Permit CITY OF TIGARD
4 . ,� ELECTRICAL PERMIT
°'��'ll DEVELOPMENT SERVICES � PERMIT #: ELC97 -0302
A19I- 11. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 05/20/97
PARCEL: 1S126OC- 01107
SITE ADDRESS...:O9499 SW WASHINGTON SQUARE RD
SUBDIVISION • ZONING:C —G
BLOCK • LOT JURISDICTION:
Project Description: Binyon's Eye World Job 8586T
- -- 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 2 W /SERVICE OR FEEDER: 80 PER INSPECTION • 0
201 — 400 amp • 0 1st W/O 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
WINMAR PACIFIC INC type amount by date recpt
PO BOX 21545 PRMT $ 520.00 JSD 05/20/97 97- 294764
SEATTLE WA 98111 5PCT $ 26.00 JSD 05/20/97 97- 294764
Phone #:
Contractor:
TUALATIN ELECTRIC $ 546.00 TOTAL
PO BOX 655
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 Ceiling Cover Elect'l Service
Phone #: 682 -2955 Wall Cover Elect'l Final
Reg #..: 000656
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e e Si n t ure
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. Issue. jay
OWNER INSTALLATION ON
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 for inspection — 639 -4175
i
■•
C OF TIGARD Electrical Permit Application Plan Check #
Rec'd SW HALL BLVD. Re d By ��
TIGARD OR 97223 Date Recd />�/ Y AO
Phone (503) 639 -4171, x304 Date to P.E.
( ) Date to DST
Inspection (503) 639 -4175 Print or Type Permit # ‘LG `77
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called -03o
1. Job Address: 4. Complete Fee Schedule Belo `' ' "'
S �u� e � .4747"...___ Name of Development UjtiS� i vltc" Number of Inspections per permit allowed
Name (or name C of business) An S �JEwdY U Service included: Items Cost Sum
(
Address 11 / / G 5 . "ii ' 11J SS\ n5>i"ty\ St . tee,/ 4a. Residential - per unit
City /State/Zip -T 3 Ard ``
/S . 1000 sq. ft. or less $110.00 4
i 3 Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof $25.00 1
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 current licenses) 4b. Services or Feeders
Electrical Co I nstallation, alteration, or relocation /3 41C
Contractor �� a QC�t'�L 200 amps or less $60.00 iad 2
Address F 0 • O I( (1.55 201 amps to 400 amps $80.00 2
City ■AlA.Scxm.);1\t State OR Zip 9! or) Q 401 amps to 600 amps $120.00 2
Phone No. Sc33 (pea- a955 601 amps to 1000 amps $180.00 2
Job No. _5-642-r Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. . " ZOO C Exp.Date 10 01 cl-7 Reconnect only $50.00 2
OR State CCB Reg. No. 5 . 0 Exp.Date 4 'au 1 46 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 2.1 Exp.Date Co/ ti1 i � Installation, alteration, or relocation
200 amps or less "� $50.00 2
201 amps to 400 amps $75.00 Signature of Supr. Elec'n " 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. � 3 S Exp.Date (0' `; $ see "b" above.
Phone No. tvsdd- ,g.
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. Q i'
Address Each branch circuit 6 ° $5.00 � 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
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: G X
Not required for temporary construction services. 5a. Enter total of above fees $ 2-(c) 5% Surcharge (.05 X total fees) $
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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 016 Cei
Total balance Due $
rte, fij 00
I. \DSTS \ELC96 APP Rev 9/96