Permit V--
' CITY OF 1"IGARD ELECTRICAL PERMIT
4,0 ,, - DEVELOPMENT SERVICES PERMIT #: EL.C97 -05`1
�I li' � '
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 08/05/97
PARCEL: 1S136AD -04000
SITE ADDRESS...:115O7 SW PACIFIC HWY #B
SUBDIVISION....:VILLA RIDGE (PART ONLY) ZONING:C -G
BLOCK..........: LOT.... ...... ...:7 JURISDICTION TIG
Project Description : Edward Jones Investaents Sign RE: 55N97 -0091
•
- - -- 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.. g 1
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......: 121 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 400 amp - 0 . ist W/O SRVC OR FDR.: 0 PER HOUR ° 0
' 401 - 600 amp......: 0 EA ADD'_ 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: - - - -- - - --
MARTIN BROS INC type amount by date recpt
3165 COMMERCIAL ST SE PRMT $ 40.00 JSD 08/05/97 97- 297937
SALEM OR 97302 5PCT $ 2.00 JSD 08/05/97 97- 297937
Phone #:
Contractor: -- --
MARTIN BROS INC $ 42.00 TOTAL
3165 COMMERCIAL ST SE
' REQUIRED INSPECTIONS - --- ----
SALEM OR 97302 . Wall Cover .
Phone #: 364 -2211 Elect'1 Final _
Reg #..: 006476 .
This pereit, 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 peroit will expire if work is not started within 180
days of issuance, or if work is suspended for core 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 DUNG by calling (503)246- 1987. . - - -,
Permittee Signat7 �d r Issued By: ` -W _^
- - - - - -- 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:
-F„+-F.4. ++ ++-I + ++ + ++++ -1- +-I + + ++ +44+ ++++ +-I--F + + ++t+-I + + ++ + ++ •h ++ ++++ + + ++ +++++++4 - +-I + + +-I ++-1-+
Call 639 -4175 by 6:06 p.m. for an inspection needed the next business day
4.+1. F + + ++ + ++ + ++ + + +++ ++ + +++ + + ++ 4- 1- * + + ++ + ++ •• + +-F-I-++++ ++ + +++ + +-1 + + + +++ +-F-f•-F- h-I-++ + ++ + + ++
V Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # C LG97 -- O 1
'Aiii Phone (503) 639 -4171 Date Issued 7
" " 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 TIC, ta-fe� k .Je SS Number of Inspections per permit allowed
,� L pk e-X
Address j /5 / tti4 ( (,t)li- i g Service included: I tems Cost(ea) Sum
City/State2ip'rjq�Q� f o � 4a. Residential - per unit -- 4
wJ 1000 sq ft or less $110 00 ,
Name (or name of business) �c e.t sr,4 o...\ MA o �1J portion thereof $25 00
—
Commercial =� Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelhng Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
n ,^ Installation, alteration, or relocation 2
Electrical Contractor /f jt �(� , ,, j ,(55 `1L¢yt>0 200 amps or less $60 00 2
Address /o L r /".0,1C-1 - tt -i S E. 201 amps to 400 amps $80 00 2
— 401 amps to 600 amps $120 00 — City /AM–, State Ole Zip q' 601 amps to 1000 amps $180 00 2
—
Phone No. 6 - X44 - ,1,, / 1 Over 1000 amps or volts $340.00 2
Contractor's License No. Reconnect only $5000 —
Contractor's Board Reg. No. 64,176/ 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or lese $50.00 2 — L i c e n s e No. 3 q S ( hone No.? ( 201 amps to 400 amps $75 00 —
0 401 amps to 600 amps $100 00
—
Over 600 amps to 1000 volts
2b. For owner installations: see - b• above
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
Cf State ZI purchase of service or feeder fee. 2
ty p Each branch circuit $5 00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35 00
Each additional branch circuit $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or imgation arde $40 00 2
Each sign or outline lighting I $40 00 1.10 o9
Signal crcuit(s) or a limned 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 ins E35 00
Per hour $55 00
In Plant $55 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 $ -W 60-c?
5% Surcharge (.05 X total fees) $ ,;
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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 $ 42.
■aecandM•Ncpm app
• RECEIVED
,JUL 3 0 1997
COMMUNITY DEVELOPMENT