Permit CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00399
41. DEVELOPMENT SERVICES DATE ISSUED: 7/6/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S104DC -08700
SITE ADDRESS: 13285 SW WOODSHIRE LN
SUBDIVISION: MORNINGSTAR ZONING: R -4.5
BLOCK: LOT : 024 JURISDICTION: TIG
Proiect Description: Installation of one branch circuit for new a/c unit. Job No. R16499.
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:
LEON PAULSON SHARPE ELECTRIC INC
13285 SW WOODSHIRE LN 22605 SW RIGGS
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: 524 -8375 Phone: 642 -7937
Reg #: LIC 000815
SUP 3344S
ELE 34 -217C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT DEB 7/6/99 $37.50 6002 Elect'l Final
5PCT DEB 7/6/99 $2.63 6002
Total $40.13
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 •• • • • - = les or direct questions to OUNC at (503)
246 -1987
Permit Signature: I ued By: 1 _ / IA,
OWNER INSTALLATION 0 ' -
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR I STALLATION ONLY
SIGNATURE OF S?UPR.CE/ 0,17,4--L.
LEC'N: — � DATE:
J
LICENSE NO: 3 y7 S
Call 639 -4175 by 7:00pm for an inspection the next business day
CITYlOF TIGARD Electrical Permit Application Plan Ch
'4'3125 SW HALL BLVD. Recd B
TIGARD OR 97223 Date Recd 7 -6 -99
Date to P.E
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit # EG0199' 0o3`19
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development (� Number of Inspections per permit allowed
Name (or name of business)�t -vt T Service included: Items Cost Sum
Address /' ,2 8'S 8141 I� prgirt�i 4a. Residential - per unit
Cit /State /Zip ---/-7 6ie � 9,, a3 1000 sq. ft or less $ 117.75 4
Each additional 500 sq ft or
portion thereof $ 26.25 1
Commercial ❑ Residentia, Limited Energy $ 60 00
Each Manut'd 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 base) Installation, alteration, or relocation
Electrical Contractor �' i i/G 200 amps or less $ 64.25 2
Address v,r2 �..,
(n -- 201 amps to 400 amps $ 85 50 2
Ci ,i� vt State �° 7 7 1i � 7 401 amps to 600 amps $ 128 50 2
ry p 601 amps to 1000 amps $ 192 50 2
Phone No. Co. Y Q., 7 Over 1000 amps or volts $ 363.75 2
Job No. ye / to y Y Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 Y A/? C- Exp.Date / 0 l /� 9 4c. Temporary Services or Feeders
OR State CCB Reg. No. rig/ Exp.Date 5 06 I nstallation, alteration, or relocation
COT Business Tax or Metro No. ,g5.3 / Exp.Date aV //an 200 amps or less $ 53 50 2
201 amps to 400 amps $ 80 25 2
Signature of Supr. Elec'n ffi k /�' 401 amps to 600 amps $ 107 00 2
Over 600 amps to 1000 volts,
3 see "b" above.
License No. 3 3 / yS Exp.Date /6/ 6( 4d. Branch Circuits
Phone No. ' Va _7 9 3
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee. I Phone No. First branch circuit L $ 37.50
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 Signature Each sign or outline lighting $ 42 75
Signal circuit(s) or a limited energy
panel, a alteration or extension $ 60.00
3. Plan Review section (if required):*
Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50 00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: b
5a. En)r total of above fees $,,‘"? '
* Submit 2 sets of plans with application where any of the above apply. 7%)d7 Surcharge (05 X total fees) $ ,, , 403
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if 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 # /3
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ p '
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