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~� ELFCl RICAI_. PERMIT
•
01T)f CSF TIGARD DATEIISSUED: 12/08/95 �.
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL! 171��IrIrl�x x- �rI�Ir171v1
13125 SW Hell BlvdS1,11. I .Tigard,Oregon 07223.6149 (503)639-4171
SUBDIVISION. . . . : ZONING: ?
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . .
P-o.ject Descriptions Installing first branch circuit and 1 add' 1 branch circoii.
----RESIDENTIAL UNIT----- ---TEMP 'SRVC/FE:E:DERS---- -- -----MISCELLANEOUS——
1000 SF OR LESS. . . .- : 0 0 ••- 200 amp. . . . . . . , Ir PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 — 400 amp. . . . . . . ! 1A SIGN/GUT LINE LTU. . : 0
LIMITED ENERGY : 0 401 _ 600 „imp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . •. 0
MANF. HM/ SVC/FUR. . : 0 601+amps-1000 Jolts. : 0 MINOR LABEL. ( illl) . . . 1 0
----SERVICE/FEEDER-•--- - -----.-BRANCH CIRCUITS---...--- (1DIJ' L IN`: 'E:CTIONS--
0 — 200 am0. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. , . . . : 0
201 — 400 ramp. . . . . . : 0 1st W/O SPgC OR FDP. : 1 PER HOUR. . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 ESA ADD' L_ BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION---_-r__.._--_--_._..._.
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only., . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLA S5 OCC.
Owner: ---.--_.__.__________---.___.___ FEES
VEF.00N RE SIDLiyCE type ama1-Ent by date r^ecp'
15380 SW 100TH PRMT 40. 00 N 12/08/95 95--.2736E _'`
5P(-_T 2. 00 B 1.2/08/95 95--x'-7369':
TIGAR', OR 97224-0000
Phone #t
Contrar.t or: .--------_.______._----___.—_.__—..--__.--.___---__.____._-_--____-_---____—__--.—___-
PHOEN I x ELECTRIC CO $ 42. OIA Tn' AL.
PO B6 ' 1432
-------- RLGU I RED INSPECTIONS ---------
TUALOTIN OR 97062 Ceiling Cover- Elect' 1 S?rvi(_e
Phone t#: Wall Cover Elect' l Final
Reg #. . ,
This perrii 1s issued subject to the regulations cnntaine:i in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other m i t t ee S ' nat ur, _
applicable laws. All work will be done in accordance with
approved plans. This permit will Mire if work is not started
within 16@ days of issuance, or if work is suspended for more
than 180 days. Issued By
.__..OWNER INSTALLATION ONLY._..____..__.__..
T'he installation is being made on property I own whict-i is not intended for-
s A I e.
orsale, lease, (3r rant.
OWN''RI q S'l UNAI URE e _._.._...... DATE c
INSTAL_LATIOIV
SIGNATURE: OF SUPR. ELEC' N: DATEt
11CENSE NO:
Call for inspection --• 639-4175
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone- 6 - 1 1
Inspection: b,
Footing Susp. Ceiling Sptink. Rough-in ApFr/Sdwlk
Foundation ("')q• Underslab Mech. Rough•in Fireplace
Post/[seam Struct. Plbg. .op Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line Cys
Plbg. Underfl-)or Rain Drain Framing -Plumb.
Alarm Water Line Insulationech
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Underflr. Insul. Shear Wall Gyp. Bd. x%
Date Requestcd:__ 2, L�y _Time:__,_AM PM
Address:_ _ �S C) C)
Builder: C
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a c�S c+✓ Permit #iy`Ej
THE
(0L.-OWING CORRECTIONS ARE REQUIRED:
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_A'PROVEI) __DISAPPROVED _APPROVED SUBJECT TO ABOVE
_ Call For Reinsp.
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 97223 Perroit t
Date Issued
Phone (503) 639-4171
CITY OF TIGrARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: l M 4. Complete Fee Schedule Below:
Name of Devraopment `% ` J Number of inspections per permit allowed
Address15 i�-�1 �` Service included: Items Cost(ea) Sum
City/State/Zip 4a. Residential -per unit
`J 1000 sq. ft. or less $11000 1
Name (or name of business)__________ 5dch additional 500 sI ft or
hportion thereof $25 00
Commercial i Residential 1_ Limned Energy $21,00
J Each Manurd Home or Modular
Dwelling Service or Feeder $66.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor r,-c na alteration,or relocation
200
_. 200 amps or lase $6000 2
Address i r 201 amps to 4u3 amps $8000 2
City_ S ate_py,__. Zip jZQ3 401 amps to 600 amps $12000 _ 2
— 60 amps to 1000 amps $160.00
Phone — _. Over 1000 amps or volts $34000 2
_
Job NO. Reconnect only $50.00
contractor's license NO_ — Reconnect
4c. Temporary Services or Feeders
Contractor's Board Reg. No. 'n2—;l1 _ Installation,anerelion,or relocation
Signature of SUDr. Elec'n_ — 200 amr or less __ 2
License No. f *-jj- 201 en,;,s 10 400 amps $5000 __ 2
��/7 �1 P N 1. 401 amps b 600 amps $75.00 2
Over 600 Limps to 1000 volts $100.00 ------
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name New,nneratlon or extension per pane
Address a)The fee for branch rrcuits with
City State ,zip_ — oru:hese of service or feeder fee.
Each branch circus _____ $5.00
Phone No. _ b)The fee'or branch circuits wlrhour _
The installation is being made on property I own which is I purchase i of circuit or leader lee / 2
not intended for sale, lease or rent. East bra uh gal br +/j` $�5 00
Each ardltlonel branch circus $5.00
Owner's Signature tie. Miscellaneous
(Service or feeder not included) z
3. Plan Review section (if required): Each pump or Irrigation circle $4000 _
Each sign or outline righting $4000
- - o
Signal circulus)or a limited energy
—I'iease check appropriate Item and enter fee in section 6B. panel,alteration or exten>•lon $4000
4 or more residential units in one structure AAlncr 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 Olowable In any of the above
as described in N.E.C. Chapter 5 Per inspection i_ $:t5 00 _
. her hour $55 00
r In Plant $55 00 — —^
Submit 2 sets of plans with application where any of the above — —
' apply. Not required for temporary construc.lon services. 5. Fees: �c
5a. Enter total of above fees $
NOTICE 5% Surcharge (05 X total fees) $ — 1
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ r
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account#
mm wit
Balance Due �`