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ELECTRICAL PERMIT
CITY OF TIGARl�
COMMUNITY DEVELOPMENT DEPARTMENT DATE. IOSUED: 03/15/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171 PARCEL. ;-::.G I I 0AB -1 0100
SITC ADDRESS. . . 14060 "'JW 11,2TH AV[_ h 1'3
SUBDIVISION. . . .
BLOCK. , ' LOT.
" "
Pi-,oj ect Description:
-- RCSTDENTIAL UI\IIT-,-.-- S'RVC/rrz.EDERS----
1000 9F OR LESS. . . . 0 0 2QA0' amp. . . . . . . : Q, PUMP/IRRIGATION. . . . : 0
EACH ADD' L '300SF. 0 2.01 400 amp. . . . . . . : - Qj SIGN/011T LINE LTG. . : 0
LIMITED ENERGY. . . . . 0 401 GOO amp. . . . . . . : 0 SIGNAL/PANEI.. . . . . . . 0
MANE. HM/ SVC/FDR -, 0 C-014-amps -10010 Volts. 0 MINOR LABEL ( 10) . . . 12)
--SERV ICE/'FEEDER-- -,----BRANCH CIRCUITc,.,-------- INSPECTIONS-
0 200 amp. . . . . . : 0 W/GERVICE OR FEEDCR. 0 PER INGPECTION. . . . . . 0
201 40,41 amp. . . . . . : 0 lot W/O SRVC OR FDR. : 0 PER 14OUR. . . . . . . . . . . : 0
401 600 amp— . . . . - 0 EA (4DD' L nRl',1CH 0 IN 1",LnNT. . . . . . . . . . . : 0
61.11 1000 amp). . . " . . la ---P.'LnN REVIEW SECT
100121+ amp/volt. . . . . : 0 ) =4 PES LJNIT73. . . . . . . . . ) 600 VOLT NOMINAL.
ReCC)nneCt Only— — : 1 SVC/FDR >= 225 AMPS. . : CLPSG AREA/SPEC OCC. :
Owner-: rEES
JOHN RICHES type amount by date V-ecpt
48(, NOVEhl)EN CT _Sc PPMT $ 50. 00 CJ5 03/15/)6 96-70032
5PCT $ 2. 50 CJS 03/15/96 96-71211215,
CALEM OR 97302
Phone #: 503-362-5475
Cont-t-actor'.
OWNER 5*L-;.'. 50 T0TnL
REQUIRED INSPECTIONS
Elect, I 5e)-Vice
Phrinp it. Elect' I Final
Reg #. . .
This aermit is issued subJect to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all cther F'e_;7W _ —
i_tt e—PS' i gnat
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is net started
within 180 days of issuance, or if work is suspended for morf
than 130 days. Iss'.lvd By
INSTni-LATION ONLY --,,-
The installation is being made on p,,-opev,ty I own which is not intended for
sale, lease, or- r-ent .
OWNERIG SIGNATURE: DOTF ,.
INSTALLATION
SIGNATURE Or- SUPIR. ELECIN. DATE:
t_17
NO: .......—-----
Call far- inspection - 639--4175
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: 1.4�
Date: 3 " Eg(- A.M. P.M. Entry:
Address: 144 6 0 - S kj I -)� " Z 3 --
Terant: Ste:^— MST:
H' 6LODvo f A-p7s�_ BLIP:
Cor/Own. MEC:
l0 2U - 2 S C g��p_I-_1'?
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector Date:
APPROVED —DISAPPROVED/CALL FOA REINSP. CF CO
Community Development ELECTRICAL_ PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued 5- /S - 196'
Phone (503) 639-4171
CITY OF TIGARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
/
Name of Development �� L � `loI�I Number of Inspections per permit allowed
Address 1 tioLO O t 1,-'�- XJC -h;,23 Service included. Items Cost(ea) Sum
City/State/Zip 4a. Residential -per unit
1 - r 1000 sq. it or less _ $11000 4
Name (or name of business), Yk�it�1L—�/ T Each additional 500 sq It or
portion-hereof $2500 1
Commercial ❑ Residential Limited Energy $2500
Each Manurd Home or Modular 2
Dwelling Service or Feeder $6800 _
2a. Contractor installation only:
4b. Services or Feeders
Installation,alteration,or relucatlon
Electrical Contractor__ _ 200 amps or legs $60 00 2
Address 201 amps to 400 amps $80.00 2
City_______ State Zip___ 401 amps to 600 amps $12000
-- -- — 601 amps to 1000 amps $18000 2
Phone No. ___ Over 1000 amps or volts / $340.00 2
Job NO. Rernnnectonly ,L7 $5000 2
contractor's license NO. - — 4c. Temporary Services or Feeders
Contractor's Board Reg. No_ _ Installation,altera•lon,or ielocation 2
Signature of Supr. Elec'n 200 amps or legs
201 snips to 400 amps $5000
2
License No. _ Phone No. 401 amps to 600 amps — $7500 2
Over 600 amps to 1000 volts $10000
2b. For owner installations: see"b"above
\- r IZIG "S 4d. Branch Circuits
Print Owner's Name . 4114 Kr New,alteration or extension per pane
Address=l� �; i 1 c s)The fee for branch circuits with
City � 1.f _ $fate i Zip—!21 l _ purchase of service or feeder fee.
— Y` f —_ p_ Each branch circuit 35 0o
Phone No.,- Z �� y�.�_ h)The fee for branch circuits wrthouf
2
The installation is being made on property I own which is purchase of service or feeder fee.
2
First branch circuit __ $3500
not intended for sale, lease Or rent. Each additional branch rlrcuit $500
Owner's Signature _ __. 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or Irrigation circle $4000
Each signor outline lighting $4000
Signal rircult(s)or a limited energy 1
Please check appropriate item and enter fee In section 5B. panel,alteration or extension _Y 34000
4 or more residential units in one structure Mlnor Labels(10) $10000
_Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.0 Chapter 5 Per Inspection $3500
P Per hour $5500
In Plant $5500 _
Submit 2 sets of plans with application where any of thH above
apply. Not required for temporary construction services 5. Fees:
5a. Enter total of above fees $
NOTICE 5% Surcharge (05 X total fees) $
g
tal
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter Subto(al of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec 3)
CONSTRUCTION OR WORK IS SUSPENDEDE
OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED wxAcnm4.N•.• ❑ Trust Account #
prm.nn
Balance Due $ a