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CITY OF TELECTRICAL_ PERMIT
DEVEL.O►PMEN'T SERVICES PERMIT #: EL.C97--0774
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 11/21/97
PARCEL: c:S 1 13AD-01 a JO
SITE ADD-ESS. . . : 16716 SW `71=ND AVE #B-16
SUBDIVISION. . . . : ROSEWOOD ACRE TRACTS `LONING: I--L_
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :011 JURISDICTION. TIG
Prc,.jec_t Description : Installation of one service or feeder at 200 amps or less.
--- RESIDEIVTTAL UNIT---- -_- fF_MF' SRVC/FEEDERS---_ __.___IhISCEI_LANEOUS-----
1000 SF OR I-ESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRTGATION. . . . : 0
EACH ADD' 1_ 5009F. . . : 0 :::01. - 400 amp . . . . . . . : 0 SIGN/OUT LINE LTG. . : 17f
LIMITED ENERGY. . . . . : Cl 401 - 600 amp. . . . . . . : 0 SIGNAL/PA:1=L.. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
-----SERVICE/FEEDER---- --- -PRfIIVCfI CIRCUITS-------- ----ADDI L IN3PECTIONS---
0 - 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
20! - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 -- 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PI...ANT. . . . . . . . . . . : 0
E.,01 - 1000 amp. . . . . : 0 - --- -- - ... _ _- - --p'LAN REV SECTION-----------------
1000+ amp/vul.t. . . . . : 0 > -4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner,: -- ---- ---.____._..___._._.._________________._________________ FEES
PACTRUST type amol_int by date recpt
1.6716 SW 7'c-:'.ND PRMT $ 60. 00 TJH It/21/97 97-1301 134
T IGARD OR (37E03 5PCT $ 3. 00 TJH 11/21/97 97--301 134
Phone #:
Contractor: - ------------------ -- ------------------------------ -----------------
BACHOFNER ELECTRIC INC $ 63. 00 TOTAL
55 E-. MAIN
- --- --- REQUIRED INSPECTIONS
- -
PORTLAND OR 97214 Ceiling Cover Elect' 1 Ser^vice
Phone #: 233-2006 Wall Cover- Elect' l Final
Reg #. . : 000445
?his permit 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 he done in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Thoie rules are set forth in OAR 952-NN1-N010 through OAR 952401-1987. You may obtain a copy
of these rules or direct questions to OX by calling (503)246-1987.
n Perm i t t e e Si gnat 1_t r•e : ;f'i't �� 1_f �K4 s s 1_I e d B y : .----
7
INSTALLATION
F-
The installation is being made on property I own which is not intended for
a
W �s. le, lease, or r'pnt.
c�. � OWNER' S SIONATURE: DATE:
—
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- -------------------------CON TRACTOR I NSTALL..AT I ON ONLY-----------------------------
SIGNATURE
----------------------------SIGNATURE OF SLIPR. ELEC' N: DATE.-
I_I CENSE NO: t.))(��, J T�
r+++++++++++4 +++i++++i++++++++++++++++++++++++4h+. ++++++++++++-h+++++++++.1-++++++
Call 639-4175 by 7:00 p. m. for an inspection needed the next bklsinpss day
++++++++4+++++++++++++++++++.4-+++++++++++ r++F+++++++++++++++++++++++++++++++•F+++
CITY OF TIGARD Electrical Permit Application Plan Check N
13125 SW HALL BLVD. Rec'd By T
Date Recd ii I21 `3 r7
TIGARD OR 97223 Date t( P.E. -/'
Phone (503) 639-4171, x304 Date to DST 17_
Print or Type
11-1
Inspection (503) 639-4175 Permit a E L 11,00 `074
Fay (503)684-7297 Incomplete or illegible will not be accepted Called Ay,,C& (-
1. Job Address: , 44.Gom Complete Fee Schedule Below:
Name of Development ( Number of Inspections per permit n'lowed
Name(or name of business)_ YacTrtst _ Service included: Items Cost Sum
Address 16716 SW 72rr7 4a. Residential-per unit
City/State/ZipM 1 CR 1000 sq.It.or less $110.00 _ 4
Each additional 500 sq.ft.or
Commercial 0 Residential ❑ portion thereof $25.00 �_ 1
Limited Energy $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $66.00 _ <
(Attach copy of all current licenses) 4b.Services or Feeders
Installation,alteration,or relocation
Electrical Contractor E;ar>U>�r F lei tric, 200 amps or less 1 $e0 60.00 2
Address 55 ,T:join e .00
01 amps to 400 amps $80.00 2
City Pcirt-1 a'1d State (F lip-97214 401 amps to 600 amps - $120.00 - 2
Phone No. (503) 233-20W 601 amps to 1000 amps $180.00 2
Job No. 6418 Over 1000 amps or volts $310.00 2
Elec. Cont. Lice. No. _2G=4,1C Exp.Date_IWJI Reconnect only $50.00 2
OR State CCB Reg. No._ 44569 Exp.[late 3/6/9$ 4c.Temporary Services or Feeders
COT Business Tax or Metro No. �Exp.Date Installation,alteration,or relocation
200 amps or less $50.00
Signature of Supr. Elec'n ' _ 201 amps to 4U0 amps $75.00 _
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License Nr 28085 Exp.Date 1011 98 _ sea"b"above,
Phone N, (503) 233-2006 -- 4d.Branch Circuits
Now,alteration or extension per panel
2b. Fo:owner iristallations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address -` Eac`:"ranch circuit $5.00
---- b)The fee for u �h lancircuits
City Stat@ Zip without purrhasa of
Phone No. _ service or feeder fee.
First branch circuit $35.00
The installation Is being made on property I own which is not Each additional branch circuit_ $5.00
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not Included)
Owner's Signature Each pump or Irrigation circle $40.00
Each sign or outline lighting $40.00
3. Plan Review section (if required): Signal clteuil(s)or a limited energy
LL panel,alteration or extension $40.00 _
cc Minor Labels(10) $100.00 -
Please check appropriate item and enter fee in section 5B.
Ln 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 $3500
-� Classified area or structure containing special occupancy Per hour $5500
as described in N.E.C.Chapter 5 In Plant $5500
U "Submit 2 sets of plans with appllca,ron where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a.Enter total of above fees $ 60.00
5%Surcharge(.05 X total fees) $ -
NOTICE Subtotal $
5b.Enter 25%of line 5a for
PERMITS BECOME VOID IF WORK CR CONSTRUCTION AUTHORIZED IS Plan ReviewfJ r q it (Sec.3) $
NOT COMMENCED WITHIN 160 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY r-�
TIME AFTER WORK IS COMMENCED. ❑ Trust Account M $ 63.(X)
Total balance Due
I
I%DSTSTLCBB APP Rev WN
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: 12 17- 77 A.M. P.M. _ MST:
Location: P C TA�V S T BUP:
Tenant:' �,� ,� Suite: Bldg: NEC:
Contractor: Phone: PLM:
Owner: _ Phone: r ELC: 17-0 7 7
ELR:
_ Err:
BUILDING BLDG(con's) PLUMBING MECHANICALELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam o ice Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling kam Vain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crowl/Found Dr Beat Pump Low Volt
Approved Approved Approved pproved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved roved Not Approved
FINAL FINAL FINAL FIN FINAL
f�L L NCR s ove riq�vlyn 42 k'/ A 6v
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O Call for ruinspectigA Reinspection fee of S required before next inspection inspection O Unable to inspect
lnspector ale� ;7, T
_ Date: / - / '7_ Page of