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', . - 6iZIID ni'p _ .' : 0 . - EP AD;='; I-: -EIF ial C;':1. iVI - .IN' PLAi� . „ . . .. , . of ' .E..; pl — 1 t' cii1 'i (.Ja . -. .. „ _ 1 ! .- •--- - -,-•- -- --- • ,C`1__' IN1 RV: y'1_I +t F.ECC`F T. qv- -- __.... 1. -I6t_.,: 1_>.mtJ % G 1 •: - . t ;71. ;' ; =I4 RFS IZ'-1`_i. ,.. o P . - _' : . r• '7r230 "V i1.L1.1.. - lP•i._..' ' , R,ec'r nn ? CJ Y.i!, v . ,— ..... = Ili _ ,`VLiiF°DR '> ^- R2_`_i 'CtiTIC-'C`. C[_t -;E5' PF'E:.'1=- ±/4SrF_C, Q,flC..' , i,'. 6 "E•'I(;f D PROPEF ?'TIEE ,isi`'1'C ' ?.r10t_i ;4_- ' I , ` ;1 ,-; t - ' I c.1! tF, '!I E. 'CIC`-IGC'iI C:I I 1.1 :+,;,,, _ - l •.in92 ��d I. I ' ? 'lr � T- �' !'a' 1 � � 7 ": �_] J a r �.x B - - L�'tT, T f' al '-i � - � :_ 1 .. I' ,, _ IA A LI V L) R 97 ;7-YE Lr C T p .Lt. •.1 - Es ., I t � 1701 I} ! -!, /• • '_, .i .!'1_ Ph6np „ :Cent ! -. C - - --- --- _----- •------ • - --- - --- -- •- •• - - - -- r I . r ---- • - -• - -- r . r-- �±1 -S i`;L��tTF I - 4 .F_ L "C'C 2`E, ;i: 'I�' °_t�4 i �1F E> - r..19, :25 T DTt il_. 1 33'2.• NE. ;7 11 .- . . ' - •- •--- --_ - -- RF. 01 r', L) I NC P iC' I t_INS: - -•- -- IFiLL.-`_=;f.O•!f_1 C,R. 971E ' , ' - Ceiling C:c7've - r - • - , • Ln(I0'; Cdn't- ��:•`. 1 it - - • 1�r,11.I- Coi'c'r" 1=i- ` 1 f , ' Rr fir, : ':3 ?., R!1''o- . Th e'Jlt ,„ is'is=_t1ed subject to the ;egbiatlnns, r antal',,'tid,,i nt�1e'+ '1 , Tigard !Ionic foal Code, 5f ar,e of th - i2Cla Slt +' arid; al'! other, e) • P- -ni it' t er c ti :i , rll - � t_l}•• e — ;`, 3ppl Iable iaws. 'ii! work i 11 be ,donee in accordance with' , ,I ' :' ,approved plans. This .permit, 'w111..;;excire it a:ork, i started 'LBO ''o ISsuan. e. on' - . i r , dr '. r ,i t , ,1 ', cI ari' r• L-� „ T S (S 7rn� lot`n 2 _ ' w.thin 'LB itaea irk- day -. :- '.I. : E s O'IPe r! B'; ,, . --------- ------ --- . - - - •- , ------ • ' I'1',I 77 AI--LfiT 3 L):v! CsNI1' e•- ' ' - - -• - -- -`--w"..7-. - -- , • - - -- - - I; ''.11:!'": e . 1, 1°1 £:i.- -- ra,:12 ,i. t:; 1'0 r"I ,i: ':i h 6 Fl g ,'i?I',k d e,:,, f.'.`n` p.r" Q, rJ E?1 . •,',,.,' I.I, 'rl 1,n,l i'in i c -1'l 1 , n 01: J:1-1 't• € 'd'. 'F' r'} 1.- . ,. ' �y- i 7 rte•, % , I_, fJ' Via.'ale -0r • {M1 tit, •t. . ' 1 ,. - • , n , • "' O E R' S 'EuI'i 1V!= TLIPE 1, _ - _ -� ,�_ DPITIE . • i d - „ „ -- - �� -r • _ : _. , - ;._.,. -' . ------- CON`;IT -TI R - I 'Ei•''.f ' 0.,IL,'--------- - - - - -- - . ;_. -_-_ _ —_..- 77 ''' I. „a1.31\11-1111 F,�f CIF CiU�'F7 i`.C...EC LIFITE' P _ 5 " ' , . f - ° .1 1 ' 4 ' O it r rl (7:r - -. 1 -. ; �?- X1 ?� - , • 1 CITY .2F TIGARD Electrical Permit Application Plan Check 13125 SW HALL BLVD. Rec'd By • VA"- Date Rec'd N'1 - 1 TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print or Type Permit # Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development / 19 ' PA LA A Number of Inspections per permit allowed . Name (or name of business) (arpC6 &Q / Service included: Items Cost Sum Address l 19 JJ • RGt -0 4- I � 4a. Residential - per unit © 1000 sq. ft. or less $110.00 4 City /State /Zi . /1 Oci(� Ott 1 -/ r Each additional 500 sq. ft. or Commercial k J 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 rre t ice se 4b. Services or Feeders Installation, alteration, or relocation Electrical Contractor 4 i.: / / L 200 amps or less $60.00 2 AddreSSyS9 S / / 7°I 201 amps to 400 amps $80.00 2 City /7 / /ti State O/t. Zip ?7/s - 79/, 401 amps to 600 amps $120.00 2 Phone No. 5 .2.. 6r 9 7 9 3f - � r5 n . 601 amps to 1000 amps $180.00 2 Job No. J '� Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. 3 V- 9,4# G Exp.Date • it • OR State CCB Reg. No0 / /20t/ Exp.Date t! Z 1M 4c. Temporary Services or Feeders COT Business Tax or Metro No.J`7-6 7r Exp.Date _. Installation, alteration, or relocation 200 amps or less $50.00 2 Si nature of Su r . Elec' 201 am to 400 am $75.00 2 g p 401 amps to 600 amps $100.00 2 - Over 600 amps to 1000 volts, License No. 370 / Exp.Date /v/9/ e see °b" above. Phone No. So - 6477 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. Address ach branch circuit $5.00 2 b) he fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit / $35.00 3 S 2 The installation is being made on property I own which is not Each additional branch circuit /6 $5.00 SO 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: Op Not required for temporary construction services. 5a. Enter total of above fees $ q 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 ...- y � c TIME AFTER WORK IS COMMENCED. ❑ Trust Account # / $ "___ __ Total balance Due I \DSTS \ELC96 APP Rev 9/96