7204 SW DURHAM ROAD STE Q-200 O
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CITYO F •r I GAR D _ ELECTRICAL PERMIT
DEVELOPMENT SERVICES DATEEIS ISSUED: 11/01/1999 0653
13125 SW Had Blvd., Tiqard, OR 97223 (503) 639-4171
SITE ADDRESS: 07204 SW DURHAM RD Q2.00 PARCEL: 2S 113AC-00103
SUBVIVISION: PA:;TRUST ZONING: I-P
BLOCK: LOT . JURISDICTION: TIG
Proiect Description: Install 16 branch circuits in existing commercial building.
_RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1U00
1000 SF OR LESS: i 0 200 amp: PUMP/IRRIGATION:^EACH ADD'!_ 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANE HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER 'YL _BRANCH CIRCUITS�— _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 6U0 amp: EA ADD'L BRNCH CIRC: 15 ,N PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS:--'— T > 600 VOLT_NOMINAL: "
Reconnect only: ,_ SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: J
Owner: Contractor:
PACIFIC REALTY STONER ELECTRIC
15350 SW SEQUOIA PKVVY #300 2701 SE 14TH
PORTLAND, OR 97224 PORTLAND, OR 97202
Phone: Phone: 233-3631 GINA1.
Reg #: LIC 00044822,
SUP 4025SORI
ELE 26-12.20
_ Required Inspections _ _
Type By Date Amount Receipt -:lect'I Service
FRMT K.IP 11/01/1999 $117.75 99-319460 Eln;;!'I Final
5PCT KJP 11/0111999 $9 47 99-319460
Total $127.17
This Permit is issued subject to the regulations contained in the Tigard Municipal Code State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work is rot started within 180 days of issuance,or d work is
suspended for mure than 180 days ATTENTIC:1 Oregoc law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordire I questions to OHNC at(503)
246-1987
PERMITTEE'S SIGNATUREISSUED BY: / !?
_ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended fcr safe, lease, or rent. ^
OWNER'S SIGNATURE: f
------ -- _ � DATE:-- - -
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. EL.EC'N: (J-y1- CV- kA- DATE' A b�
!_!CENSE NO:
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Call 639-4175 by 7:00pm for an inspection the next business day
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CITY OF TIGARD Plan Check
13125 SW HALL BLVD.RECE,v�� Electrical Permit Application Recd By
TIGARD OR 97223 �ggg Date Rec'd
Phc ie(503)639-4171, x30,00 R Date to')E.
N} Date to DST
Ins,)oction (5+03)C39-4175�M�%IV DE���(�PME Print of Type Permit#Et-c /119
Fax(503) 598-1960 Incomplete or illegib!,will not be accepted Caned
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development, Number of Inspections per permit allowed
Name(of name of business) Service included: Items Cost Sum
Address !/ �+>• '�c'f/ �J�Q 4a. Residential-per unit
City/State/Zip Com' t�J? (A 1000 sq.R.or less $ 117.75 4
0 ^e*t�h additional 500 sq ft or
[[7711 rf��11 , 4 9 portion thereof $ 26.25 _ 1
Commercial !S! ResidentialEl Limited Energy $ 60.00
Each Manuf d Home or Modular
2a. Contractor Installation only: Dwelling Service or Feeder $ 71.75 `^ 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data base). Installation,alteration,or relocation
Electrical Contractor Ne:�' : K 200 amps or less _ $ 64.25 2
Address ZZc"yl sc_ 201 amps to 400 amps $ 85.50 2
401 amps ti.600 amps $ 128.50 2
City State _Zip �7ZfJ� 601 amps to 1000 amps $ 1192.50 _ 2
Phone No. Over 1000 ampr,or volts $ 363.75 2
Job No. 3 Reconnect only ___ $ 5350 2
Elec.Cont. Lice. No. Z&—(Z 2 Exp.Date 4c.Temporary Services or Feeders
OR State CCB Reg. No. 44 8'Z-- _Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro W4WjY& Exp.Date 200 amps or less $ 53 50 _ _ 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n J 401 amps to 600 amps $ 10700 ^_ z
Over 600 amps to 1000 volts,
License No. _ p.Date /C see"b"above.
Phone No �y 2,3�- :3E'3( ad.Branch Circuits
- — ----- New alteratioi�it extension per panel
a i The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit _ $ 5.35 7
b)The fee for branch circuits !
Address _ without purchase of service I
City`. — _State %ip _ or feeder fee.
Phone No.. First branch circuit $ 37.50
Each additional branch circuit $ 1,35
-
The installation is being made on property I own which is not 4e.Mlsenllaneous
intended for sale, lease or rent. (Service or feeder not Included)
Each pump or irrigation circle $ 42 7E _
Owner's Signature �Y Each sign or outline lighting V_ $ 42 75 —� -
Signal circult(s)or a limited energy
3. Plan Review section (if required):* Mipanel.nor labeelslsalte(100) or extension — $ 60 00
( $ 10700
Please check appropriate Item and enter fee In section 58. 4f.Each additional Inspection over
4 or more residential units In one structure the allowable in any of the above
- `Se vice and feeder 225 amps or more Per inspection _ _ $ 5000
—
-- — Per hour $ 5000
Sy tem over 600 volts nominal in Plant $ 5900
Cl ssified area or structure containing special occupancy as
de.cribed in N E C Chapter 5 5. Fees:
54.Enter total of above fees 711
" Submit 2 sets of plans with application where any of the above epply. 84 Surcharge((VX total fees) $ L
Not required for temporary construction services. Subtotal $
5b.Enter 25%of line 6a for
NOTICE Plan Review if required(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHOR!?ED Subtotal S /
IS NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR nn
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS LJ Trust Account#_
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $12-7.17
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