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CITY OF TIGARD c-!..""rTRICnL F'ERMIT
DEVELOPMEN f SERVICES PERMIT #: rt.C97--0516
13125 SW Nall Blvd., 1'Igard, OR 97223 (503)639.4111 DfgTP r'7511FD a 07/31 /97
r"'ARCEL: 2SIO'C-P
i: ; •: 1' i aP,. . :. . :WT1. ' '1tJFTTF' 7ONING: R -It. "
CK. . . . . . . . . . LOT. . . . . . . . . , . , . . 1; 1, TI_.1RIS DICT ION
j fact Le ,cr• i pi. i(in : installing service or feeder to 280 apps and two branch
-uits
Rr- TUF::I\1TIAL UPITT - TEIIP RVC,/FErDFR' MIarELLfahJr.O1J1
'r)0 Cr- OR LESS. . . . : fit 0 - 200 amp. . . . . . . . 0 PUMP/IRRIGATION. . . . : C
':N ADD' L- 300GF. . . : 0 x_01 400 amp. . . . , ., . . 0 S I GWOL1T LINE LTG. „
MTTED ENERGY. . . . . : 0 401 - GOO amp. . . . . •. . : ti SIGNAL./PANEL... . . . . . . : 0
iv. I-IM/ wVr/rDP. . : Qt GO A �ainps t000, v;,1 c . : 0 MINOR L..ASEL. ( 10) . . . o 17
S'ERVICE''FEF.DEFi_.__._ ____.�RANCN CIRCU1Tc;_._._.-.. --nDD' L IWE-IPECTI"
"'O►Z •:.amp. . . . . . 1. W/T)rn'JTCC OR. r-ErDER. PER INSPECTION. . .
4:.
400 amp. . . . . . . 0 1st Wo E;RVG OR FDR' : 0 ;''CR HOUR. . . . . . . . . . . T
1 GOO :.amp. . . . . . , 411 C'n fel;Ll' L. 13R.NCtl CTRL: 0 IN PL.ANT. . . . . . ., . .
I -- 1000 amp. . . . . : 0 _PLAN REVIEW SECTI(?N - - __.____._.__.___ ...
0+ amp/v 01t. . . . . : 0 ) ;=4 W'S) UNT15. . . . . . . . : 600 VOLT NOIN1,TKIAL. . :
,::orrrrect wily. . . . . . 0 SVC/FnR ? - 225AMPS. . . CLf155 AREA/ )Prr' nr•r., ,
r"ECS . .
RIL.YS WALKER type aIn01.111t by date ;.
"her rW .if1ME s 5T PRMT t (`10. 00 P 07/ 1. ,"�7 '.)7
;ARD OR 972413 SPOT $ 3. 00 P 07,131 /97 977r??,
Jrrn-. #k:
._.I. f7WITt.1NnU'r1_.DTNC: ^ERVICCS I OO 'T't!Tnt,
"1 nRr0'Rr71"N C' ECTRTCnL_ CONST 70
N MASON _.__..,.._.._._.. pi7vt.l I RED
"LOWD OR 9717 Rcrh iry EIec t' 1 Final
rntz #: E.Iec_,t' 1 Sc, iI:e
pet-lit is issued subject to the regli'ations contained in Vie Tigo-d Municipal Code, State of Oregon Specialty Codes and all other
icable lav,:. A11 work will be done in a.cordance with, approved plans. This persit will ex;ire if work i! r,ot started wit',.r lav
of Issuance, or if work is .uspended for sore than 180 days, ELATION: Oregon law requires you to follow the rules adopted by
Cregon Utility Notification Center, "hose r,,les t 'ort, P OAR 952481-Nl1 through JAR 952-W-1987, Yau say obtair a c.oi,
'hese rules or direct questions tc 4031'
C
_.... .__._. ._. OWNER INSTALLATION ONLY-
in t; itr;r iy laeiny made tin ,)t,clkaert;y T own vilIi( Ir i. -
1 c, ] e.;a5v t.rr rent.
'drR' S STGNATURF: I)f1T1 .
r. ,-rr,(tr•rr.'t T rl^-r•ni n"r'T flhl 17'
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Ha;l Blvd. _
Date Issued '
Tigard, OR 97223 Permit # _ 7-
31 ' 7
Phone (503) 639-4171 —
CITY OF TIOARQ FAX (503) 684-7297
TDD No (503) 684-2772
Inspection (503) 639-41-5
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Wimber or Inspections per permit allowed
Address 1 ,9 3 .1 e .S lv -.I t-jMi c 5 Z Servtc^ included. Items Cost(ea) Sum
w City/State/Zip 'T 6/4C D (J, 3 4a. Residential -per unit
k 1000 sq ft or less $11000 4
Name (or name of business) Al Each additions;500 sq ft or
portion thereof $2500
Commercial ❑ Residential Limited Energy $2500
Each Manufd Home or Modular
Owelling Service or Feeder $6800
2a. Contractor installation only:
i s + 41 1,A- 11 I'll" ( � / r 4b. services or Feeders
Electrical Contractor?&C-(,/i L E /i- LLL �. -S rR ,
installation alteration,or relocsa�n
2W amps or less $6000 2
Address_ 4 m S'r 201 amps to 400 amps $8000 —— 2
City 7 C _M State C PC Zlp t' 401 amps to 60C amps $120 00 2
Phone No. -;4S-A' Over 1000 amps or volts $340.0000 2
Job NO. Reconnect only $5000 2
contractor's license NO. .:i 41 1-, C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. C 6, Installation,alteration,or relocation c•
Signature? of Sup- t ;'nom/ `;t��r _,r .� 200 amps or less ! "^� 1_� 2
? 201 amps to 400 amps $50.00 2
License No. ._ Phone No✓.` _ 401 amps to 800 amps $7500
Over 600 amps to 300 voila $100.00 —
2b. For owner installations: see"b"above•.
4d. Branch Circuital
Print Owner's Name New.alteration or extension per pane
Address_ e)The tett for branch circuits with
City State Zip purchase o)'eervrae or i seder fee. /� t
Phone No. b)T'ebranch circuit $5. 00
e fee for brsnch circuits without L5L_
Thp installation is being made on property I own which is purchase ofser.':eorfeederties. 2
not intended for sale, (ease or rent. Peet branch circuit $35.00 2Fach additional branch circuit $5.00
owner's Signature _ _ 4e. Miscellaneous
-------------__--_.---
(Service or feeder not Included)
3. Plan Review section (/f required): Each pump or Irrigation circle $40.00
Each sign or outline lighting $4000
filgnel clrcult(s)or a limited energy -
lease check appropriate Item and enter fee in section 5B. panel,altercilo�nr--t-�slon $4000
4 or more residential units in one structure Minor Labels(10) $10000 —
J� Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure contain,ig special occupancy the allowable In any of:he above
as described In N E C Chapter 5 Per Inspection $3500
Per hour _ $5500
In Plant $55 00 _
S'tbmit 2 sets of plans with application where any of the above —�
apply. Not required for temporary construction services. 5. Fees: o r
NOTICE 5a. Enter total of above fees $
5%Su.charge (.05 X tote! fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED W THIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPEIIDED OR ABANDONED Fu.-, Plan Review if required (Sec.3) $
A PERIOD 09: 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. iruSt Ar count 0
$
— - ---� --Balance Due _ a ��_—