15910 SW 81ST AVENUE 15910 SW 81st Ct . C
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97- 0409
1315 SW Hall Blvd., Tigard,OR 9723 j503)639.4171 DATE ISSUED: 06/2:5/97
PARCEL. E'S 1. 12CC-05700
3 I TF (ADDRESS. . . : 1.5910 SW f31 ST CT
SUBDIVISION. . . . :BOND PARK NO, 4 ZONING: P-12
BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . :85 JURISDICTION: TIG
Pr-oJect Description :
-- -RF'SIDENTIAL_ LINIT•----- ---TEMP SRVC/FEEDERS----- ------MISCF_I-I-ANEOLIS------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . 0
EACH ADD' I._ 5O0SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERSY. . . . . : 0 401. - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 vorts. : 0 MINOR I-..ABEI._ ( 10) . . . : 0
_.---SERVICE/FEEDER-- --- - -- BRANCH C:IRCUITS--_...-.._-.-. ----ADD' L INSPECTIONS-
0c.
- 00 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSP'ECT'ION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER FLOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -_____________---_•-P'L..AN REVIEW SECTION---------------
1000+ amp/volt . . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL_. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPEC OCC. :
Owne r-: _.. ....-- -- _ ------------------------------------ -- FEEc; _ ------ ---___
ED VICKERY type amount by date recpt
15910 SW 81!:11 PRMT $ 35. 00 JSD O6/25/97 97-296.3;9_;1
TIGARD OR 00 SPCT $ 1. 75 JSD 06/25/97 97-296393
Phone #:
-.;ontr-actor: -------------------•---•-------•---------------.------------•-------•------
CHARP'E ELECTRIC INC $ 36. 75 TOTAL
22605 SW R I GGS
REQUIRED INSPECTIONS
- - -
BEAVERTON OR 97007 Rol.igh--in
Phone #: 642-7937 Hlect' l Final
Reg #. . : 000815
This permit is issued subject to the regulations contained in the Tigard Municipal Code;. State of Dregon Specialty Codes and all other
applicable laws. All North will be done in accordance with approved pla-is. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. A77tNTION; Oregon law requires you to follow the rules adopted by
the Oreyon Utility Notification Centpr.,--,Thosy rules are set forth in DAR 952-01!-8018 through OAR 952-M1-1987. You may obtain a cope
of these rules or direct questions t calling (583) -1987.
nr^mittee Si gnat o.lre : _ i!51..lpLi B
y
---------------------------------OWNER I NSTALLAT I CIN C)NL..Y--_-.__---_-----------------_
The installation is being made an property I own which is not intended fol.,
sale, lease, or• rent.
OWNER' S SIGNATURE: --- _ _-�- V—_-� DATE:
INSTALLATION OML_Y ----_-_- -------- ----_ --
S T GNATURE OF SUPR. ELEC' N s DATE: __..
i1CENSE NO:
14 +++++++++4++++++++++++++++++++++++++++++++++++++++++++++++++•r++++++•++++++++++
Call 639-4175 by 6:00 p. m. for- an inspection needed the ne>(t bmsiness day
/ 1-+++++++++++++F+-++-F ++++++f+-f•+++++++•++++++++++++++++++++•i+++tt++++++++i++t+++++
I
CITY OF TIGARD Electrical Permit Application Plan Check#_
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503)639-4171, x304
Inspection (503 639-4175 Print or Type Date to DST
Ins
P ) Permit# 1-Z C
Fax (503)684-7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Number of Inspections per permit allowed -
Name(or name of business) _ `I Service Included: Items Cost Sum
Address 1 �. 9 w 4a. Residential-per unit
1010 sq.ft.or less $110.00 _ 4
City/State/Zip [ach additional 500 sq.ft.or
Commercial ❑ Residential portion thereof $25.00 1
%/� � Limited Energy � $25.00
/J`t, � Each Manuf d Homo or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of ajl qurrent Ilcens 4b.Services or FeodArs
Electrical Contr ctor v "la✓` --. C4 _ 1 I- Installation,alteration,or relocation
Addre&s c 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $12C oe 2
Phone No. - _ 601 amps to 1000 amps A $180.CO _ 2
Job N0. Over 1000 amps or volts V_ $:140 00 2
Elec.Cont. Lice. No. Exp,Date Reconnect only $5000 2-
OR State CCB Reg. No. ` EXP Da 4c.Temporary Services or Feeders
COT Business Tax or Metr ` _Exp.Date Installation,alteration,or relocation
200 amps or less 2
Signature 0}Supr. Elec^ly / 201 amps l0 400 amps $75.00 2
401 amps to 600 amps $100.00 2
-� -� // 11 r Over 600 amps to 1000 volts,
License No. `1 Exp.Date (j�� " see"b"above.
Phone No. A -- - 4d.Branch circuits
Now,alteration or extension pe-panel
2b. For owner Installations: ;a) The fee for branch circuits with
purchase of service or
Print Owner's Namefeeder lee.
Address _ Each branch circuit $5.00 2
-- h)The fee for hranch circuits
City _ States_ Zip without purchase of
Phone No. service or feeder fee. Z r'
First branch circuit $35.00 �,, C1 2
The installation is being made on property I own which Is not Each additional branch circuit 4- $5.00 2
intended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not Included)
Owner's Signature___ _ Each pump or Irrigation circle $40 00 - 2
Each sign or outline lighting $4000 -_ 2
3. Plan Review section (if required):* Signal circult(s)or a limited energy
panel,alteration or extension $40.00 - 2
Please check appropriate Item and enter fee in section 5B. Minor Labels(10) $1 no 00
4 or more residential units in one structure 41.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 _ $55.00
as described in N E.C.Chapter 5 In Plant $55.00
Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. So.Enter total of above fees $
5010 Surcharge(.05 X total fees) $
NOTICL Subtotal $
5b.Enter 2590 of line Be for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review 11 reguir (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK Subtotal $ ----
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account M_ s r
Total balance Due