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816*7 SW CAROLt, CT
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd.,Tigard,OR 97223 (502)6394171 PERMIT #: ;7LC'37-0117
DATE ISSUEDt 03/0,3/97
PARCEL: 2S112BC-081.00
e3l ]J". (ADDRES"). - - 08167 SW CARnLE CT
"UDD T V I S I ON. . . . R(-)ZE MEADOWS Z0NING:R--4. 5
BL-017F. . . . . . . , . I (I T, .. . . . .. . . . . . . . ..4
Project Description: TNETL 1 BRANCH CIRCUIT
-_-TEMP SRVC/FEEDERS---- -----MISCELLANEOUS----_
1.000
----MISCELLANEOUS---- -
1.000 SF OR LESS. 0 200 alp. . . . . . . : 0 PUMP/IRRIGATION....: 0
EACH ADDIL 500SF. . . : 0 201. 400 amp,. . . . . . . 9 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 60Q' rPmp. . . . . . . t 0 S I GWAL/PANEL : 0
MANF. HM/ SVC/FDR. . - 0 601+afflps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
" -----SERVTCE,/FFFI)ER -- - --- --BRANC11 CTRCUTTc.:3)--- -ADDII-. INSPFCT TONS—
a - 200 amp. . . . . . : 0 W/SERVICE OR FFEDERt 0 PER INSPECTION. . . . . s 0
201 400 a m F). 1st W/O GRVC OR FDR. : I PER HOUR. . . . . . . . . . 0
401 600 amp. . . . . . : 0 EA ADD' i_ SRNCH CIRCe 0 IN PLANT. . . . . . . . . . . a 0
F.01. 1000 ami-.1. . . . . 21 REVIEW SECTION—
1.000+ amp/volt. . . . . 0 ) =4 RES UNIT01 . . . . . . . : ) 600 VOLT NOMI NAL. . i
Rpronnect only. . . . . . r SVC/FDR > = 22n AMPS. . - '7LASS AREA/SPEC OCC. :
Owner: FEES
f-AR01 /DAN HAIDER tyle mal-int by date reept
8167 SW CAROLE CT PRMT It 35. 0e 'TAT 03/03/917 97-291091
9F."f-T It 1. 75 TAT 03/03/97 97 -291091
TTGAPP OR 97223
Phone #:
Contractor:
WErP-3TPF ELErTRTr f, 36. 75 TOTAL.
7518 EW MACADAM AVE
REQUIRED INSPEC7IONS ------
PORTLAN'j OR 97219 Ceiling Cover Undergroi.ind Cove
Phone 503-245-3385 Wall Cnver Elect' l Service
Reg
This persit is issued subject to the regulations captained ii; the
Tigard Muni--ip4l Code, Stat6 of Ore. Specialty Codes and all other P P r ee
applicable 'awB. r',! wort, hill be done in arcorlArce with /
approved plans. This pervit will expire if work is not started
within IN days of issuance, or if wort; is suspended for more
than IN days.
INSTALAXTION ONLY-
The installation is being made! on property I own which is not intended foi
Galey lease, or rent.,
nWNER' S SIGNATURE: DATE:
INSTALLATION
GNATURE OF SUPH. ELECIN- DATE :
' CENSE NO.
Call for inspect .'.or, 639-4175
i
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 97223 Permit #
Date Issued
Phone (503) 639-4171 v –
CITY OF TtOARD FAX (503) 684-7297
TDD N- (503) 684-2772
Inspection (503) 639-4175
1. 'ob Address: _ 1 [4. Complete Fee Schedule Below:
Name of Development- /__ Number of Inspections per pei-mit allowed
Address .7 /-l!_ �/ ' Service included Items Cost(ea) Sum
Cay/State/Zip / 4/ 4a. Residential •per unit
/ / 1000 sq. It or less $,1000 4
Name (or name of business) �i'D/ �c- C u� Each additional 500 sq n or --
�/ portion thereof $2500
Commercial ❑ Residential is Limited Energy $2500 — 1
Each Manurd Home or Modular
Dwelling Service or Feeder $6R CO
2c' Contractor installation only: 4b. Services or Feeders
Electrical Contractor LtY' / flee
i 41 t
Installation,dipor l alteration,or reloca;hn
200 amps or lase $6000 2
Address 7�/ _ ort. �>< 201 amps to 4W amps —— $8000 — 2
City _ State _Zip l 401.mps to 600 amps _ $12000 _ 2
C i. C. 601 amps to 1000 amps $18000 2
Phone No. Over 1000 amps or volts $34000 2
,Job NO Z2 �, - ) Reconnect only �— $1,000 2
contractor's license NO. 4 6 _�U= __ 4c. Temporary Services or Feeders
Contractor's Board Reg. No. (� ins.alla ion.alteration,or relocation
Signature of Su r. Elec'n _ _.. 2Uu amps or less 2
License No,��_, / hone No. 'J 201 amps to 400 amps $5000 2
401 amps to 600 amps $'5 00 2
Over 600 amps to 1000 volts $11)000 —
2b. For owner installations: gee"b"above
Print Owner's Nanio4d. Branch Circuits
_....—__ __ New.alteration or extension per pane
Address—.-- _ a)The fee for branch circuits wlflr
-ity State�R Zip______ purchase or s4rvlce or feeder fee
Each b+anch circuit _ sl;00
Phone No. _ _ b)The fee for branch circuits without
The installation is being made on property I own which is I purchase of aervfce or feeder fee - 2
First branch circr.A $11100
not intended for safe, lease or rent. i Each addillonr.branch r.ircuh $1,00 �—
Owner's Signature____, 4e. Miscellaneor+s
(Service or feeder not included;
' Each pump or irrigation circle $4000
3. Plan Review section (I/ requJrel�. Each sign or outline lighting $4000 _
Sigi,al circudis)or a limited energy
Please check appropriate item and enter fee in section 5B. panel,alteration or extension _ $4000
_4 or more residential writs in one structure Minor Labels 001 $10000
Service and feeder 225 amps or more Y
_ System over 600 vutts nominal 4f. Each additional Inspection over
Classified area or structure contatnd.- special occup®+a:y the ailowable In any of the above
as described in N E C Chapter 5 +'er inspernon _ _ $3500
P,haw $5500
n n+ ---
Submit 2 sets of plans with application whom— an $5500 of the above - --" ----
apply. Not rerl_:ired for temporary construction services. 5. Fees:
N0110E 5a. En'er total of above fees $
— 5%n Surcharge (05 X ; -al fees) q
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%n of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plai Review if required (Sec 3) g _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal r J $ -- --
COMMENCED .,r:m,+•••• l_ Trust Account #
o m ran $ —
7 �
Balance Due a
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT 1:1-UMBING PERM ;,
13125 —OV Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171
. . . . . . . . PL.111)'I_ill 1 4
D(TrE !S!iULL'i 09/0",
IC ADDRI-,-"' 08167 SW CnRQ1-.L-
"JSDI ;;1—ILJ1\. RAZE MEADOWS ZONIN(3- F2-4. 5
LOT. . . . . . . .. . . . . . .4
1OM[ SPACES.
Cal" WUf4;." '�JJL)J) GARBAL-A D I SPOSAL'Z3. MOBILE I
UP USE. . . . -8F WA SH I NO MACH. . . . . . . : PACKFLOW PREVN'TRS. .
j
JF44NCY 03RP. . i:F43 FLOOR DRA 1 1 INIE pfli* 61, . . . . . . . . . . . . .
i ul RA L 11:t. . . . . . . . 12 WVER HErliTERS. . . . . . CATCH BASINS. . . . . . .
LOUNDR- Y TRAY;. . . . . . . SF RAIN DRAINS. . . . .
INKS. . . . . . . . . . . URINALS. . . . . . . . . . . . GREASE TRAPS. . . . . . . :
tivnIORILS. . . . . . OTHER FIXTURE-3. . . . .
IJB/SHOWERG. SEWER LINE ft )
I SHWASHLRS. . . RA'N DRAIN 'ft) . . . .
SPRINKL.ER 1JEW, I
FEES
HAIDEP T.-y 1:)e amal.trit y
1617 SW CAPOLE CT PR M T 15. 00 JH 09/09/93
5PCT 0. 755 JIA 112.19193
IGARL OR '17224
11-11-10 #g
R EU U I R D I Nf�-J-'LC'T I ONE
''i% persit Is issuec sub,)#,.,t to the regulations contained in the RP/Sac--k f I aLq P,-e v
iprd Municipal Code, State of Grp. Specialty Codes and all other Pinal lrmpi-ctior
applicable laws, All work will be done in accordance with
approved plars. Thjs persit will expire if KorL is not starter
within 184 days of issuance, or, if work is suspended for sort
days.
o t t e P G i.q ri Lit t 1-i
639-4175