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9600 SW OAK ST STE 300
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CAL
C17Y OF TIGARD PERMITI#: ELC96-0497
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/29/96
13125 SW Hall Blvd.Tigard,9rogcn 97223*8199 (503)539.4171
PARCEL: 1S135BD-02100
SITE ADDRESS. . . : 09600 SW OAK ST #300
SUBDIVISION. . . . L ASHBROOK FARM ZONING:C--F',
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5
Project Descriptiun: Installing five branch circuits;.
-------------------------------------------------------------------
---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- -----MISCELLANF_OUS------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 40(A amp. . . . . . . : 0 SIGN/OUT LINE L.T,j. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FUR. . : 0 601+amps-.1000 volts. : 0 MINOR LAPEL ( 10) . . . : 0
-----SERVICE/FEEDER--- ----BRANCH CIRCUITS----- ----ADD' L INSPIEC'1'IC1NS- --
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPE:CTION. . . . . : 0
201 - 400 camp. . . . . . : 0 1st W/O SRVC OR P'DR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - C-00 amp. . . . . . e 0 EA ADA' L BRh:L-"H CIRC: 4 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : o -------------------PLAN REVIEW SECTION-----------
1000+ amp/volt. . . . . : 0 1=4 RES UNITS. . . . . . . . ,, > 600 VOLT NOMINAL— :
R-►connect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ----------------------------------------------------- FEES -----------------
LANDMARK type amount by date recpt
9600 SW OAK ST PRMT $ 55. 001 CJS 07/29/96 96-282265
SUITE_- #300 5PCT 6 2. 75 CJS t07/29/9G 96-282265
TIGARD OR 97223
Phone #:
Contractor: -------------------.___--__-_-_--__---__-_----__---_--_-_-,__-_-.-.----__.-.__.. .
AMP ELECTRIC :7. 73 TOTAL
94010 NE 4TH PLAIN RD
REQUIRED INSPECTIONS --- - - - -
VANCOUVER WA 91,,662 Wall Cover FIect' 1. Final.
Phone #: 222--164;7 Elect' 1 Service
Rey #. . : 76152
(his peroit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'erm i tt ee Signature
Applicable laws. All Mork will be done in accordance with
approved plans. This perait will expire if work is not started
within 1U days of issuance, or if work is suspended for more f-
than 190 days. I s s t.ted B-
IL INSTALLATION ONLY--------_._.___
The installation is being made on property I own which is not intended for
F- gale, lease, or, rent.
N OWNER' S SIGNATURE: DATE:
INSTALLATION
co
WSIGNATURE OF SUPR. EL_EC' N: ��1p�-,�/ � � DATE: r W�
t_.TCENSE NO:
Call for inspection - 639--4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # Sra 901-197 _
Date Issued
Phone (503) 6394171
CITY OF TIOARa FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 63941,75
1. Job Address: 4. Complete Fees Schedule Below:
Name of Development_ S/ Number of Inspections per permit at'mved
Address._✓ � 'T " 1,Q< .S//71 Service included Items Cost(es) Sum
City/State/Zip_ / l�_ 4a. Residential -per unit
1000 Sqft. or Mss 11110.00 _ 4
t
Name (or name of business) _ Each a thereof f sq n a $25 00
7ottbn hsr1
Commercial Residential ❑ L'.m#odEnergy _^ $2500 - �Each!Arnurd Nome or Modular 2
Dwelling Service or Fe"ei $88.00
2a. Contractor installation only:
4b. Services or Fsedertr
Installation,afteretion,or reiocalkm
Electrical Contractor��� 4 t�c_Tilt u 200 env or leas Woo — 2
Address ��_/v�• �,�Z A+0_S� 201 amps to 100 amps _ 000 2
101 amps to e0o sKnWo 0pa .---.--- 2
Ciilr+,/Q_ State_, Zip ¢!' 801 amps to 1000 anrps $190 00 2
Phone No.2Z'Z �a S/ Over!ono amps at v0% -- S310 00 2
Job NO._,r�j7U Re:,onnedonly $50.00 — 2
contractor's license NO. %JO/ — 4c. Temporary Services or Feoders
Contractor's Board Reg. No. �� � installation,alteration,or relocation
Signature of u r. Elec' _h- 200 amps or Mea -- --
201 amps to 400 amps 1150 on 2
License No.fgftf Phone 401 amps to 800 amps �_. $7500 --- 2
Over 800 emps to low wows 1100.00
2b. For owner installations: '°a"b"aboVe
4d. Branch Circuits
Print Owner's Nnme New,sMer W or extension ps,parts
P�dr9S3 a)The fee for branch circuits lafMr I
-- purchase of service or feeds►M.
City State Zip Eech branch circuit __ $5.00
Phone No. _ __ b)The fee for branch ckrunn refNrorrr
The installation is being made on property I own which is purehese of service or hele
er fae. 2
First branch clrcutt $ 5.00 s 2
not intended for sale, lease or rent. Each additional branch circuit $500 '
Owner's Signature_ __._ 4e. Miscellaneous 2
(Service or feeder not included)
Each purnp or irrigation c" $40.00 2
3. Plan Review section (if re,yuired): Each sign or outlkts righting —� $4000 _
Signal chrult(s)or a Iknlled energy 2
d. Please check appropriate Item and enter fee in section 58. panel,alteration or axtenslon $40.00
4 or more residential units In one structure Mawr Labels(10) _! $100.00
I7•- Service and feeder 225 amps or more
� 411.Each additional Inspection scar
—�System over 800 volts nominal the allowable In any of the above
Classified area or structure containing special occupancy Per h ipsdion $35.00
_ as described in N E C Chapter 5 Per hnw -- $55.00
m In Plant $55.00 a
(a Submit 2 sets of plans with application where nny of the above
W apply. Not required for temporary construction services. .5, Fees:
NOTICE So. Enter total of Pbove fees 5 ��
5%Surc4arge (.05 X total fees)
Subtotal =
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 8b. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review If req 'red (Sec.3) $
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal s
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. ❑ Trust Account
�m
$ —
Balance Due $ r7 S