14100 14110 14118 14820 14200 14202 14410 SW 112TH AVENUE ADDRESS:
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CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMTT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #: EL_C96-0645
DATE. ISSUED: tO/14/96
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PARCEL: E5110AS-00400
`-)ITE ADDRESS. . . 14100 SW II"DTH AVE '
S11BI.)I V I S I Ohl. . . . : CANTERBURY PI_HCfr. ZONING: R_.12
BLOCK. . . . . . . . . . . LO•.. . . . . . . . . . . : 1--5
r-'tojE _t Description : Installinq' t 200 amp service' or- feEa,der •a'nd 1 branch circ'-tit
at PGE POLE #20.7-9, NEAREST 1.4100 SW 112TH (CANTERBURY So FRONTAGE RD)
---REST.DENTIAL. UNIT------ ---TEMI=' SRVC/FEEDERS•_...__......_. - -----.ihISCI�I_L_AIUEOL.IS-- --
t OOO SF OR LESS. . . . : 0 0 -- ''00 amp. . . . . . . : 0 PUMP/I RR I GAT I ON. . . . : 0
EACH ADD' I_ 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTC. . : 0
LIMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : 0 SIGNAL/PANEL... . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 Fj01+amps --lV11Z10 volts. : 0 MINOR LABEL ( 10) . . . : 171
-._.-.-_SERV I CE/F'EEDE R---- ---E►RWIUCI CIRCUITS---,--- -----ADD' L. INSPECTIONS.........
0 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 1 PER INSPECTION. . . . . : 0
.='01 - 400 :amp. . . . . . . 0 1st W/0 SRVC OR FDR. . 0 PER HOUR. . . . . . . . . . . . 0
401 - 600 amp,. . . . . . : 0 EA ADD' I_ BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
GO! - 1000 amp. . . . . : 0 ___.---_____._-.- _---FLAN REVIEW SF_CTION__.________-----.-__-.__
1.000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
'?econnect only. . . . . : 0 SVC/FDR >= 225 AMPS. . : CLASS AREA/EPEC OCC. :
FEES .___...--•-------_________.
TCI CABLE type amo'.tnt by date recpt
PRMT $ 65. 00 JMH 10/ 1 4/96 96-J:'8:1102
5PCT $ 3. c5 JhIH 10/14/96 96-28510c,
Phone #:
Contractor-: __ ___..---.-____----_.__. .__..__-_________-____.._._...____.--•---__..______.______ _.__....____---...._....._.
ONDERSONS I NTEGR T T Y ELECTRIC t 68. r_'5 TOTAL
1301 A SW LAURMONT DR
-- - -_-- REDU T RED I N SPECT I ONS --- - --
TIGARD OR 97223 Under,qr-o'.ind Cove Elect' 1 Final
Phone #: 503-524--6017 Elect;' I c v ' ca
Req #. . : 91410
This persit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee
applicable laws. All work will be dune in accordance with
approved plans. This !persit will expire if work is not started I ' ,,. j ��
within 190 days of issuance, at, if work is suspended for sore W�-
than 160 days. I s'.Ied By
INSTAL_LA'TTOhd
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: e DATE: _
INSTALLATION
I GNATURE OFF SUPR. El_EC' N: DATE e _
LICENSE NO:
Call for inspection -- 6.39-4175
C!TY 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.
PIbg.Und/Flr/Slab Plbg. Top Out Insulation Elect.
Post/Beam Stiuct. Mech. Rough-in Gyp. Bd. -Bldg.
Sari. Sewer Gas Line Appr/Sdwlly,,d R S.
Other:
Date: �O " /to `Z G A.M. —P.M. Entry: ---
Address: Lq/00 sw 4j1►f w //it —---- -
Tenant: L I C#4 e Ste: MST:
BLIP —-_,-_--
Con/Own:-T // rf.[/J��'� MEC:
THE FOLLOWING CORRECTION', ^RE REQUIRED ELR:
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Inspector: u� __- Date: 7=
_APPROVED ___DISAPPROVED/CALL FOR REINSP. CF CO
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OF 1 ltjf ktl _. PVt M"T OF PAYMENI RELL1111 NO.
NAME a I-CI CABLE' CASH AMUUN I'
AI?111REf�lti : Fifa I D BY e ANDERE(JN' :-) IN1'E.(44I 1 Y PAYMIEN1 DDI E.
FLECTIC:, INC:. IlUBDIVi~.3IUy e
I tll*K, !:,W PAC: HWY #D, 1 WIL.H 1 IN y i06P---
PURPUSFw UF PAYMENT HMUUN I VIA f U PURPUSh LIF PAYMr14 I AMS ON F I,f'I t D
wLii' R L 00 NUILD PER 3. .`':'�
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Community Developme:.t ELECTRICAL PERMIT APPLICATION
13125 SW Flail Blvd.
Tigard, OR 9722:: Planck/Rec. # r(1- 1 -Z
Permit # C `4
Phone (503) 639-4171 Date Issued ► r - (�
CITY OF TIGARD FAX (503) 684-7297 Issued by __ r
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: f rj I 4d ,,� 4. Complete Fee Schedule Below:
Name of Development 71U Number of Inspections per permit allowed
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Ad -dressr— j !1A Q �w 117:11- V-rr '( Service included. Items Cost(ea) Sum
City/State/Zio_T_oL 4a. Residential- per unit 4
1000" It or lom $11000
Each additional
Name or name of business) portion thereof
sq It or $2500 _ 1
Commercial PR Residential ❑ LimitEach Energy — 52500
Each Menut'd Homo or Modular 2
Dwelling Service or Feeder 568 00
2a. Contractor installation only: 4b.Services or Feeders
Installation alteration,or relocation d'O 2
Electrical Contractor200 amps or let's �— $6000 b b 2
IQ Q
Address I f-1 �_ �2/ 201 amps to 400 amps $8000 2
t ?Q 6 401 amps to 600 amps $12000 2
CI U 4 Q (�c State Q Zip 9 601 amps to 1000 amps $18000 2
Phone No. �L- _ Over 1000 amps or volts $34000 _ 2
Contractor's License No. y - 3 C,3 L Reconnect only $FO no _
Contractor's Board Reg No.___ 9�1 4c. Temporary Services or Feeders
relallation,alteration or rely alv , 2
Signature of Su r. Elec'ri )(�. � 200 amps or less _ $50 00
License No. 377C)5 �� hone No. y (,y, 201 amps to 400 ampsrrIA $000
S Y.- 401 amps to 600 amps _ $too 00
Liver 600 Amps to 1000 volts
2b. For owner installations: see W above
4d. Branch Circuits
Print Owner's Name _ New,Alteration or extension per panel
Address a)The lee for branch circuits with
purchase of servlet or feeder aWx!rZ)
City State zip.--- Each branch circuit .� $5 00
Phone No. b)The lee for branch circuits without
The installation is being made on property I own which is purchase of service or Waller fee, r
First french circuit
not intended for sale, lease or rent. Filbra500
$ _
Each Adrttl�orwl branch arcual 55 00
Owner's Signature _ _ 4e. Ulliscelloneous
(Service or feeder not included)
3. Plan Review section (it required): Each pump or irrigation circle $4000 _
Fach sign or outline lighting _ A $4000
Signal cimuil(s)or a limdPd energy '
Please check appropriate item and enter fee In section 5B. panel alleration or oxtens-on $4000
4 or more residential units in onto structure Minor I absls(10) $10000
y Service and feeder 225 amps or more
r System over 600 volts nominal 41. Each additional inspection ova
Classified area or structure containing special occupancy the allowable In any of the above
>- as described in N E C Chapter 5 Per inspection $35 00
Per hour $55 00 _
In Plant $55 00 _^
Submit 2 sets of plane with application where any of the above
apply. Not required for temporary construction services. $. Fees:
/ ate
5a. Enter total of above fees $ S
1' NOTICE
51%Surcharge(05 X total fees) $ _
PEHPAITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR PI3n Review if required(Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal g
COMMENCED ❑ Trust Account# $
Balance Due $ —�
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