Complete Fee Schedule Below:
'Name of Development Number of Inspections per pdrmlt allowed
Name (or name of business) Me1)O4/44/3S Service included: Items Cost Sum 4-
Address 9if�.3 54i iJ4s4/ . Qo 4a. Residential - per unit
City/State/Zip 7;c4zn Q2 5 7 .2.23 1000 sq. ft. or less $ 117.75 4
Each additional 600 sq. ft. or
portion thereof $ 26.75 1
Commercial ® Residential El Limited Energy $ 60 00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data basal._ , Installation, alteration, or relocation
Electrical Contractor f -1 FLte T /e/G 200 amps or less _
n✓ $ 64.25 2
Address l= .3Uk N /� 201 amps to 400 amps _ $ 85.50 2
City /JL , I State .O' Zip 97.32 / 401 amps to 600 amps $ 122.50 2
601 amps to 1000 amps $ 192.50 2 •
S
Phone No. `/ /- 9c28- ?6o 9: Over 1000 amps or volts _ $ 383.75 2
Job No. , 00.266' Reconnect only 5 53.50 2
Elec. Cont. Lice. No. la -3C Exp.Date /C • 0/- -,0 4c. Temporary Services or Feeders
OR State CCB Reg. No. ,3.4,2 Exp.Date oil-IT-O.? Installation, alteration, or relocation
COT Business Tax or Metro N E .Date 200 amps or less - $ 63.60 2
A �� 401 201 amps amps l0 to 000 400 a s mm ps ps $
Signature of Supr. EIeC'n `t+�N.., Over 600 amps to 1000 volts, _ $ 107.00 80.25 2
2
see "b" above.
• Ucense No. ,.3.---s S Exp.Dat /0 --0/- 6 2 4d. Branch Circuits
Phone No. .5 4219- 7 (.9 r
New, alteration or extension per panel
a) The foe for branch circuits
2b. For owner Installations: wah purchase of service or
feeder fee.
Print Owner's Name • Each branch circuit 5 5.35 2
Address b) The fee for branch ciiculls
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit )( $ 37.60 , 7 5 P
Each additional branch circuit $ 5.35
The installation Is being made on property I own which Is not 4e. Miscellaneous '
intended for sale, lease or rent. (Service or feeder not Included)
Each pump or irrigation circle $ 42.75
Owner's bignature Each sign or outline lighting _ $ 42.75
Signal circuit(s) or a limited energy
• (if required):* pane e lereuon or extension $ 60.00
3. Plan Review section
1 . Minor Labels (10) $ 497:09
Please check appropriate Item and enter fee In section SB. 4f. Each additional Inspection over /�"�
al
4 or more residential units In one structure the allowable In any of the above
Per Inspection 5 50.00
Service and feeder 225 amps or more Per hour t $ 50.00 -
System over eo0 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 6 5. Fees:
a. Enter total of above fees 4 -T' Y $ .37 -5
* Submit 2 sets of plans with appllcatton'where any of the above apply. 3 Oro Surcharge (.Rex total fees) $ ___;/„_____"
- -"=�
services. required for temporary construction sees. Subtotal • or $
6b. Enter 25% of line 6a for
• NOTICE Plan Review )f required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED , Subtotal $ -
• IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account 0
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ .i
I:\dstslforms eiectrlc.doc
•
JAN -19 -2000 17:42 503 598 1960 P.002